Interprofessional Simulation to Promote Transcultural Healthcare
Purpose: Racial and ethnic disparities in U.S. healthcare are widely reported in the literature. People in ethnic minority groups have poorer health status and are less likely to receive adequate health care than non-minority groups. Cultural competence in healthcare and the provision of transcultural care has been touted as a means of closing the racial/ethnic gap. Studies have shown that teaching healthcare students concepts related to cultural competence has a positive impact on their knowledge and ability to provide transcultural care. However, teaching these concepts is challenging due to its multifaceted nature and lack of consensus regarding optimal pedagogy. This study examined the impact an interprofessional simulation and guided discussion had on Doctor of Physical Therapy (DPT) students' attitudes, awareness and beliefs related to transcultural healthcare.Methods/Description: A convenience sample of 91 students in a DPT program were recruited. Inclusion criteria was enrollment in a neurological rehabilitation course and exclusion criteria was failure to complete pre- and post-surveys. A pre-test/post-test experimental design was utilized. A simulation was developed in which the same episode of care was videotaped with standardized patients; once with healthcare providers exhibiting a lack of cultural sensitivity, and a second more culturally competent scenario. Students volunteered to take an anonymous survey with 13 questions rated on a 5-point Likert scale adapted with permission from the Cultural Competence for the Health Professional survey. Students viewed the first scenario and participated in a faculty-guided discussion. The second scenario was then viewed, and the difference in patient outcomes between the two scenarios were highlighted. Students were then asked to complete the post-simulation survey with one additional, open-response question regarding impact of the experience. A paired sample t-test was used to analyze difference in group means (p= 0.05).Results/Outcomes: A total of 29 students completed both the pre- and post-simulation surveys. Improvements in all survey items were found. A statistically significant improvement was found on 4 of the 13 questions [31%] including definitions of cultural competency/proficiency and the necessity of on-going education to develop cultural agility. Qualitative feedback gathered in an open-response question highlighted positive aspects of participating in this educational module and a greater awareness of the barriers to transcultural healthcare.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: This original research addresses the conference themes of "...advancing PT education to promote access and equity" and "leading through innovation and simulation." The use of interprofessional simulation and discussion had a positive impact on DPT students’ awareness of cultural competence and should improve their ability to provide culturally sensitive, patient-centered care. This approach has been shown to decrease racial/ethnic disparities and improve outcomes for minority patients.References: Beach, M. C., Price, E. G., Gary, T. L., Robinson, K. A., Gozu, A., Palacio, A., ... & Powe, N. R. (2005). Cultural competency: A systematic review of health care provider educational interventions. Medical care, 43(4), 356. Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2003). Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public health reports, 118(4), 293-302. Health Policy Institute; Georgetown University. (2004). Cultural competence in health care: is it important for people with chronic conditions? Issue Brief Number 5. Accessed January 17, 2017 at: https://hpi.georgetown.edu/agingsociety/pubhtml/cultural/cultural.html Long, T. B. (2012). Overview of teaching strategies for cultural competence in nursing students. Journal of cultural diversity, 19(3), 102. Rose, P. R. (2012). Cultural Competency for the Health Professional. Jones & Bartlett Publishers.