Abstract
Purpose: Training residents to deliver care to increasingly diverse patients in the United States is an important strategy to help alleviate racial and ethnic disparities in health outcomes. Cross-cultural care training of residents continues to present challenges. This study sought to explore the associations among residents' cross-cultural attitudes, preparedness, and knowledge about disparities to better elucidate possible training needs.Methods: This cross-sectional study used web-based questionnaires from 2013 to 2014. Eighty-four internal medicine residency programs with 954 residents across the United States participated. The main outcome was perceived preparedness to care for sociocultural diverse patients.Key Results: Regression analysis showed attitude toward cross-cultural care (beta coefficient [β]=0.57, 95% confidence interval [CI]: 0.49–0.64, p<0.001) and report of serving a large number of racial/ethnic minorities (β=0.90, 95% CI: 0.56–1.24, p<0.001), and low-socioeconomic status patients (β=0.74, 95% CI: 0.37–1.10, p<0.001) were positively associated with preparedness. Knowledge of disparities was poor and did not differ significantly across postgraduate year (PGY)-1, PGY-2, and PGY-3 residents (mean scores: 56%, 58%, and 55%, respectively; p=0.08).Conclusion: Residents' knowledge of health and healthcare disparities is poor and does not improve during training. Residents' preparedness to provide cross-cultural care is directly associated with their attitude toward cross-cultural care and their level of exposure to patients from diverse sociocultural backgrounds. Future studies should examine the role of residents' cross-cultural care-related attitudes on their ability to care for diverse patients.
Highlights
Cross-cultural care training has been identified as an important strategy to help healthcare providers deliver higher quality care to socioculturally diverse patients.[1]Sociocultural factors include race, ethnicity, primary language, income, education, religion, and other customs and values that characterize a group.[2]
We examined respondents who self-identified as being in postgraduate years (PGYs) 1–3
The majority of residents trained in institutions that were located in an urban setting, 900 (94.3%) versus nonurban, 54 (5.7%)
Summary
Cross-cultural care training has been identified as an important strategy to help healthcare providers deliver higher quality care to socioculturally diverse patients.[1]. Sociocultural factors include race, ethnicity, primary language, income, education, religion, and other customs and values that characterize a group.[2] These characteristics can play a role in shaping patient’s beliefs, perceptions, and health behaviors.[3] Health communication and clinical decision-making can be adversely affected, when patient and providers have differences in their sociocultural backgrounds (e.g., differences in English proficiency resulting in language barriers).[4].
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