ABSTRACT
Cultural differences between physician and patient are of great interest to the public and to those responsible for training health professionals. The current interest stems from the increasing cultural diversity of global populations and the existing health disparities between some ethnic groups. To enhance the cultural competency of physicians, we developed a means of measuring "culturally relevant behaviors" in the course of the physician-patient encounter.
The extent to which a physician is culturally competent may be assessed by how often her/she employs cultural behaviors. The extent to which cultural behaviors are employed can be assessed by systematic observation and recording of these behaviors during the physician/patient interaction - under simulated or real-time conditions.
Observing Cultural Behavior in Setting (OCBIS) is used to assess a physician-trainee's culturally-competent behaviors. The observation protocol covers two broad fields: Setting Data, and Behavior Data. The Setting variables provide the physical, social and cultural context of the physician/patient interaction.
The Behavior variables capture the use of culturally-competent behaviors and their level of cultural function. Using the OCBIS, data is recorded electronically by trained observers from 20-minute videotaped episodes of physicians examining standardized patients, and of real-time observation in a clinical setting.
The data analysis provides a profile of the frequency and level of function of culturally- competent behaviors demonstrated by the physician. These data, combined with counseling and instruction provide specific feedback to the trainee, and a basis for working on specific behaviors to improve cultural sensitivity and competency.
Learning Objectives: At the conclusion of this session, participants will be able to: 1. Recognize the importance of cultural context in the medical encounter between physician and patient in terms of behavior towards patients that is respectful, comforting and accommodating. 2. Describe the OCBIS protocol's data collection paradigm of setting and behavior variables. 3. Discuss the need for including cultural competency in the medical education curriculum. 4. Define the "same - different gradient" as the cultural distance between physician and patient. 5. Assess the practicality and value of real-time assessment of cultural behavior using the OCBIS. 6. Articulate how time, space and behavior are used as units for studying behavior in real-time.
Keywords: Teaching, Behavioral Research
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Mount Sinai School of Medicine
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.