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APHA Scientific Session and Event Listing

Marné Castillo, MEd, PhD¹, Anthony M. Errichetti, PhD², Thomas F. Gordon, PhD¹, and Grace X. Ma, PhD³. (1) Department of Public Health, Temple University, 623 East Thompson Street, Philadelphia, PA 19125, 267-997-4090, castillo@email.chop.edu, (2) Clinical Learning and Assesment Center, Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Rowland Hall 532, Philadelphia, PA 19131, (3) Public Health Center for Asian Health, Temple University, P.O. Box 2843, Philadelphia, PA 19122

Cultural competence is an essential skill for the medical practitioner to achieve positive health outcomes among diverse populations. It is established that a physician's ignorance of culturally relevant issues and health beliefs can negatively affect patient health outcomes. Yet, formal instruction and assessment in health care provider education programs is not standard practice. This pilot project explores the efficacy of a cultural competence curriculum integrated into an existing standardized patient (SP) program for physician assistant (PA) students at the Philadelphia College of Osteopathic Medicine. Standardized patients have evolved into a commonly used, valid and respected method to teach and evaluate a wide range of skills. Research indicates that student performances with SPs are more accurate reflections of actual practice than written examinations. It seems logical that they would prove to be an effective element of cultural competence instruction. This curriculum focuses on teaching students to explore the patient's perception of their illness and cultural beliefs affecting health behaviors. Using three valid assessment tools, standardized patients evaluated 1) if questions related to health beliefs and culture were included during history taking; 2) the quality of provider communication and; 3) agreement on the goals and tasks for treatment. Forty-seven PAs participated in the course including completion of five culturally challenging standardized patient encounters. Cultural competence skills were evaluated using various methodologies, such as review of the patient note, but the primary emphasis was on the standardized patient assessments. Based on the data analysis, standardized patients proved to be reliable evaluators of student skills. Statistical analysis found improvements in student performance based on the SP ratings of the cultural competence domains from the first SP encounter to the last. Performance for the research group was significantly better than that of the control group. The standardized patient encounters proved to be an effective method for immediately applying learned competency skills, and served as a useful feedback mechanism for student cultural competence skills improvement. There are many models for teaching cultural competence, but few provide a systematic method of skills evaluation. No one assessment tool could be found that suited this situation, so a series of pre-existing instruments were used. Valuable findings emerged, yet the creation of a standardized patient evaluation tool to assess a health care provider's ability to engage a patient in a culturally competent medical interview and physical exam may be in order.

Learning Objectives:

• Participants will be able to identify specific observable cultural competence skills for health care providers.
• Participants will be able to identify and possibly construct methods for assessing cultural competence skills for health care students.

Keywords: Communication Evaluation, Cultural Competency

Presenting author's disclosure statement:

Not Answered