Explicitly Addressing Implicit Bias in a Cultural Competence Curriculum for Pediatric Trainees

Abstract

This article was migrated. The article was not marked as recommended. Background:Medical providers must learn to communicate effectively and demonstrate sensitivity to an increasingly diverse patient population. Implicit bias can contribute to stereotyping and miscommunication. Traditional cultural competence curricula that focus on memorizing lists of customs, beliefs and behaviors may inadvertently increase stereotyping. Methods: We created a workshop designed to introduce the concepts of implicit bias, health disparities, and individuated care to pediatric trainees. We surveyed participants on perceived preparedness for cross-cultural care prior to and immediately following the workshop. We delivered the workshop twice per year from 2011-14 to a convenience sample of pediatric residents on elective rotations (PGY-1-3) as well as to pediatric subspecialty fellows during their core curriculum. Results: Fifty-four residents and 21 fellows participated. All completed the pre-workshop survey; 52 completed the post-workshop survey. Ninety-four percent found the workshop useful. At baseline, 92% felt prepared to care for patients from different cultures. This did not change significantly. In aggregate, trainees reported increased skillfulness in assessing the patient's understanding of illness (83% to 92%, p= 0.04) and identifying cultural customs that might affect clinical care (69% to 90%, p=0.01). Discussion: The workshop was feasible and well received. Although it did not change trainees' perceived preparedness in caring for patients from different cultures, it did improve perceived skillfulness in specific areas important to providing individuated care. Learners may overestimate their preparedness to provide culturally competent care at baseline, which reinforces the need for objective assessment of skills and patient important outcomes around similar interventions in the future.