Measuring residents' perceived preparedness and skillfulness to deliver cross-cultural care.
BACKGROUND
As patient populations become increasingly diverse, we need to be able to measure residents' preparedness and skillfulness to provide cross-cultural care.


OBJECTIVE
To develop a measure that assesses residents' perceived readiness and abilities to provide cross-cultural care.


METHODS
Survey items were developed based on an extensive literature review, interviews with experts, and seven focus groups and ten individual interviews, as part of a larger national mailed survey effort of graduating residents in seven specialties. Reliability and weighted principal components analyses were performed with items that assessed perceived preparedness and skillfulness to provide cross-cultural care. Construct validity was assessed.


METHODS
A total of 2,047 of 3,435 eligible residents participated (response rate = 60%).


RESULTS
The final scale consisted of 18 items and 3 components (general cross-cultural preparedness, general cross-cultural skillfulness, and cross-cultural language preparedness and skillfulness), and yielded a Cronbach's alpha = 0.92. Construct validity was supported; the scale total was inversely correlated with a measure of helplessness when providing care to patients of a different culture (p < 0.001).


CONCLUSIONS
We developed a three-component cross-cultural preparedness and skillfulness scale that was internally consistent and demonstrated construct validity. This measure can be used to evaluate residents' perceived effectiveness of cross-cultural medical training programs and could be used in future work to validate residents' self assessments with objective assessments.
Park
Elyse R
ER
Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA. epark@partners.org
Chun
Maria B J
MB
Betancourt
Joseph R
JR
Green
Alexander R
AR
Weissman
Joel S
JS
D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003431:Cross-Cultural Comparison; D018864:Cultural Diversity; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000592:standards*; D008297:Male; D010817:Physician-Patient Relations; D015203:Reproducibility of Results