TY - JOUR
T1 - Residents' Attitude, Knowledge, and Perceived Preparedness Toward Caring for Patients from Diverse Sociocultural Backgrounds
AU - Marshall, Jessie Kimbrough
AU - Cooper, Lisa A.
AU - Green, Alexander R.
AU - Bertram, Amanda
AU - Wright, Letitia
AU - Matusko, Niki
AU - McCullough, Wayne
AU - Sisson, Stephen D.
N1 - Funding Information:
Dr. Marshall had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The study concept and design were by S.D.S., J.K.M., A.B., A.G., and L.A.C. Acquisition, analysis, or interpretation of data was by J.K.M., A.B., A.G., L.A.C., and S.D.S. Drafting of the article was by J.K.M. and S.D.S. Critical revision of the article for important intellectual content was done by all authors. Statistical analysis was by J.K.M. and A.B. Administrative, technical, or material support was by J.K.M., A.B., and N.M. Study supervision was by S.D.S. The authors would like to sincerely thank Dr. Brady West of the University of Michigan Center for Statistical Consultation and Research for his assistance with the statistical analysis. Dr. Sisson has received compensation from the Department of Medicine at the Johns Hopkins University for editing the article’s featured curriculum. Dr. Cooper is supported by a grant from the National Heart, Lung, and Blood Institute (K24 HL083113).
Publisher Copyright:
© Jessie Kimbrough Marshall et al., 2017; Published by Mary Ann Liebert, Inc. 2017.
PY - 2017/8
Y1 - 2017/8
N2 - Purpose: Training residents to deliver care to increasingly diverse patients in the United States is an important strategy to help alleviate racial and ethnic disparities in health outcomes. Cross-cultural care training of residents continues to present challenges. This study sought to explore the associations among residents' cross-cultural attitudes, preparedness, and knowledge about disparities to better elucidate possible training needs. Methods: This cross-sectional study used web-based questionnaires from 2013 to 2014. Eighty-four internal medicine residency programs with 954 residents across the United States participated. The main outcome was perceived preparedness to care for sociocultural diverse patients. Key Results: Regression analysis showed attitude toward cross-cultural care (beta coefficient [β]=0.57, 95% confidence interval [CI]: 0.49-0.64, p<0.001) and report of serving a large number of racial/ethnic minorities (β=0.90, 95% CI: 0.56-1.24, p<0.001), and low-socioeconomic status patients (β=0.74, 95% CI: 0.37-1.10, p<0.001) were positively associated with preparedness. Knowledge of disparities was poor and did not differ significantly across postgraduate year (PGY)-1, PGY-2, and PGY-3 residents (mean scores: 56%, 58%, and 55%, respectively; p=0.08). Conclusion: Residents' knowledge of health and healthcare disparities is poor and does not improve during training. Residents' preparedness to provide cross-cultural care is directly associated with their attitude toward cross-cultural care and their level of exposure to patients from diverse sociocultural backgrounds. Future studies should examine the role of residents' cross-cultural care-related attitudes on their ability to care for diverse patients.
AB - Purpose: Training residents to deliver care to increasingly diverse patients in the United States is an important strategy to help alleviate racial and ethnic disparities in health outcomes. Cross-cultural care training of residents continues to present challenges. This study sought to explore the associations among residents' cross-cultural attitudes, preparedness, and knowledge about disparities to better elucidate possible training needs. Methods: This cross-sectional study used web-based questionnaires from 2013 to 2014. Eighty-four internal medicine residency programs with 954 residents across the United States participated. The main outcome was perceived preparedness to care for sociocultural diverse patients. Key Results: Regression analysis showed attitude toward cross-cultural care (beta coefficient [β]=0.57, 95% confidence interval [CI]: 0.49-0.64, p<0.001) and report of serving a large number of racial/ethnic minorities (β=0.90, 95% CI: 0.56-1.24, p<0.001), and low-socioeconomic status patients (β=0.74, 95% CI: 0.37-1.10, p<0.001) were positively associated with preparedness. Knowledge of disparities was poor and did not differ significantly across postgraduate year (PGY)-1, PGY-2, and PGY-3 residents (mean scores: 56%, 58%, and 55%, respectively; p=0.08). Conclusion: Residents' knowledge of health and healthcare disparities is poor and does not improve during training. Residents' preparedness to provide cross-cultural care is directly associated with their attitude toward cross-cultural care and their level of exposure to patients from diverse sociocultural backgrounds. Future studies should examine the role of residents' cross-cultural care-related attitudes on their ability to care for diverse patients.
KW - cross-cultural care
KW - graduate medical education
KW - resident training
KW - vulnerable populations
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U2 - 10.1089/heq.2016.0010
DO - 10.1089/heq.2016.0010
M3 - Article
AN - SCOPUS:85049793162
SN - 2473-1242
VL - 1
SP - 43
EP - 49
JO - Health Equity
JF - Health Equity
IS - 1
ER -