Abstract
Background: Inequity in health and healthcare is a critical issue that will not likely be solved without adequate physician knowledge about underserved populations. The ACGME and medical schools have begun to address this by expecting competency in systems-based practice which embraces the greater systems issues that influence health inequities. In our residency programs—and we suspect in many others—there is no baseline knowledge of issues affecting the communities residents serve. Previous studies have emphasized the importance of working with key stakeholders and experts to develop effective curricula and obtain needs assessments.
Methods: Through discussion with representatives of our Offices of Cultural Diversity and Community Outreach and Engagement, as well as review of the literature and our health system’s most recent CHNA, we modeled a survey to assess resident knowledge of 4 underserved groups in our community: African Americans, Latinos, LGBTQ, and Orthodox Jews. All incoming residents to our institution in June 2016 attended a panel discussion as part of orientation. Community members representing the 4 underserved groups served on the panel and introduced incoming residents to the needs and issues of the communities that they will serve during their residency. All residents (n = 46) were encouraged to take pre- and post-panel surveys to assess the change in their cultural competency. Thirty-eight surveys were available for analysis.
Results: Resident knowledge was greatest (highest pretest scores) in the customs and issues involving African Americans and Latinos and poorest regarding cultural competency pertaining to LGBTQ and Orthodox Jews. There was a significant difference in the pre- and post-panel survey responses (P < 0.001), indicating an increase in cultural competency. The panel discussion format was well received by residents (compared to standard lecture); the panel session was the most highly rated during orientation.
Conclusion: Use of a community member panel is an effective method to teach residents about cultural competency. Panelists, more effectively than administrators or faculty, provide clinical pearls to improve patient interactions in addition to medical knowledge. Results of pre- and post-survey findings can guide resident education for the systems-based practice ACGME competency.
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