29 Assessing Paediatric Trainees’ Confidence in Providing Culturally Responsive Care to Patients

Abstract

Abstract Background Extensive data consistently demonstrate inequities in access and delivery of healthcare for patients from historically marginalized populations, resulting in poorer health outcomes. To address systemic oppression in healthcare, it is necessary to embed principles of equity, diversity, and inclusion (EDI) within medical education. Currently, limited data exist regarding paediatric trainees’ interest in EDI curricula and confidence in applying this knowledge to provide culturally responsive care. Objectives To assess paediatric trainees’ confidence in applying EDI knowledge to provide culturally responsive care to children and youth from historically marginalized communities. Design/Methods An anonymous online survey was distributed to paediatric trainees at a Canadian paediatric tertiary care centre during the 2021/22 academic year. Closed-ended questions used a Likert scale to assess respondents’ confidence and interest in providing culturally responsive care to patients. Open-ended questions explored trainees’ perceptions of effective EDI learning modalities. Quantitative data was summarized using descriptive statistics. Descriptive content analysis was used to highlight themes within qualitative data. Results 116 paediatric trainees completed the survey, of which 72/116 (62%) were subspecialty residents/fellows and 44/116 (38%) were core residents. Nearly all respondents indicated importance (mean 97%) and interest (mean 95%) in learning about providing culturally responsive care to patients from historically marginalized communities. However, many trainees lacked confidence in their knowledge of providing culturally responsive care (mean 51%) and applying their knowledge in clinical practice (mean 53%). Respondents identified direct clinical exposure through rotations, immersive experiences, and continuity clinics as effective EDI teaching modalities. Identified barriers included time constraints in the clinical environment, burnout, and lack of exposure to diverse patient populations. Conclusion Most paediatric trainees want to provide culturally responsive care to patients from historically marginalized communities, but do not feel confident in their knowledge to do so. These study findings will be utilized to develop and implement an enhanced EDI education curriculum for both core trainees, as well as subspecialty residents and fellows, across the Department of Paediatrics.