Increasing cultural competence through experience-based learning: Preventing child Injury in Israel

Abstract

Abstract Background Future practitioners need to learn to communicate with culturally diverse patients, understand their perspectives on disease and provide individually tailored guidance. SHABI (Keeping our Children Safe in Hebrew) is a program set up with a dual purpose of improving families' home-safety and providing students with experience-based learning. 11 medical/nursing students twice visited 135 families who were recruited in an emergency-room following unintentional injury of a preschool child on May 2019-March 2020. 50% of families were ultra-Orthodox Jews, 11% Arab, and 28% had ≥3 children ≤5 years old. Training included child injury prevention, communication skills and insights on religious communities led by a local ultra-Orthodox Rabbi and head of Arab municipal social services. Objective To examine SHABI's impact on students' cultural competence, evaluated through student interviews 8 months after baseline, their written reports after home visits (n = 233), parent interview calls (n = 212) and change in observed home safety assessed by a checklist 4 months later (n = 233). Results Students reported that training helped them to culturally adapt the visits, and that the home visits increased their understanding of cultural and religious groups with whom they had little familiarity. Students worried that they would be perceived as judgmental, but parents reported they were sensitive, and the visits were beneficial. Following the first visit, 64% of parents reported increased awareness about home safety and 59% that the visit improved home safety. Effectiveness of student skills were confirmed by observed 15% improvement in home-safety after 4 months. Conclusions This experience-based learning helped to develop students' self-perceived cultural competence and improve families' home safety. SHABI may serve as a model of how students can learn to engage with disadvantage populations after a medical encounter, promoting their skills while benefitting families. Key messages Participating in experience-based learning and engaging with diverse populations developed cultural competence and benefited local populations. The SHABI program presents a feasible model to introduce into healthcare education.