title: Assessment of Military Cultural Competence: A Pilot Study.
abstract: OBJECTIVE
  Cultural competence is widely considered a cornerstone of patient care. Efforts to improve military cultural competency have recently gained national attention. Assessment of cultural competence is a critical component to this effort, but no assessment of military cultural competence currently exists.
  
  
  METHODS
  An assessment of military cultural competence (AMCC) was created through broad input and consensus. Careful review of previous cultural competency assessment designs and analysis techniques was considered. The AMCC was organized into three sections: skills, attitudes, and knowledge. In addition to gathering data to determine absolute responses from groups with different exposure levels to the military (direct, indirect, and none), paired questions were utilized to assess relative competencies between military culture and culture in general.
  
  
  RESULTS
  Piloting of the AMCC revealed significant differences between military exposure groups. Specifically, those with personal military exposure were more likely to be in absolute agreement that the military is a culture, were more likely to screen for military culture, and had increased knowledge of military culture compared to those with no military exposure. Relative differences were more informative. For example, all groups were less likely to agree that their personal culture could be at odds with military culture as compared to other cultures. Such perceptions could hinder asking difficult questions and thus undermine care.
  
  
  CONCLUSIONS
  The AMCC is a model for the measurement of the skills, attitudes, and knowledge related to military cultural competence. With further validity testing, the AMCC will be helpful in the critical task of measuring outcomes in ongoing efforts to improve military cultural competence. The novel approach of assessing variance appears to reduce bias and may also be helpful in the design of other cultural competency assessments.
authors.affiliation: University of Texas Health Science Center, San Antonio, TX, USA, ERIC.meyer@US.AF.MIL.
authors.forename: Eric G
authors.initials: EG
authors.lastname: Meyer
authors.forename: Brittany N
authors.initials: BN
authors.lastname: Hall-Clark
authors.forename: Derrick
authors.initials: D
authors.lastname: Hamaoka
authors.forename: Alan L
authors.initials: AL
authors.lastname: Peterson
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D054521:Cultural Competency / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008887:Military Medicine / Q000193:education*; D008889:Military Personnel; D015279:Organizational Culture; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D055815:Young Adult