Table 2.

Medical Student Readiness to Provide Cross-Cultural Care

	% Of respondents, N=260
	Year 1, N=66	Year 2, N=50	Year 3, N=72	Year 4, N=72	% Difference between year 1–4
Preparedness
In general*	19.7	44	65.2	75	55.3
From cultures different from your own*	18.5	21.5	44.4	44.4	25.9
Who are transgender*	16.7	21.6	45.8	38.9	22.2
Who are gay, lesbian, or bisexual*	36.4	45.1	70.8	58.3	21.9
With limited English proficiency*	10.6	19.6	38.9	31.9	21.3
Who are persons with disabilities*	16.7	25.5	41.7	34.7	18
Who are members of racial and ethnic minorities*	42.4	43.1	65.3	59.7	17.3
With a distrust of the U.S. health care system	9.1	9.8	11.1	20.8	11.7
Who are new immigrants	13.6	9.8	20.8	22.2	8.6
Whose religious beliefs affect treatment	18.2	13.7	23.6	23.6	5.4
With health beliefs or practices at odds with Western medicine	10.6	11.8	12.5	13.9	3.3
Who use complimentary or alternative medicines	15.2	15.7	22.2	12.5	−2.7
Skillfulness
Assessing the patient's understanding of the cause of their illness*	33.3	43.1	65.3	66.7	33.4
Negotiating with the patient about key aspects of the treatment plan*	12.1	25.5	40.3	43.1	31
Working effectively with a medical interpreter*	16.7	29.4	61.1	47.2	30.5
Taking a social history*	38.5	54.9	69.4	66.7	28.2
Identifying whether a patient is mistrustful of the health care system or physician	15.2	19.6	23.6	27.8	12.6
Determining how a patient wants to be addressed and interacted with	51.5	47.1	66.7	63.9	12.4
Identifying cultural (nonreligious) customs that might affect clinical care	7.7	13.7	12.5	18.1	10.4
Counseling patients about their use of complimentary or alternative medicine	10.6	13.7	13.9	20.8	10.2

Percentages shown reflect percent of students responding that they were well or very well prepared or skilled in the domains shown.

^* p<0.05 based on first year versus fourth year chi-square analysis.