Checking The Pulse On Cultural Competence And Bias Literacy In Medical Education

Abstract

Although medical schools often require diversity training, research indicates individuals from racial and ethnic minorities and those from low socioeconomic backgrounds are adversely impacted by the lower quality of healthcare they sometimes receive from physicians due in part to stereotypes, negative predispositions, and bias. Understanding if and how faculty members are teaching medical students to identify and mitigate their own implicit biases within clinical encounters may reduce current nationwide healthcare disparities for stigmatized groups. This study involved an online mixed methods questionnaire of faculty members at twenty-seven LCME-accredited medical schools in the Southeastern United States. The purpose of this study was to: 1) understand if medical school faculty members, course directors, clerkship directors, and program directors equally integrate cultural competence and bias literacy learning objectives in their respective roles; and 2) understand how medical school faculty members, course directors, clerkship directors, and program directors are integrating learning objectives related to cultural competence and bias literacy in their respective roles.

The results of this study indicated medical school faculty members, course directors, clerkship directors, and program directors equally integrated learning objectives regarding health disparities, community strategies, bias/stereotyping, and self-reflection on the culture of medicine; however, integration of learning objectives regarding communication skills specific to cross-cultural communication and use of interpreters were statistically significant. Five participants cited neutral or negative perceptions of cultural competence education as a tool to equip future physicians to address disparities in healthcare and 95% of participants described perceived benefits including: 1) increased self-awareness, 2) increased understanding of the social and historical nature of health disparities, 3) error reduction and improved outcomes, 4) competent and holistic care, 5) specialized care, 6) cultural sensitivity, 7) established trust, and 8) mutual respect. Informal and formal interventions used to integrate cultural competence were reported across institutional curricula. Faculty members self-reported specific curricular interventions, role modeling, critical appraisal of literature, explication of social barriers, and experiential learning within impacted communities to address disparities in healthcare in their respective roles. These findings necessitate standardization within medical education regarding learning objectives related to communication skills specific to cross cultural communication and use of interpreters.