| Cultural competence is an essential skill if the effective medical practitioner is to achieve positive health outcomes among diverse populations like those in the United States. It has been established that a physician's ignorance of culturally relevant issues and health beliefs can negatively affect patient care and health outcomes (Betancourt & King, 1999; Brach & Fraser, 2000; Chin, Monroe, & Fiscella, 2000). According to the Institute of Medicine, equal access to health care, which is at the root of our nation's health care crisis, is directly related to the cultural competence of the health care workforce (2002). Yet, formal instruction in medical schools and in health care provider education programs is not a standard practice (Tervalon, 2003).;This pilot investigation explores the efficacy of a cultural competence curriculum integrated into an existing standardized patient (SP) program for physician assistant (PA) students at the Philadelphia College of Osteopathic Medicine (PCOM). Forty-seven PAs participated in a cultural competence course, including five culturally challenging standardized patient encounters. Cultural competence skills were assessed through standardized patient assessments, student self-assessments and review of the patient notes for presence of culturally relevant content. Statistical analysis found improvements in student performance in the cultural competence domains from the first SP encounter to the last encounter. Results from a survey and debriefing session for the course and standardized patient sessions revealed that students felt the material was relevant, and an important skill in achieving clinical competence. The use of standardized patients proved to be an effective method for immediately applying learned competency skills, and served as a useful feedback mechanism. Recommendations are provided for a curricular model to teach cultural competence skills, based on results from the data analysis, comments from students and faculty, and feedback from the standardized patients. |
