Improving clinicians' skills to provide culturally competent care: Educational opportunities offered through a system-wide Healthcare Equity Campaign

Background: Providing culturally competent care has been shown to decrease and even eliminate disparities in healthcare quality by race, ethnicity, and language. Henry Ford Health System (HFHS) in Detroit, Michigan initiated a system-wide Healthcare Equity Campaign to, in part, improve individual and organizational cultural competency. In order to improve individual-level cultural competency, various educational opportunities were offered. Methods: The LEARN Model is a collaborative tool for communicating across culturally diverse patient populations. Teach Back is a communication tool that ensures patient understanding of treatments and procedures, so that health literacy barriers are mitigated. Both tools are utilized in the Campaign's training opportunities. In a skills-based workshops open to all HFHS clinicians, the LEARN model is presented and participants engage in role-play activities using culturally diverse patient cases. Additionally, all HFHS second-year residents are required to go through an online module on the social determinants of health and health care disparities, followed by a structured small group discussion on the same topic facilitated by their faculty preceptor. They also learn the two culturally competent communication methods and then practice them in an Observed Structured Clinical Exam (OSCE) where they visit with two standardized patients while under observation. Afterward, the residents receive feedback from the patients and their faculty preceptor. Results: Thirty-six clinicians participated in the workshop and 42 residents took part in the OSCE. Satisfaction results for both courses have been overwhelmingly positive. The clinician workshop resulted in 90% of respondents reporting “outstanding” or “above average” in categories of lecture content, value of discussions, and application of course to participants' practice. The residents participating in the OSCEs reported increases in skills pre-OSCE compared to post-OSCE, with 93% reporting that it would improve their interactions with patients and 86% that their confidence using the communication skills increased as a result of the experience. Conclusions: HFHS clinicians and residents were satisfied with cultural competency skills-based courses, reported high relevance of the content to their practice area, and most importantly, increased their confidence using these communication skills. These are all important outcomes for improving care for all patients and for reducing healthcare disparities for racial, ethnic, and language minority patients. Although these results are based on self-reported satisfaction, plans are under way to develop a follow-up evaluation to determine whether participants of both courses continue to use these communication skills and to realize the beneficial impact months after the training.