Seventh National Conference on Quality Health Care for Culturally Diverse Populations:

Preconference B-1 What can Health Professions teams do to improve Cross-cultural Communication between Patients, Families & Providers?

The National Consortium for Multicultural Education for Health Professionals (Consortium) comprises educators representing 18 U.S. medical schools, funded by the National Heart Lung and Blood Institute, National Institutes of Health. Collective lessons learned from curriculum implementation have the potential to guide similar educational endeavors.  Using a 53-question structured 3-part questionnaire, the Consortium has documented self-reported challenges with curricular development, solutions, and new curricular products.  Common barriers and challenges identified by Consortium members were: finding administrative and leadership support, sustaining the momentum, continued funding, finding curricular space, accessing and engaging communities, and lack of education research methodology skills.  Several of these challenges are common to new curricular efforts: integrating new material into a curriculum that is perceived as already full, adding curriculum work to existing duties, and sustaining the new curriculum.   Solutions identified included engaging stakeholders, project-sharing across schools, advocacy and active participation in committees and community, and seeking sustainable funding. One unique challenge to this topic area and kind of endeavor was the theme of “accessing communities and skills to engage communities.”  Community connections are crucial to professional multicultural education efforts.

All Consortium members reported new curricular products and extensive dissemination efforts outside their own institutions.  Each school focused on slightly different curricular approaches.  Consortium members used existing videos, websites, online curricula and written materials in their cultural competency education and training activities. All reported creating new curricular products. Thirteen Consortium members developed cases or case vignettes including a textbook of cases, and an online self-study CME activity.  Seven of the 18 Consortium PIs developed videos or other educational tools available in MedEdPORTAL.

Assessment tools or performance checklists were developed, modified or validated by 13 Consortium members including those published in the peer-reviewed literature.   Standardized patient (SP) formative and evaluative cases were implemented by 10 Consortium PIs.  Experiential learning opportunities such as in-clinic visits, community-based practicums, or learning abroad programs were implemented by 13 Consortium members. Twelve Consortium members implemented evaluations of their curricular products.

Several of these products, as well as an online training module, have been highlighted on the Consortium’s (http://culturalmeded.stanford.edu/) and NHLBI websites (http://www.nhlbi.nih.gov/training/).  For example, new discussion guides were developed to accompany the PBS series “Unnatural Causes: Is Inequality Making Us Sick?” to better tailor the series on “upstream factors” (e.g., social, employment and civic factors) for health disparities to medical and other health professional learners, (available at http://culturalmeded.stanford.edu/teaching/unnaturalcausesresource.html). Several Consortium members implemented new reflective practice and self-reflection approaches through their professionalism course content, such as the online Implicit Association Test as a trigger for self-reflection and discussion about unconscious bias and its effects on patient care (see https://implicit.harvard.edu/implicit/).

A wide range of approaches was used to disseminate curricular innovations including international conferences, national or regional meetings, poster presentations, and at own institutions or as continuing medical education (CME) grand rounds.  Peer-reviewed journal articles, books, book chapters, casebooks and magazine articles were also used to disseminate curricular innovations. As a further demonstration of successful dissemination beyond their home institutions, six respondent PIs reported contributing to changes in state and local policies regarding the future of cultural competency training for health professionals by participating on committees or through consultation.

The Consortium model has added benefits for curricular innovation and dissemination for cultural competence education to address health disparities.   The Consortium was able to provide enhanced support for individual educators, and to expand the scope of impact of their individual work.  This observation alone may fuel increasing interest in supporting and developing the consortium approach to medical education in this and other areas. Lessons learned by the Consortium may be applicable to other educational innovation efforts.  

Conducted by Consortium members, this interactive workshop addresses interprofessional education to improve communication between Patients, Families & Providers. Participants will learn of tools to improve client satisfaction and health outcomes through interdisciplinary and interprofessional cultural competency training.  This workshop particularly addresses cultural barriers in the context of chronic disease care for the patient and community.  Training materials and tools can be used to help direct service staff to recognize and practice team skills to impact longitudinal care for conditions including preventive care and screening, diabetes, asthma, hypertension and depression.  Attendees will gain knowledge and skills to improve patient/provider relations, patient satisfaction and clinical outcomes, all important aspects of eliminating health disparities.

This workshop incorporates interactive role playing scripts, video, power point presentation, discussion and handouts (including a bibliography).  Training materials and tools can easily be adapted by other trainers for specific settings.  Examples of effective strategies to work with an interpreter, how to recognize and address bias and stereotyping, use Kleinman questions in an interview setting, and elicit health beliefs with practice examples will be shared. If you view interprofessional training as an important foundation to improved patient/provider satisfaction and outcomes, and if you recognize communication as an obstacle in many patient/provider relationships, then you will want to attend this session.

Monday, October 18, 2010: 1:30 PM - 4:30 PM