Abstract
Background:
Inequity in health and healthcare is a critical issue that will not likely be solved without adequate physician knowledge about underserved populations. The ACGME and medical schools have begun to address this by expecting competency in systems-based practice which embraces the greater systems issues that influence health inequities. In our residency programs—and we suspect in many others—there is no baseline knowledge of issues affecting the communities residents serve. Previous studies have emphasized the importance of working with key stakeholders and experts to develop effective curricula and obtain needs assessments.
Methods:
Through discussion with representatives of our Offices of Cultural Diversity and Community Outreach and Engagement, as well as review of the literature and our health system’s most recent CHNA, we modeled a survey to assess resident knowledge of 4 underserved groups in our community: African Americans, Latinos, LGBTQ, and Orthodox Jews. All incoming residents to our institution in June 2016 attended a panel discussion as part of orientation. Community members representing the 4 underserved groups served on the panel and introduced incoming residents to the needs and issues of the communities that they will serve during their residency. All residents (n = 46) were encouraged to take pre- and post-panel surveys to assess the change in their cultural competency. Thirty-eight surveys were available for analysis.
Results:
Resident knowledge was greatest (highest pretest scores) in the customs and issues involving African Americans and Latinos and poorest regarding cultural competency pertaining to LGBTQ and Orthodox Jews. There was a significant difference in the pre- and post-panel survey responses (P < 0.001), indicating an increase in cultural competency. The panel discussion format was well received by residents (compared to standard lecture); the panel session was the most highly rated during orientation.
Conclusion:
Use of a community member panel is an effective method to teach residents about cultural competency. Panelists, more effectively than administrators or faculty, provide clinical pearls to improve patient interactions in addition to medical knowledge. Results of pre- and post-survey findings can guide resident education for the systems-based practice ACGME competency.
PROJECT MANAGEMENT PLAN – A Panel Discussion by Community Members Will Increase Residents’ Knowledge of Cultural Competency.
| Vision Statement | We will demonstrate that the panel discussion format is effective at increasing resident knowledge regarding cultural competency. |
| Team Objectives | Findings from pre- and post-panel surveys will inform and influence systems-based presentations for residents for the remainder of the academic year. Year-to-year improvement in resident knowledge regarding how best to serve residents from these communities will be tracked through surveys. Key stakeholders include incoming residents and residency programs, the Meridian Health (MH) Office of Community Outreach, and the MH Office of Cultural Diversity. |
| Success Factors | The most successful part of our work was the engagement of the residents with community members. We were inspired by how community members spoke with pride about their cultures and were enthusiastic about the prospect of residents better understanding the needs of their communities. |
| Barriers | The largest barrier encountered was identifying community members willing to sit in front of 40 residents for 90 minutes! We overcame this challenge by working with our Offices of Community Outreach and Cultural Diversity to identify panelists and by having the project principal investigator meet with them in advance of the panel session. |
| Lessons Learned | The single most important piece of advice to provide another team embarking on a similar initiative is to pilot the pre- and post-panel surveys with residents. |