Promoting Quality Care for Recently Resettled Populations: Curriculum Development for Internal Medicine Residents

Abstract

Background Residents report they lack preparation for caring for an increasingly diverse US population. In response, a variety of curricula have been developed to integrate cultural competency into medical training programs. To date, none of these curricula has specifically addressed members of recently resettled populations. Methods A preliminary assessment was conducted among internal medicine (IM) residents at 1 program (N = 147). Based on 2 conceptual frameworks and the survey results, a pilot curriculum was developed and integrated into the interns' ambulatory block education within the general IM track (n = 9). It included (1) online information made available to all hospital staff; (2) 4 interactive didactic sessions; and (3) increased exposure to newly arrived patients. The curriculum was qualitatively evaluated through 2 focus groups. Results The preliminary assessment was completed by 101 of 147 residents (69%), with 61% of respondents indicating they felt that they received less than adequate education in this area. Eight of the 9 interns exposed to the new curriculum participated in the focus groups. Overall, respondents reported they thought patient care had improved for recently resettled populations and across their patient panels after exposure to the curriculum. Conclusions This study demonstrated that an intervention that included didactics and enhanced exposure to a diverse population improved IM interns' perceptions of care for all patients, including recently settled individuals.

Cultural Competence in Refugee Service Settings: A Scoping Review

“… 21 , 22 , 29 , 31 , 31 , 33 , 39 , 45 Several cultural competence training programs for medical students, medical residents, social workers, and nursing students working with refugees were described in the literature. 28 , 36 , 45 , 46 These were generally positively evaluated by provider participants; however, only one study sought the perspective of a single refugee participant. 28…”

“…21,22,29,31,31,33,39,45 Several cultural competence training programs for medical students, medical residents, social workers, and nursing students working with refugees were described in the literature. 28,36,45,46 These were generally positively evaluated by provider participants; however, only one study sought the perspective of a single refugee participant. 28 Handtke et al reported a number of organizationwide cultural competence initiatives, 31 including the ''Sick-Kids Cultural Competence Initiative'' at the Hospital for Sick Children in Canada, which trained more than 2100 hospital staff as cultural competence champions.…”

“…Professional interpreter services were the most frequently cited examples of this. [20][21][22]31,33,[38][39][40][41][42]46 There was a consensus that professional interpreter services were preferable to relying on family members, friends, or other staff members, due to issues of privacy, quality, and ethics. However, several barriers to using professional interpreters were identified, including cost and time constraints and limited availability of interpreters, particularly for rare languages.…”

“…29,39,41 Several providers, including medical students, doctors, and social workers, highlighted the critical role of interpreters as cultural guides who improved the quality of interactions with refugee clients through triangulated discussion and constructive feedback. 20,40,46 Some studies recommended the provision of linguistically and culturally appropriate verbal, written, and visual material across the service continuum, including during scheduling, reception, appointments, referrals, and follow-up; providers believed that this improved engagement with and retention in services. 21,31,43 Incorporating culturally appropriate terms and concepts into services may also improve organizations' cultural competence.…”

Self-Assessment of Preparedness among Critical Care Trainees Transitioning from Fellowship to Practice

“…Often the proportion to which these competencies are developed depends on personal characteristics related to emotional intelligence, social communication, and interpersonal skills. In the last decade, training programs have begun to place more emphasis on teaching these skills using a variety of techniques and approaches [4,5,6,7,8,9]. However, little has been done to evaluate the effectiveness of these programs, which hope to address the issues, but may not succeed [10,11].…”