Journal of General Internal Medicine

, Volume 24, Issue 9, pp 1053–1056 | Cite as

Measuring Residents’ Perceived Preparedness and Skillfulness to Deliver Cross-cultural Care

  • Elyse R. ParkEmail author
  • Maria B. J. Chun
  • Joseph R. Betancourt
  • Alexander R. Green
  • Joel S. Weissman
Brief Report



As patient populations become increasingly diverse, we need to be able to measure residents’ preparedness and skillfulness to provide cross-cultural care.


To develop a measure that assesses residents’ perceived readiness and abilities to provide cross-cultural care.


Survey items were developed based on an extensive literature review, interviews with experts, and seven focus groups and ten individual interviews, as part of a larger national mailed survey effort of graduating residents in seven specialties. Reliability and weighted principal components analyses were performed with items that assessed perceived preparedness and skillfulness to provide cross-cultural care. Construct validity was assessed.


A total of 2,047 of 3,435 eligible residents participated (response rate = 60%).


The final scale consisted of 18 items and 3 components (general cross-cultural preparedness, general cross-cultural skillfulness, and cross-cultural language preparedness and skillfulness), and yielded a Cronbach’s alpha = 0.92. Construct validity was supported; the scale total was inversely correlated with a measure of helplessness when providing care to patients of a different culture (p < 0.001).


We developed a three-component cross-cultural preparedness and skillfulness scale that was internally consistent and demonstrated construct validity. This measure can be used to evaluate residents’ perceived effectiveness of cross-cultural medical training programs and could be used in future work to validate residents’ self assessments with objective assessments.


cultural competency measurement medical education-graduate 



This work was supported by grant 20021803 from The California Endowment and grant 20020727 from The Commonwealth Fund. Additional support for Dr. Park was provided through the American Cancer Society’s Mentored Research Scholar Award (Park) (MRSG-005-05-CPPB). We would like to thank Ms. Jennifer Pandiscio for her assistance with preparing this manuscript.

Conflict of Interest

Drs. Betancourt and Green have received honoraria from Merck Speakers’ Bureau to speak about disparities and cross-cultural care. Dr. Park reports that Pfizer has supplied medication for a pilot smoking cessation trial. Dr. Chun and Dr. Weissman do not have any potential conflicts of interest to report.


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Copyright information

© Society of General Internal Medicine 2009

Authors and Affiliations

  • Elyse R. Park
    • 1
    Email author
  • Maria B. J. Chun
    • 2
  • Joseph R. Betancourt
    • 1
  • Alexander R. Green
    • 1
  • Joel S. Weissman
    • 1
    • 3
  1. 1.Institute for Health PolicyMassachusetts General HospitalBostonUSA
  2. 2.Department of SurgeryUniversity of Hawaii John A. Burns School of MedicineHonoluluUSA
  3. 3.Department of Family and Community MedicineUniversity of Massachusetts Medical SchoolWorcesterUSA

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