Improving Surgical Residents' Performance on Written Assessments of Cultural Competency

Aleksandra Krajewski, Christine Rader, Anthony Voytovich, Walter E. Longo, Robert A. Kozol, Rajiv Y. Chandawarkar

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Context: The pressure to implement cultural-competency training at the level of GME is high. The rapidly diversifying American population and the ACGME demand it, and cultural competency is recognized as a core competency under "Professionalism.". Objectives: The objectives for this study were (1) to assess residents' baseline levels of cultural competence, (2) define barriers to skill-acquisition, and (3) examine efficacy of educational programs in improving cultural competence. Setting & Participants: In all, 43 residents from the University of Connecticut School of Medicine participated in a prospective, Institutional Review Board (IRB)-approved study. Design: During Step 1 (pretest), baseline performance was recorded using 3 assessments: (1) Healthcare Cultural Competency Test (HCCT), (2) Cultural skills acquisition (CSA), and (3) Clinical Scenarios Test (CSE). During Step 2 (Educational Intervention), a 2-part lecture that focused on principles of cultural competency and continued self-learning was presented. Last, for Step 3 (posttest), the post-program evaluation was administered as in Step 1. Main Outcome Measures: Answers for Step 1 (pretest) and Step 3 (posttest) were compared using a paired t-test for HCCT and CSE and the chi-square test for CSA. Results: Thirty-five replies were evaluated. Every resident performed better on the posttest than the pretest. Specifically, participants showed 88% improvement in their scores on the HCCT (pretest: 360, posttest: 696; p < 0.01), 2-fold improvement on the CSA (pretest: 6, posttest: 12; p < 0.009), and 40% improvement in CSE (pretest mean score = 23.3, posttest = 34.6; p < 0.01). Commonly identified barriers to learning included inadequate teaching tools and absence of formal training. Conclusions: Surgery residents tested for 3 aspects of cultural competence prior to and after teaching sessions showed marked improvement on all 3 assessment measures after this brief intervention.

Original languageEnglish (US)
Pages (from-to)263-269
Number of pages7
JournalJournal of Surgical Education
Volume65
Issue number4
DOIs
StatePublished - Jul 2008

Keywords

  • ACGME Outcomes Project
  • cultural competency
  • Interpersonal & Communication Skills
  • Patient Care
  • Professionalism
  • transcultural health care

ASJC Scopus subject areas

  • Surgery
  • Education

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    Krajewski, A., Rader, C., Voytovich, A., Longo, W. E., Kozol, R. A., & Chandawarkar, R. Y. (2008). Improving Surgical Residents' Performance on Written Assessments of Cultural Competency. Journal of Surgical Education, 65(4), 263-269. https://doi.org/10.1016/j.jsurg.2008.05.004