Dataset Information

A novel emergency medicine cultural competency curriculum addressing health care disparities.

ABSTRACT:

Background

Effective cultural competency (CC) training for future health professionals is an important first step towards improving healthcare disparities (HCD). The Accreditation Council for Graduate Medical Education (ACGME) now requires that institutions train residents and faculty members in CC relevant to the patient population they serve.

Methods

Using Kern's Model, we created and implemented a novel CC curriculum tailored to specific program needs in an emergency medicine residency program.

Results

At the end of the curriculum, respondents reported having a better understanding of the importance of CC for their practice (p = 0.004) and of how a patient's personal and historical context affects treatment (p = 0.002). They also reported an increase in the frequency of practicing strategies to reduce bias in themselves (p < 0.001) and others (p < 0.001), as well as comfort interacting with and treating patients from different backgrounds (p < 0.001). Lastly, they reported improved preparedness to collaborate with communities to address HCD (p = 0.004) and to identify community leaders to do so (p < 0.001).

Conclusions

The challenges of CC training demonstrate the need for a standard yet adaptable framework. We have designed, implemented, and evaluated a novel curriculum tailored to the specific needs of our EM residency program. The curriculum improved participants' attitudes, preparedness, and self-reported behaviors regarding CC and HCD. This framework represents an example of a successful model to meet ACGME requirements.

SUBMITTER: Akhetuamhen AI

PROVIDER: S-EPMC9677360 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

A novel emergency medicine cultural competency curriculum addressing health care disparities.

Akhetuamhen Adesuwa I AI Ibiebele Abiye L AL Leibowitz Maren K MK Welch Sarah B SB Campbell Mobola M Shakeri Nahzinine N Bailitz John M JM

AEM education and training 20221121 6

<h4>Background</h4>Effective cultural competency (CC) training for future health professionals is an important first step towards improving healthcare disparities (HCD). The Accreditation Council for Graduate Medical Education (ACGME) now requires that institutions train residents and faculty members in CC relevant to the patient population they serve.<h4>Methods</h4>Using Kern's Model, we created and implemented a novel CC curriculum tailored to specific program needs in an emergency medicine r ...[more]

PMID: 36425792

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Project description:IntroductionEmergency medicine (EM) residency programs have variable approaches to educating residents on recognizing and managing healthcare disparities. We hypothesized that our curriculum with resident-presented lectures would increase residents' sense of cultural humility and ability to identify vulnerable populations.MethodsAt a single-site, four-year EM residency program with 16 residents per year, we designed a curriculum intervention from 2019-2021 where all second-year residents selected one healthcare disparity topic and gave a 15-minute presentation overviewing the disparity, describing local resources, and facilitating a group discussion. We conducted a prospective observational study to assess the impact of the curriculum by electronically surveying all current residents before and after the curriculum intervention. We measured attitudes on cultural humility and ability to identify healthcare disparities among a variety of patient characteristics (race, gender, weight, insurance, sexual orientation, language, ability, etc). Statistical comparisons of mean responses were calculated using the Mann-Whitney U test for ordinal data.ResultsA total of 32 residents gave presentations that covered a broad range of vulnerable patient populations including those that identify as Black, migrant farm workers, transgender, and deaf. The overall survey response was 38/64 (59.4%) pre-intervention and 43/64 (67.2%) post-intervention. Improvements were seen in resident self-reported cultural humility as measured by their responsibility to learn (mean responses of 4.73 vs 4.17; P < 0.001) and responsibility to be aware of different cultures (mean responses of 4.89 vs 4.42; P < 0.001). Residents reported an increased awareness that patients are treated differently in the healthcare system based on their race (P < 0.001) and gender (P < 0.001). All other domains queried, although not statistically significant, demonstrated a similar trend.ConclusionThis study demonstrates increased resident willingness to engage in cultural humility and the feasibility of resident near-peer teaching on a breadth of vulnerable patient populations seen in their clinical environment. Future studies may query the impact this curriculum has on resident clinical decision-making.

Project description:Audience and type of curriculumThis longitudinal leadership curriculum is designed for emergency medicine residents at all levels, with individual sessions designed for each residency year.Length of curriculumThis curriculum runs once annually over three to four years of emergency medicine residency.IntroductionLeadership is a vital skill for emergency physicians but is often passively taught during residency training. Strong leadership skills can lead to improved patient outcomes, but very few residency programs in any specialty and no emergency medicine residency programs have published comprehensive leadership training curricula.Educational goalsThe goals of this curriculum are to expose Emergency Medicine residents to the basics of leadership, to provide a graduated series of interactive, psychologically safe environments to explore individual leadership styles, to review interesting relevant literature, and to discuss leadership principles and experiences with senior leaders in our Emergency Department.Educational methodsThe educational strategies used in this curriculum include: brief lecture-style seminars, small group discussion and reflection, and a panel-style discussion.Research methodsThe educational content of this curriculum was evaluated by learners via feedback surveys after each session.ResultsCourse evaluations conducted in both 2017 and 2020 showed that more than 89% of resident participants found these sessions "useful" or "very useful." All residents surveyed agreed that leadership is an important topic for emergency medicine residency, and 76% felt that the inclusion of leadership content strengthened the residency's curriculum. Suggestions for future topics included handling personal conflict and discussing transitions in leadership during yearly residency promotions.DiscussionThe curriculum has been successfully implemented for seven years. It has proven to be sustainable and requires minimal resources. The residents report high satisfaction with the curriculum and agree that formal instruction on the topic of leadership is important to their on-shift performance and careers.TopicsLeadership, communication.

Project description:Audience and type of curriculumThis curriculum, designed and implemented at the Ronald O. Perelman Department of Emergency Medicine at NYU Langone Health, primarily targets third- and fourth-year emergency medicine (EM) residents, and is an immersive observation medicine rotation that can be integrated into existing emergency medicine residency training.Length of curriculumThe curriculum is designed for a dedicated rotation of two weeks for senior residents and can be expanded to 4 weeks.IntroductionObservation medicine is an extension of emergency medicine and is increasingly playing a role in the delivery of acute healthcare, with over half of all observation units (OUs) in the nation being led by emergency medicine.1 Despite this, many emergency medicine residencies have yet to establish a formal observation medicine curriculum. In a 2002 study by Mace and Shah, only 10% of emergency medicine residencies had a dedicated observation medicine rotation, despite 85% of emergency medicine residency directors believing this was an important part of emergency medicine training.2 The first description of a model longitudinal observation medicine curriculum did not appear until 2016.3 In order to prepare our graduates for the evolving demands of the EM workplace, we must provide diverse educational experiences that train and showcase the expanding skill set of future emergency physicians.Educational goalsThe primary goal of this observation medicine curriculum is to train current EM residents in short-term acute care beyond the initial ED visit. This entails caring for patients from the time of their arrival to the OU to the point when a final disposition from the OU is determined, be it inpatient admission or discharge to home.Educational methodsThe educational strategies used in this curriculum include experiential learning through supervised direct patient care, independent learning based on prescribed literature, and didactic teaching.Research methodsEducation content was evaluated by the learners through pre- and post-rotation surveys, as well as written attending evaluations describing the progress of the learners during the rotation.ResultsAll residents reported increases in the confidence of their abilities to perform observation care.DiscussionObservation medicine is an increasingly vital aspect of emergency medicine, but education in observation medicine has not developed in tandem with its implementation. A lack of observation medicine training represents a missed opportunity for each trainee to gain a robust understanding of the interface between inpatient and outpatient care, and how to arrive at the most appropriate disposition for ED patients. Considering the wide breadth of clinical conditions managed in OUs and the variability of OU management at various learning sites, the curriculum must be tailored to the specific unit to maximize effectiveness of the learning experience.TopicsObservation medicine, curriculum, education, clinical rotation.

Project description:IntroductionEmergency physicians are in a unique position to impact both individual and population health needs. Despite this, emergency medicine (EM) residency training lacks formalized education n the social determinants of health (SDoH) and integration of patient social risk and need, which are core components of social EM (SEM). The need for such a SEM-based residency curriculum has been previously recognized; however, there is a gap in the literature related to demonstration and feasibility. In this study we sought to address this need by implementing and evaluating a replicable, multifaceted introductory SEM curriculum for EM residents. This curriculum is designed to increase general awareness related to SEM and to increase ability to identify and intervene upon SDoH in clinical practice.MethodsA taskforce of EM clinician-educators with expertise in SEM developed a 4.5-hour educational curriculum for use during a single, half-day didactic session for EM residents. The curriculum consisted of asynchronous learning via a podcast, four SEM subtopic lecture didactics, guest speakers from the emergency department (ED) social work team and a community outreach partner, and a poverty simulation with interdisciplinary debrief. We obtained pre- and post- intervention surveys.ResultsA total of 35 residents and faculty attended the conference day, with 18 participants completing the immediate post-conference survey and 10 participants completing the two-month delayed, post-conference survey. Post-survey results demonstrated improved awareness of SEM concepts and increased confidence in participants' knowledge of community resources and ability to connect patients to these resources following the curricular intervention (25% pre-conference to 83% post-conference). In addition, post-survey assessment demonstrated significantly heightened awareness and clinical consideration of SDoH among participants (31% pre-conference to 78% post-conference) and increased comfort in identifying social risk in the ED (75% pre-conference to 94% post-conference). Overall, all components of the curriculum were evaluated as meaningful and specifically beneficial for EM training. The ED care coordination, poverty simulation, and the subtopic lectures were rated most meaningful.ConclusionThis pilot curricular integration study demonstrates feasibility and the perceived participant value of incorporating a social EM curriculum into EM residency training.

Dataset Information

A novel emergency medicine cultural competency curriculum addressing health care disparities.

Background

Methods

Results

Conclusions

Publications

A novel emergency medicine cultural competency curriculum addressing health care disparities.

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