Addressing health workforce cultural competence is a common approach to improving health service quality for culturally and ethnically diverse groups. Research evidence in this area is primarily ...focused on cultural competency training and its effects on practitioners' knowledge, attitudes, skills and behaviour. While improvements in measures of healthcare practitioner cultural competency and other healthcare outcomes have been reported, there are concerns around evidence strength and quality. This scoping review reports on the intervention strategies, outcomes, and measures of included studies with the purpose of informing the implementation and evaluation of future interventions to improve health workforce cultural competence.
This systematic scoping review was completed as part of a larger systematic literature search conducted on cultural competence intervention evaluations in health care in Canada, the United States, Australia and New Zealand published from 2006 to 2015. Overall, 64 studies on cultural competency interventions were found, with 16 aimed directly at the health workforce.
There was significant heterogeneity in workforce intervention strategies, measures and outcomes reported across studies making comparisons of intervention effects difficult. The two main workforce intervention strategies identified were cultural competency training and other professional development interventions including other training and mentoring. Positive outcomes were commonly reported for improved practitioner knowledge (9/16), skills (7/16), and attitudes/beliefs (5/16). Although health care (6/16) and health (2/16) outcomes were reported in some studies there was very limited evidence of positive intervention impacts. Only four studies utilised existing validated measurement tools to assess intervention outcomes.
Training and development of the health workforce remain a principle strategy towards the goal of improved cultural competence in health services and systems. Diverse approaches are available to increase health workforce cultural competence. However, the effects of interventions beyond practitioner knowledge and attitudes remains unclear. Assessment of practitioner behavioural outcomes as well as measures of intervention impact on healthcare and health outcomes are needed to build a stronger evidence base.
•Cultural complications (CC) curricula exist in 3 main types in surgical education.•Didactics are the most common type of CC curriculum.•Morbidity & Mortality style curricula are gaining ...popularity.•Published interventions on cultural complications grown in the last 2 decades.
Several factors contribute to surgical outcome disparities, including structural racism and implicit bias. Research into how surgical residency programs intervene on Cultural Complications via education remains sparse. We review the literature for how surgical residency programs use education to combat staff and patient exposure to Cultural Complications.
We searched PubMed, SCOPUS, and Google Scholar for curricula aimed at improving cultural competency in surgical residencies. OBGYN curricula were included. Non-US studies were excluded.
Studies were organized by intervention type: Didactic, Grand Rounds, and M&M. The most common interventions were Didactics, with Grand Rounds being the least common. Target measures improved anywhere from 20-88%.
The common types of cultural competency curricula are clear, and certain interventions show improvement in trainees’ education. Scarcity of data on these curricula does not necessarily indicate their lack of existence but does suggest additional research is needed into curricular interventions and how they may address cultural complications.
Cultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health ...disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area.
A systematic review of review articles published between January 2000 and June 2012 was conducted. Electronic databases (including Medline, Cinahl and PsycINFO), reference lists of articles, and key websites were searched. Reviews of cultural competency in health settings only were included. Each review was critically appraised by two authors using a study appraisal tool and were given a quality assessment rating of weak, moderate or strong.
Nineteen published reviews were identified. Reviews consisted of between 5 and 38 studies, included a variety of health care settings/contexts and a range of study types. There were three main categories of study outcomes: patient-related outcomes, provider-related outcomes, and health service access and utilization outcomes. The majority of reviews found moderate evidence of improvement in provider outcomes and health care access and utilization outcomes but weaker evidence for improvements in patient/client outcomes.
This review of reviews indicates that there is some evidence that interventions to improve cultural competency can improve patient/client health outcomes. However, a lack of methodological rigor is common amongst the studies included in reviews and many of the studies rely on self-report, which is subject to a range of biases, while objective evidence of intervention effectiveness was rare. Future research should measure both healthcare provider and patient/client health outcomes, consider organizational factors, and utilize more rigorous study designs.
Cultural Humility Foronda, Cynthia; Baptiste, Diana-Lyn; Reinholdt, Maren M. ...
Journal of transcultural nursing,
05/2016, Letnik:
27, Številka:
3
Journal Article
Recenzirano
Diversity is being increasingly recognized as an area of emphasis in health care. The term cultural humility is used frequently but society’s understanding of the term is unclear. The aim of this ...article was to provide a concept analysis and a current definition for the term cultural humility. Cultural humility was used in a variety of contexts from individuals having ethnic and racial differences, to differences in sexual preference, social status, interprofessional roles, to health care provider/patient relationships. The attributes were openness, self-awareness, egoless, supportive interactions, and self-reflection and critique. The antecedents were diversity and power imbalance. The consequences were mutual empowerment, partnerships, respect, optimal care, and lifelong learning. Cultural humility was described as a lifelong process. With a firm understanding of the term, individuals and communities will be better equipped to understand and accomplish an inclusive environment with mutual benefit and optimal care.
Dermatoses caused by cultural practices Vashi, Neelam A.; Patzelt, Nicole; Wirya, Stephen ...
Journal of the American Academy of Dermatology,
July 2018, 2018-07-00, Letnik:
79, Številka:
1
Journal Article
Recenzirano
The second article in this continuing medical education series discusses cosmetic practices associated with cultural dermatoses, including hair care, traditional clothing, and skin decorations. ...Often, the steps individuals take to enhance their physical appearance are determined by cultural perceptions of beauty. Without awareness of cultural practices, a multitude of cutaneous dermatoses may be missed by the dermatologist. Recognition and understanding of patients' cultural backgrounds and habits will allow the practicing dermatologist to offer better counseling and treatment options while providing a more meaningful and understanding physician–patient relationship.
Background: It is becoming increasingly important for researchers to critically reflect on approaches that can have a positive impact on the health outcomes of indigenous people. Such issues are of ...great importance and perhaps of special relevance to researchers in the Global South, and to the African context in which we work.
Objective:To share some lessons learned from our fieldwork to contribute to current knowledge and conversations on decolonising research process.
Methods: We used an African lens to critically reflect upon some issues raised from individual interviews and focus group discussions with our participants which we deem to be important for consideration in a decolonising research process.
Results: The major issues that we raise are about important structures such as power, trust, cultural competence, respectful and legitimate research practice and recognition of individual and communities' health assets in a decolonising research process.
Conclusions: Our paper argues for alternative approaches which are culturally appropriate for health research and for improved health outcomes of marginalised groups. In addition, we argue that participatory and transformative research methods which recognises individual and communities' assets are needed. We hope that the lessons that we share in this paper can contribute towards a respectful and good research practice among the marginalised population groups in our context.
The 2013 American College of Clinical Pharmacy (ACCP) White Paper by O’Connell and colleagues introduced instructional approaches and resources for assessing health disparities and cultural ...competency training within the pharmacy curriculum. Instructional standards, such as the Accreditation Council for Pharmacy Education (ACPE) Standards 2016, have been updated to state the importance of teaching “cultural awareness” and exposure to “diverse populations” within pharmacy curricula. There remains a gap in understanding how various programs should implement these concepts. To ensure that the knowledge students learn is meaningful, it is critical for approaches to HDCC education to be intentional, integrative, and comprehensive. Without this type of approach, students may lose key skills and be unable to deliver culturally responsive, patient-centered care upon graduation. In this theme issue, three papers will introduce areas for HDCC inclusion and explore how these topics are currently being covered in pharmacy education. Recommendations on best practices are provided.
Pharmacy has recognized the importance of education in health disparities and cultural competency (HDCC) for two decades. More recently, there has been emphasis on incorporating equity, diversity, ...and inclusion (EDI) in pharmacy programs. While many institutions identify a need to incorporate a programmatic approach to HDCC education to meet the growing needs of a diverse population, pharmacy curricula continue to lack a holistic, programmatic approach. More than ever, Doctor of Pharmacy (PharmD) students should graduate with the knowledge, values, and skills to provide culturally appropriate care for a diverse patient population. This commentary advocates for a holistic, programmatic approach to integrating HDCC education and serves as a call to action for curricular development. It is hoped that this commentary will also set the foundation for additional scholarly work and recommendations regarding a programmatic approach.
The objective of this research was to test an individual competency causal model affecting performance of personnel in higher education institutions. The study was conducted among education ...institutions in the upper southern of Thailand. The instrument used in the study was questionnaire. Data analysis was conducted using descriptive statistics, Pearson's correlation coefficient, confirmatory factor analysis, and causal factor analysis.
The findings from the study found that 1) the individual competency causal model had an effect on performance of personnel in higher education institutions. It was consistent with the empirical data, considered from χ² = 994.860, df = 249, p = 0.000, χ²/df = 3.99, CFI = 0.94, TLI = 0.93, RMSEA = 0.06, SRMR = 0.04. Individual competency causal factors had an effect on performance of personnel with statistical significance. All predictor variables in the model could describe variance of performance, core competency, and job competency by 70.0%, 83.0% and 88.0% respectively.
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