title: Assessing Cultural Competence Among Oncology Surgeons.
abstract: OBJECTIVE
  Racial and ethnic minority groups in the United States have the highest mortality rates for the most common cancers. Various factors, including a perceived lack of culturally congruent care and culturally competent providers, might lead minority patients to decline or delay care. As part of a large multimethod study to understand barriers to care among American Indian and Alaskan native patients with cancer, we examined surgical provider attributes associated with culturally congruent care.
  
  
  METHODS
  Surgical providers from six hospitals in the Puget Sound region of Washington State were invited to participate. Participants completed a 50-item survey that assessed demographic data and incorporated the Cultural Competence Assessment (CCA) and the Marlowe-Crowne Social Desirability Scale.
  
  
  RESULTS
  Survey response rate was 51.1% (N = 253). Participants reported treating diverse patient populations; 71% encountered patients from six or more racial and ethnic groups. More than one half of participants (58%) reported completing cultural diversity training, with employer-sponsored training being the most common type reported (48%; 71 of 147). CCA scores ranged from 5.99 to 13.75 of a possible 14 (mean, 10.3; standard deviation, ±1.3), and receipt of diversity training was associated with higher scores than nonreceipt of diversity training (10.56 v 9.82, respectively; P<.001). After controlling for Marlowe-Crowne Social Desirability Scale score and hospital system,participation in diversity training was the variable most significantly associated with CCA score (P<.001).
  
  
  CONCLUSIONS
  Culturally competent care is an essential but often overlooked component of high-quality health care. Future work should compare training offered by various hospital systems.
authors.affiliation: University of Washington, Seattle, WA; University of Michigan, Ann Arbor, MI; and University of New Mexico, Albuquerque, NM doorenbo@uw.edu.
authors.forename: Ardith Z
authors.initials: AZ
authors.lastname: Doorenbos
authors.affiliation: University of Washington, Seattle, WA; University of Michigan, Ann Arbor, MI; and University of New Mexico, Albuquerque, NM.
authors.forename: Arden M
authors.initials: AM
authors.lastname: Morris
authors.affiliation: University of Washington, Seattle, WA; University of Michigan, Ann Arbor, MI; and University of New Mexico, Albuquerque, NM.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Haozous
authors.affiliation: University of Washington, Seattle, WA; University of Michigan, Ann Arbor, MI; and University of New Mexico, Albuquerque, NM.
authors.forename: Heather
authors.initials: H
authors.lastname: Harris
authors.affiliation: University of Washington, Seattle, WA; University of Michigan, Ann Arbor, MI; and University of New Mexico, Albuquerque, NM.
authors.forename: David R
authors.initials: DR
authors.lastname: Flum
authors.affiliation: University of Washington, Seattle, WA; University of Michigan, AnnArbor, MI; and University of New Mexico, Albuquerque, NM doorenbo@uw.edu.
authors.forename: Ardith Z
authors.initials: AZ
authors.lastname: Doorenbos
authors.affiliation: University of Washington, Seattle, WA; University of Michigan, AnnArbor, MI; and University of New Mexico, Albuquerque, NM.
authors.forename: Arden M
authors.initials: AM
authors.lastname: Morris
authors.affiliation: University of Washington, Seattle, WA; University of Michigan, AnnArbor, MI; and University of New Mexico, Albuquerque, NM.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Haozous
authors.affiliation: University of Washington, Seattle, WA; University of Michigan, AnnArbor, MI; and University of New Mexico, Albuquerque, NM.
authors.forename: Heather
authors.initials: H
authors.lastname: Harris
authors.affiliation: University of Washington, Seattle, WA; University of Michigan, AnnArbor, MI; and University of New Mexico, Albuquerque, NM.
authors.forename: David R
authors.initials: DR
authors.lastname: Flum
mesh_terms: D000328:Adult; D054521:Cultural Competency; D018864:Cultural Diversity; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D011787:Quality of Health Care; D066231:Surgeons; D011795:Surveys and Questionnaires; D014861:Washington