Cultural Competency Training in Emergency Medicine

Oren J Mechanic,Nicole M Dubosh,Carlo L Rosen,Alden M Landry

doi:10.1016/j.jemermed.2017.04.019

Oren J Mechanic, Nicole M Dubosh + Show 2 more

Open Access

https://doi.org/10.1016/j.jemermed.2017.04.019

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Abstract

BackgroundThe Emergency Department is widely regarded as the epicenter of medical care for diverse and largely disparate types of patients. Physicians must be aware of the cultural diversity of their patient population to appropriately address their medical needs. A better understanding of residency preparedness in cultural competency can lead to better training opportunities and patient care. ObjectiveThe objective of this study was to assess residency and faculty exposure to formal cultural competency programs and assess future needs for diversity education. MethodsA short survey was sent to all 168 Accreditation Council for Graduate Medical Education program directors through the Council of Emergency Medicine Residency Directors listserv. The survey included drop-down options in addition to open-ended input. Descriptive and bivariate analyses were used to analyze data. ResultsThe response rate was 43.5% (73/168). Of the 68.5% (50/73) of residency programs that include cultural competency education, 90% (45/50) utilized structured didactics. Of these programs, 86.0% (43/50) included race and ethnicity education, whereas only 40.0% (20/50) included education on patients with limited English proficiency. Resident comfort with cultural competency was unmeasured by most programs (83.6%: 61/73). Of all respondents, 93.2% (68/73) were interested in a universal open-source cultural competency curriculum. ConclusionsThe majority of the programs in our sample have formal resident didactics on cultural competency. Some faculty members also receive cultural competency training. There are gaps, however, in types of cultural competency training, and many programs have expressed interest in a universal open-source tool to improve cultural competency for Emergency Medicine residents.

Highlights

The Emergency Department is widely regarded as the epicenter of medical care for diverse and largely disparate types of patients
12.2% of these programs include residency education on all topics of interest, including race and ethnicity, gender identity and sexual orientation, patients with limited English proficiency (LEP), and social determinants of health. 40.5% of programs have training for faculty, primarily utilizing lectures or didactics. 95.2% of programs are interested in a universal open-source cultural competency curriculum
92% of respondents reported improved patient care as the most important reason for Emergency physicians (EP) to communicate with primary care physicians (PCP)

Summary

Introduction

The Emergency Department is widely regarded as the epicenter of medical care for diverse and largely disparate types of patients. Physicians must be aware of the cultural diversity of the patient population they care for to appropriately address their medical needs. A better understanding of residency-preparedness in cultural competency education can lead to better training opportunities and patient care. Emergency physicians (EP) and primary care physicians (PCP) believe that the transition of care to the outpatient setting is important. Limited data exist discussing transitions of care from the emergency department (ED) to the primary care setting (PCS)

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