Campbell, Mobola

AbstractBackgroundEffective cultural competency (CC) training for future health professionals is an important first step towards improving healthcare disparities (HCD). The Accreditation Council for Graduate Medical Education (ACGME) now requires that institutions train residents and faculty members in CC relevant to the patient population they serve.MethodsUsing Kern's Model, we created and implemented a novel CC curriculum tailored to specific program needs in an emergency medicine residency program.ResultsAt the end of the curriculum, respondents reported having a better understanding of the importance of CC for their practice (p = 0.004) and of how a patient's personal and historical context affects treatment (p = 0.002). They also reported an increase in the frequency of practicing strategies to reduce bias in themselves (p < 0.001) and others (p < 0.001), as well as comfort interacting with and treating patients from different backgrounds (p < 0.001). Lastly, they reported improved preparedness to collaborate with communities to address HCD (p = 0.004) and to identify community leaders to do so (p < 0.001).ConclusionsThe challenges of CC training demonstrate the need for a standard yet adaptable framework. We have designed, implemented, and evaluated a novel curriculum tailored to the specific needs of our EM residency program. The curriculum improved participants' attitudes, preparedness, and self‐reported behaviors regarding CC and HCD. This framework represents an example of a successful model to meet ACGME requirements.

Hospitalists care for a growing population of older patients with unique social needs that can often be addressed by providing caregiver help in the home. The importance of addressing social needs is well-recognized, yet older patients sometimes refuse these services. This refusal of services may result in rehospitalization and increased morbidity for patients. We aimed to overcome this refusal of social support through an innovative workshop training hospitalists in negotiation and dispute resolution. Hospitalists at a tertiary care, urban academic medical center completed a one-hour interactive workshop on negotiation and dispute resolution focused on addressing older patients’ refusal of social services. One month post workshop, participants reported increased confidence in engaging patients and families in conflicts and felt empowered to negotiate in both their clinical practice and personal lives. Training hospitalists to negotiate with older adults needing social services is feasible and positively impacts the ability to provide geriatric care.