The Case: Lee A. Zon, MD, medical director, Care for All Hospital, just finished reviewing the monthly patient-satisfaction surveys, generally completed on discharge by patients’ English-speaking family members or advocates. During the past three months, patient complaints have been on the rise regarding physicians’ lack of communication skills and inability to clearly convey the meaning of inpatient testing and procedures.
Dr. Zon is puzzled. There have been numerous opportunities for staff members to create professional development activities and resources to address cultural and linguistic competencies, so why is this a growing problem? He schedules a meeting with the CME director to review in-house courses addressing this content area, including how often they are held and who attends them.
Closing Disparity Gaps
Why are heath disparities and cultural competence important topics to cover in CME?
Overstreet: Clinicians’ perceptions and attitudes toward patients can be influenced by a patient’s race or ethnicity, often in subtle ways, and diagnostic and treatment practices may vary according to the race or ethnicity of the patient.
Parochka: Several states have taken steps to improve patient outcomes by encouraging healthcare professionals to exhibit more tolerance for cultural and linguistic differences. For example, California’s AB 1195, which went into effect in 2006, mandates that CME providers meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. New Jersey has also mandated training on cultural and linguistic competency; Arizona, Illinois, and New York are considering similar bills.
Overstreet: While providing education to address disparities is a requirement for CME providers in some states, all providers can play a role in addressing this important public health issue.
What can CME professionals do to appropriately address cultural and linguistic disparities?
Overstreet: Providers should understand the demographics of learners—and of the patient populations treated by those learners—to ensure that the education they offer addresses true needs and accurately reflects the realities of clinical practice. Educators should also work with expert in planning content that mirrors patient demographics for specific diseases.
Parochka: Some providers have created cultural diversity forms that include the definitions of cultural and linguistic competency and ask the presenter, “If there is relevant cultural diversity information relating to age, gender, race, socioeconomics, sexual orientation, religion, language, ethnicity, etc., that affects the care of the patient, you are requested to include this information in your presentation.” Presenters can be asked to outline the various diversities that relate to demographics, diagnosis, and treatment and document what information will be included in their content.
What could CME professionals do to become familiar with cultural and linguistic competence?
Parochka: CME professionals could begin by conducting a literature search on these topics and reviewing self-assessment tools available on the Internet. The National Center for Cultural Competence has self-assessment tools for organizations and practicing physicians. These assessment tools can be used to describe one’s own cultural background and explore potential biases.
Karen Overstreet, EdD, RPh, FACME, CCMEP, is executive director, instructional design and outcomes with Medscape Education, Blue Bell, Pa. Reach her at Koverstreet@medscape.net.
Jacqueline Parochka, EdD, FACME, is president and CEO, Excellence in Continuing Education Ltd., Gurnee, Ill.; and partner, PTR Educational Consultants. Reach her at JacquelineParochka@comcast.net.
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