Cultural Humility Curriculum to Address Healthcare Disparities for Emergency Medicine Residents.

Autor: Tsuchida RE; University of Wisconsin, School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin., Doan J; University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan., Losman ED; University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan., Haggins AN; University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan., Huang RD; University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan., Hekman DJ; University of Wisconsin, School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin., Perry MA; University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan.
Jazyk: angličtina
Zdroj: The western journal of emergency medicine [West J Emerg Med] 2023 Mar 06; Vol. 24 (2), pp. 119-126. Date of Electronic Publication: 2023 Mar 06.
DOI: 10.5811/westjem.2023.1.58366
Abstrakt: Introduction: Emergency 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.
Methods: At 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.
Results: A 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.
Conclusion: This 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.
Databáze: MEDLINE
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