Via Research Recognition Day 2024 VCOM-Carolinas

Educational Reports

CULTIVATING CULTURAL COMPETENCE: A COMPREHENSIVE ASSESSMENT OF MEDICAL STUDENTS PRE AND POST IMPLEMENTATION OF A STRUCTURED CULTURAL COMPETENCY LECTURE SERIES

Numa Rehmani, OMS-III, Shweta Bhatnagar, OMS-III, Nicole Gentile, OMS-III, Doralyn Jones, DO Edward Via College of Osteopathic Medicine – Carolinas Campus. Spartanburg, South Carolina

Results

Conclusions

Introduction

References Study Conclusions: This quality improvement study concluded that medical students' self-reported cultural competence levels improved after attending a structured lecture series on various topics of cultural competency. Future studies should explore the effectiveness ofsimilar or different methods of implementing acultural competence curriculum in a medical education setting. Benefits of a Standardized Medical School Cultural Competency Curriculum: • While medical schools are required to ensure that their medical graduates meet a standard level of cultural competence, there is no nationally standardized curriculum on topics such as language barriers or cultural stigmas. 1 Current research supports that cultural competence training may improve the skillset of medical students, as well as improve their attitudes towards patient care. 1 • The implementation of a standardized curriculum on topics of cultural competence could potentially benefit patient-provider relationships, improve communication within the medical care team, increase culturally informed medical decision making, and empower patients to be more involved in their care. 1 • These initiatives could lead to a more culturally prepared physician workforce that can meet the needs of diverse patient communities both nationally and globally. 1 1. Jernigan VB, Hearod JB, Tran K, Norris KC, Buchwald D. An Examination of Cultural Competence Training in US Medical Education Guided by the Tool for Assessing Cultural Competence Training. J Health Dispar Res Pract. 2016;9(3):150-167. 2. AAMC. (2022). Diversity, Equity, and Inclusion Competencies Across the Learning Continuum. AAMC.org. This Quality Improvement Initiative was reviewed and determined to not meet the criteria for human subjects research by the Edward Via College of Osteopathic Medicine Institutional Review Board. Lecture series presented by the VCOM-Carolinas' chapters of AMWA, ACOOG, SNMA, D&I Committee, CMDA, MMSA, HCMO, ACOFP, IHC, and ACOEP. Acknowledgements

With increasingly diverse patient populations in the United States, healthcare providers must be well equipped to take care of communities with various backgrounds and needs. Holistic care requires a physician to be competent in understanding the impacts of social determinants of health, cultural stigmas and differences, and language barriers on patient care. There is currently no standardized national medical curriculum which includes a specific focus on such topics of cultural competence. 1 A thorough and focused education in the importance and impact of cultural competence is necessary for a comprehensive medical education, and ultimately, will benefit population health and patient care. This quality improvement study aims to evaluate the effectiveness of a structured cultural competency series. A 7-lecture series covering a wide variety of cultural competency topics was created with the help of the organizations that serve on VCOM Carolinas’ Diversity and Inclusion Committee. Medical students attended this optional series and completed an optional pre and post assessment for evaluation of the lecture series. Pre/post survey competencies were developed and chosen based on theAAMC Diversity, Equity, and Inclusion (DEI) Competencies. Using 5-point Likert scale questions, students were asked to provide self-ratings on their perceived comfort with the listed cultural competencies. These surveys were de-identified to ensure confidential data and used to determine if there was an improvement in self reported cultural competency levels. Comparison of pre and post survey scores was conducted via paired t-test analysis. Lecture Topics Normal Menstruation & Considerations for Different Populations Impacts of Systemic Racism on the Health System Dermatologic Manifestations of Darker Skin The Role of Faith in Healing, Medicine, and End of Life Care Cultural Competency for Muslim Patients Healthcare Challenges for Spanish Speaking Patients Allyship in the Emergency Department Competencies 2 (1) Demonstrate evidence of self- reflection regarding how one’s personal identities, biases, and lived experiences (e.g., professional hierarchy, culture, class, gender) may influence one’s perspectives, clinical decision-making, and practice (2) Demonstrate knowledge of the intersectionality of a patient’s multiple identities (race, ethnicity, primary language, SES, LGBTQ identification), and how each identity may result in varied and multiple forms of oppression or privilege related to clinical decisions and practice (3) Identifies the system-level policies, procedures, and practices that may or may not promote diversity in the health care system (4) Identify systems of power, privilege, and oppression and their impacts on health outcomes (e.g., white privilege, racism, sexism, heterosexism, ableism, religious oppression) (5) Describe health equity concepts (e.g. health inequities, root causes of inequities, social determinants of health, oppression, privilege, implicit bias) and the relationships among them (6) Articulate race as a social construct and how historical and current examples of racism and oppression (internalized, interpersonal, institutional, and structural) have impacts on individual and community health (7) Differentiate between inclusive and exclusive policies and practices within the local health care system to ensure people from a variety of backgrounds and abilities have equal access to services and resources (8) Identify the practices and values that foster belongingness and inclusion in partnership with a diverse health care team and patient population (e.g., authenticity, respect, support) Methods

Figure 1. Mean Change in Self-Reported Cultural Competency Levels and Paired t-Test Analysis ( n = 39)

Mean Post Survey Score

p-Value (p < 0.05)

Competency #

Mean Change in Cultural Competency

Mean Pre Survey Score

(1)

3.897

4.538

0.641

<0.0001

(2)

3.846

4.461

0.615

<0.0001

(3) (4)

3.589 3.692

4.435 4.487

0.846 0.794

<0.0001 <0.0001

(5)

3.692

4.538

0.846

<0.0001

(6)

3.487

4.435

0.948

<0.0001

(7)

3.512

4.307

0.794

<0.0001

(8)

3.820

4.564

0.743

<0.0001

Figure 2. Pre and Post Survey Score Means by Competency ( n = 39)

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2024 Research Recognition Day