title: Using clinical vignettes to assess doctors' and medical students' ability to identify sociocultural factors affecting health and health care.
abstract: BACKGROUND
  Methods are needed for assessing clinicians' cultural knowledge frameworks.
  
  
  METHODS
  We used a mail survey containing four short clinical vignettes to explore respondents' ability to identify sociocultural factors affecting health and health care. Participants included 299 physicians working at the University Hospitals of Geneva, 156 private physicians, and all 134 local medical students in their clinical years. Twenty-one sociocultural "domains" were identified through inductive coding of responses. For each vignette, we obtained the sum of codes as a measure of the respondent's awareness of sociocultural factors that might affect care in this particular situation. As internal consistency was reasonably high (0.68), we computed a single total score as the sum of responses given to all four vignettes.
  
  
  RESULTS
  Reponses correlated with factors that might be expected to impact clinicians' awareness of sociocultural factors affecting care. Medical students, females, respondents who had received cultural competence training, those with greater interest in caring for immigrant patients, and those with high self-assessed skills at exploring psychosocial and migration-related issues scored higher on the vignettes.
  
  
  CONCLUSIONS
  Brief clinical vignettes appear to be a relevant and feasible method for exploring physicians' knowledge of social and cultural factors affecting health and health care.
authors.affiliation: Geneva University Hospitals, Geneva, Switzerland. patricia.hudelson@hcuge.ch
authors.forename: Patricia
authors.initials: P
authors.lastname: Hudelson
authors.forename: N Junod
authors.initials: NJ
authors.lastname: Perron
authors.forename: Thomas
authors.initials: T
authors.lastname: Perneger
mesh_terms: D001291:Attitude of Health Personnel; D001364:Awareness; D054521:Cultural Competency; D003625:Data Collection; D004504:Education, Medical, Undergraduate / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010820:Physicians / Q000523:psychology*; D015203:Reproducibility of Results; D012381:Role Playing; D012647:Self-Assessment; D012959:Socioeconomic Factors; D012962:Sociology, Medical / Q000379:methods*; D013223:Statistics as Topic; D013337:Students, Medical / Q000523:psychology*; D013557:Switzerland