Improving surgical residents' performance on written assessments of cultural competency.
BACKGROUND
The pressure to implement cultural-competency training at the level of GME is high. The rapidly diversifying American population and the ACGME demand it, and cultural competency is recognized as a core competency under "Professionalism."


OBJECTIVE
The objectives for this study were (1) to assess residents' baseline levels of cultural competence, (2) define barriers to skill-acquisition, and (3) examine efficacy of educational programs in improving cultural competence.


METHODS
In all, 43 residents from the University of Connecticut School of Medicine participated in a prospective, Institutional Review Board (IRB)-approved study.


METHODS
During Step 1 (pretest), baseline performance was recorded using 3 assessments: (1) Healthcare Cultural Competency Test (HCCT), (2) Cultural skills acquisition (CSA), and (3) Clinical Scenarios Test (CSE). During Step 2 (Educational Intervention), a 2-part lecture that focused on principles of cultural competency and continued self-learning was presented. Last, for Step 3 (posttest), the post-program evaluation was administered as in Step 1.


METHODS
Answers for Step 1 (pretest) and Step 3 (posttest) were compared using a paired t-test for HCCT and CSE and the chi-square test for CSA.


RESULTS
Thirty-five replies were evaluated. Every resident performed better on the posttest than the pretest. Specifically, participants showed 88% improvement in their scores on the HCCT (pretest: 360, posttest: 696; p < 0.01), 2-fold improvement on the CSA (pretest: 6, posttest: 12; p < 0.009), and 40% improvement in CSE (pretest mean score = 23.3, posttest = 34.6; p < 0.01). Commonly identified barriers to learning included inadequate teaching tools and absence of formal training.


CONCLUSIONS
Surgery residents tested for 3 aspects of cultural competence prior to and after teaching sessions showed marked improvement on all 3 assessment measures after this brief intervention.
Krajewski
Aleksandra
A
Division of Plastic Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
Rader
Christine
C
Voytovich
Anthony
A
Longo
Walter E
WE
Kozol
Robert A
RA
Chandawarkar
Rajiv Y
RY
D001291:Attitude of Health Personnel; D002983:Clinical Competence; D015331:Cohort Studies; D003431:Cross-Cultural Comparison; D018864:Cultural Diversity; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D004521:Educational Measurement; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D033183:Interdisciplinary Communication; D007396:Internship and Residency; D008297:Male; D010817:Physician-Patient Relations; D015397:Program Evaluation; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D055815:Young Adult