A Mixed Methods Comparison of Two Interventions to Impact StudentsÕ Cultural Agility: A Pilot Study
Purpose
Disparities in healthcare and health status among underrepresented minorities and other marginalized groups remain a concern in the US. Educating future clinicians about transcultural healthcare has been proposed as a means of reducing disparities. However, there is a dearth of literature regarding optimal instructional methods for teaching these concepts. This study aims to evaluate the impact of two educational methods, video based simulation and traditional paper cases, on student beliefs, awareness and attitudes about transcultural care. The themes of interventions were ageism and racial bias in pain management.
Methods/Description:
Subjects were recruited from a convenience sample of 92 DPT students at a large, private university in the Northeast. Subjects were randomly assigned to either the simulation video or paper case group. Data was collected via pre-test and post-test questionnaires adapted from Patti RoseÕs Cultural Competence Assessment Survey. Qualitative data was collected by transcribing student conversations during the structured discussion for each group. Wilcoxon Rank Sum tests were used to assess inter-group baseline. The Signed Rank test was used to assess intra-group change in pre- and post-test responses.
Results/Outcomes:
No significant inter-group differences were found at baseline. Student responses changed more favorably in the video group. There was a statistically significant increase with agreement that culturally sensitive language is important, heightened understanding that patient and family beliefs may impact response to care, and understanding the definitions of cultural proficiency and cultural competency. However, participants in the video group felt less assured in their beliefs that translation and signage should be available to patients with limited English proficiency, and reported less interest in attending future cultural training sessions. In the paper case group, there was a significant improvement in the belief that participants were culturally competent, and increased desire to improve cultural competence through future training. However, students felt less confident in their understanding of cultural competence, and were more in agreement that patients should be able to speak English if they want care. Two main themes emerged from qualitative analysis of transcriptions from discussions in both conditions: Assumptions and Communication.
Conclusions/Relevance to the conference theme:
The US population is aging; 20% of people are predicted to be over the age of 65 by 2030. Additionally, the US is expected to become a minority majority population by 2045. The shift in demographics means more people will experience disparities unless measures are taken to improve cliniciansÕ ability to provide culturally agile care. Furthermore, the APTA Code of Ethics mandates that all physical therapists provide culturally competent care. Physical therapy educators therefore must gain a better understanding of optimal instructional methods for developing these skills. While the video simulation pedagogy was found to have a more significant effect on studentsÕ cultural beliefs and attitudes, further research is needed.