title: A multimethod approach for cross-cultural training in an internal medicine residency program.
abstract: BACKGROUND
  Cultural competence training in residency is important to improve learners' confidence in cross-cultural encounters. Recognition of cultural diversity and avoidance of cultural stereotypes are essential for health care providers.
  
  
  METHODS
  We developed a multimethod approach for cross-cultural training of Internal Medicine residents and evaluated participants' preparedness for cultural encounters. The multimethod approach included (1) a conference series, (2) a webinar with a national expert, (3) small group sessions, (4) a multicultural social gathering, (5) a Grand Rounds presentation on cross-cultural training, and (6) an interactive, online case-based program.
  
  
  RESULTS
  The program had 35 participants, 28 of whom responded to the survey. Of those, 16 were white (62%), and residents comprised 71% of respondents (n=25). Following training, 89% of participants were more comfortable obtaining a social history. However, prior to the course only 27% were comfortable caring for patients who distrust the US system and 35% could identify religious beliefs and customs which impact care. Most (71%) believed that the training would help them give better care for patients from different cultures, and 63% felt more comfortable negotiating a treatment plan following the course.
  
  
  CONCLUSIONS
  Multimethod training may improve learners' confidence and comfort with cross-cultural encounters, as well as lay the foundation for ongoing learning. Follow-up is needed to assess whether residents' perceived comfort will translate into improved patient outcomes.
authors.affiliation: Department of Internal Medicine, University of Tennessee College of Medicine-Chattanooga, Chattanooga, TN 37403, USA. lisa.staton@erlanger.org
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Staton
authors.forename: Carlos
authors.initials: C
authors.lastname: Estrada
authors.forename: Mukta
authors.initials: M
authors.lastname: Panda
authors.forename: David
authors.initials: D
authors.lastname: Ortiz
authors.forename: Donna
authors.initials: D
authors.lastname: Roddy
mesh_terms: D054521:Cultural Competency / Q000193:education*; D003479:Curriculum; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D020407:Internet; D007396:Internship and Residency; D008297:Male; D057566:Self Report; D013663:Teaching / Q000379:methods*; D013714:Tennessee
keywords: community resources; cultural competence; internal medicine; racial disparities; residency education; web-based curriculum