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Personal Characteristics Associated with Resident Physicians’ Self Perceptions of Preparedness to Deliver Cross-Cultural Care

Journal of General Internal Medicine volume 23, pages 1953–1958 (2008)Cite this article

Abstract

BACKGROUND

Recent reports from the Institute of Medicine emphasize patient-centered care and cross-cultural training as a means of improving the quality of medical care and eliminating racial and ethnic disparities.

OBJECTIVE

To determine whether, controlling for training received in medical school or during residency, resident physician socio-cultural characteristics influence self-perceived preparedness and skill in delivering cross-cultural care.

DESIGN

National survey of resident physicians.

PARTICIPANTS

A probability sample of residents in seven specialties in their final year of training at US academic health centers.

MEASUREMENT

Nine resident characteristics were analyzed. Differences in preparedness and skill were assessed using the χ2 statistic and multivariate logistic regression.

RESULTS

Fifty-eight percent (2047/3500) of residents responded. The most important factor associated with improved perceived skill level in performing selected tasks or services believed to be useful in treating culturally diverse patients was having received cross-cultural skills training during residency (OR range 1.71–4.22). Compared with white residents, African American physicians felt more prepared to deal with patients with distrust in the US healthcare system (OR 1.63) and with racial or ethnic minorities (OR 1.61), Latinos reported feeling more prepared to deal with new immigrants (OR 1.88) and Asians reported feeling more prepared to deal with patients with health beliefs at odds with Western medicine (1.43).

CONCLUSIONS

Cross-cultural care skills training is associated with increased self-perceived preparedness to care for diverse patient populations providing support for the importance of such training in graduate medical education. In addition, selected resident characteristics are associated with being more or less prepared for different aspects of cross-cultural care. This underscores the need to both include medical residents from diverse backgrounds in all training programs and tailor such programs to individual resident needs in order to maximize the chances that such training is likely to have an impact on the quality of care.

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Acknowledgements

Dr. Lenny Lopez acknowledges the support of an Institutional National Research Service Award #5 T32 HP11001–19. This work was supported by grant 20021803 from The California Endowment and grant 20020727 from The Commonwealth Fund. This paper was presented as a poster at the March 2007 New England Regional SGIM meeting and the April 2007 National SGIM meeting.

Conflict of interest

None disclosed.

Author information

Affiliations

  1. Institute for Health Policy and Department of Medicine, Massachusetts General Hospital; Harvard Medical School, Boston, MA, USA

    Lenny Lopez MD, MDiv, MPH, Joseph Betancourt MD, MPH & Joel S. Weissman PhD

  2. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

    Joel S. Weissman PhD

  3. Behavioral Medicine and Orthopedics Hand and Upper Extremity Services, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA

    Ana-Maria Vranceanu PhD

  4. The Disparities Solutions Center, Massachusetts General Hospital, Boston, MA, USA

    Lenny Lopez MD, MDiv, MPH & Joseph Betancourt MD, MPH

  5. Harvard School of Public Health, Boston, MA, USA

    Amy P. Cohen BA

  6. Institute of Health Policy, Massachusetts General Hospital, Boston, MA, USA

    Lenny Lopez MD, MDiv, MPH

  7. Massachusetts Executive Office of Health and Human Services, Boston, MA, USA

    Joel S. Weissman PhD

Authors
  1. Lenny Lopez MD, MDiv, MPH
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  2. Ana-Maria Vranceanu PhD
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  3. Amy P. Cohen BA
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  4. Joseph Betancourt MD, MPH
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  5. Joel S. Weissman PhD
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Corresponding author

Correspondence to Lenny Lopez MD, MDiv, MPH.

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Lopez, L., Vranceanu, AM., Cohen, A.P. et al. Personal Characteristics Associated with Resident Physicians’ Self Perceptions of Preparedness to Deliver Cross-Cultural Care. J GEN INTERN MED 23, 1953–1958 (2008). https://doi.org/10.1007/s11606-008-0782-y

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  • DOI: https://doi.org/10.1007/s11606-008-0782-y

KEY WORDS

  • cross-cultural care
  • graduate medical education
  • workforce diversity