Assessing cultural competency skills in gastroenterology fellowship training

Sophie Balzora, Benjamin Abiri, Xiao Jing Wang, James McKeever, Michael Poles, Sondra Zabar, Colleen Gillespie, Elizabeth Weinshel

Research output: Contribution to journalArticlepeer-review

Abstract

AIM: To assess and teach cultural competency skills at the fellowship training level through the use of objective structured clinical examinations (OSCEs). METHODS: We revised four scenarios to infuse a specific focus on cross-cultural care, and to render them appropriate for gastroenterology fellows. Three are discussed here: (1) Poor Health Literacy; (2) Disclosing/Apologizing for a Complication to a Patient Who Mistrusts the Healthcare System; and (3) Breaking Bad News to a Fatalistic Patient. A fourth case emphasizing shared decision-making will be described elsewhere. Four stations were completed by fellows and observed live by four faculty members, and the fellows' performance was assessed. RESULTS: Eleven fellows from four programs participated in the four OSCE. In the "Poor Health Literacy" case, 18% (2/11) of participants recognized that the standardized patient (SP) had below-basic health literacy. None successfully evaluated the SP's reading skills in a culturally-sensitive manner. In "Disclosing/Apologizing for a Complication", 4/11 (36%) personally apologized for the complication. 1/11 recognized the SP's mistrust of the medical system. With "Breaking Bad News", 27% (3/11) explored the patient's values to identify her fatalistic beliefs. CONCLUSION: OSCEs can be used to assess deficiencies in culturally-competent care at the fellowship level. OSCEs also afford fellowships the opportunity to inform future training curricula.

Original languageEnglish (US)
Pages (from-to)1887-1892
Number of pages6
JournalWorld Journal of Gastroenterology
Volume21
Issue number6
DOIs
StatePublished - Feb 14 2015

Keywords

  • Cultural competency
  • Education
  • Gastroenterology
  • Graduate
  • Health care
  • Health literacy
  • Objective structured clinical examination
  • Patient care
  • Patient care
  • Physician-patient relations
  • Trainees

ASJC Scopus subject areas

  • Gastroenterology

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