Mixed Messages: Residents??? Experiences Learning Cross-Cultural Care

Massachusetts General Hospital / Harvard Medical School, 50 Staniford Street, 9th floor, Boston, MA 02114, USA.
Academic Medicine (Impact Factor: 2.93). 10/2005; 80(9):874-80. DOI: 10.1097/00001888-200509000-00019
Source: PubMed


An Institute of Medicine report issued in 2002 cited cross-cultural training as a mechanism to address racial and ethnic disparities in health care, but little is known about residents' training and capabilities to provide quality care to diverse populations. This article explores a select group of residents' perceptions of their preparedness to deliver quality care to diverse populations.
Seven focus groups and ten individual interviews were conducted with 68 residents in locations nationwide. Qualitative analysis of focus-group and individual interview transcripts was performed to assess residents' perceptions of (1) preparedness to deliver care to diverse patients; (2) educational climate; and (3) training experiences.
Most residents in this study noted the importance of cross-cultural care yet reported little formal training in this area. Residents wanted more formal training yet expressed concern that culture-specific training could lead to stereotyping. Most residents had developed ad hoc, informal skills to care for diverse patients. Although residents perceived institutional endorsement, they sensed it was a low priority due to lack of time and resources.
Residents in this study reported receiving mixed messages about cross-cultural care. They were told it is important, yet they received little formal training and did not have time to treat diverse patients in a culturally sensitive manner. As a result, many developed coping behaviors rather than skills based on formally taught best practices. Training environments need to increase training to enhance residents' preparedness to deliver high-quality cross-cultural care if the medical profession is to achieve the goals set by the Institute of Medicine.

8 Reads
  • Source
    • "In recent studies, it has been shown that physicians are unprepared to provide culturally competent care. This indicates the need to increase cultural competency training [112] [114] [115] [116] [118] [119] [126] [127]. However, as these authors note, we must avoid making sweeping generalizations [28]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Patient-centered care that encompasses informed decision making can improve treatment choice, quality of care and outcomes. Patient-centered care recognizes the need for major changes in the process of care that arranges health care system around the patient. Objective: Study objective was to evaluate and discuss the interplay of components of patient-centered care by developing a conceptual model of patient-centered care. Methods: Comprehensive literature review was conducted using Medline, CINAHL, and Cochrane databases. Included were English language studies addressing issues related to patient-centered-care and patient reported outcomes. Results: Though the concept of patient-centered care emerged in the early 50s, it exploded in the health care research policy arena exponentially in the late nineties. The conceptual model described here can aid objective and subjective evaluation of patient-centered care. As we strive to improve the quality of care, patient-centered care can play a pivotal role in this process. This however requires changes in our healthcare system so as to improve overall quality of care by minimizing wasteful health resource consumption. Conclusions: With healthcare costs projected to continue their rapid increase, the current paradigm of healthcare is unsustainable. More research is needed to explore the various attributes of patient-centered care, its acceptability, and comparative effectiveness in the healthcare arena.
    Preview · Article · Apr 2011 · The Open Health Services and Policy Journal
  • Source
    • "(d) When it would be difficult to get a workout in, or if you don't want to do the workout, why do you go (when you go)? Participants unable to attend the focus groups due to scheduling conflicts were asked the same questions in individual interviews. This balance of focus group and interview material offered a means of cross checking of data sources and thus a means of improving the quality of the data (Malterud, 2001; Office of Behavioral and Social Sciences Research, 1999; Park et al., 2005). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This research analyzes motivations expressed by young, healthy, sedentary women before and after an exercise intervention. Young women (aged 18-30, n = 39) participated in focus groups or interviews during a 4-month exercise intervention. Afterward, 22 of these women and 20 controls completed physical activity diaries for 6 months and were interviewed. For the majority of women (n = 24), obligation to the study prevailed as the motivator during the intervention. Some ( n = 15) became physically active for their own benefit. Afterward, exercisers and controls said they were physically active to feel better and/or healthy (n = 20), for body image and/ or weight loss (n = 20), or both. Women expressed motivations for physical activity in ways that resonated with self-determination theory. Their commentaries expand on theory to include experiencing multiple motivations simultaneously and motivations shifting over time and in differing contexts. Social motivations were compelling, both those associated with societal values (research, health) and cultural trends (body image).
    Preview · Article · Aug 2010 · Health Education & Behavior
  • Source
    • "Thematic Hidden curriculum should be examined (Park, et al., 2005) Thematic Important and relevant, limited part of curriculum (Park, et al., 2006) Thematic Important and relevant, limited part of curriculum, ambivalent, cautions about sole focus on knowledge-based content (Tang, et al.) "

    Preview · Article · Jan 2009
Show more