Cultural Competency Matters
Regina Stokes Offodile, MD, CHSE, is an assistant professor in the Department of Medical Education, Division of Clinical Skills and Competencies at Meharry Medical College. She currently instructs first- and second-year medical students on clinical skills, physician patient interaction, and clinical correlations of breast disease. Her research interests include cultural competency. She is pursuing a Masters in Health Professions Education at Vanderbilt University. This is part of a series of posts looking at diversity in the health care workforce.
Cultural diversity in the health care workforce may be something that many have not thought about or considered a topic of concern. It is a concept that health care providers, health care delivery systems, and hospitals need to have on their radar. Having a culturally diverse workforce is a matter of patient safety. Employing a diverse workforce increases the likelihood of having employees who understand how a wide cross section of patients looks at disease, its diagnosis and treatment. A diverse workforce may also address the language barriers and cultural disconnect that may exist in some health care delivery systems.
In order to meet the increasing culturally diverse patrons of health care, there will be a need to have a corresponding change in the health care workforce. There will also be a burden on medical schools and residency training programs to produce culturally competent physicians, and to increase the number of physicians who are able to interact with and treat a culturally diverse patient population.
More pressing than a culturally diverse workforce is a culturally competent health care workforce. “Providing culturally competent care also serves as a means to ensuring that cultural issues or behaviors that may inhibit delivery of care or affect maintenance of treatment plans will be identified and reconciled” (Beverly Moy, "American Society of Clinical Oncology policy statement: Opportunities in the patient protection and affordable care act to reduce cancer care disparities," Journal of Clinical Oncology, Vol. 29, # 28, October 2011, 3816-3824).
Cultural diversity spans race, religion, disability, sexual orientation and gender identity. One thing that I am interested in pursuing is the impact of medical simulation and the use of standardized patients (individuals trained to deliver medical histories and reproducible physical examinations) to increase cultural competency among medical students and residents. By “practicing” and by interacting with culturally diverse standardized patients, students and residents can develop cultural competency skills.
Providing each medical student and resident with multiple opportunities or hours of face time with simulated patients will impact their cultural competency. The students can master these skills in low stress, low stakes environments. This technology may enable physicians to master communication and cultural competency skills that will assist them in serving their patients and increasing patient safety. This will ultimately produce increasing numbers of culturally diverse and culturally competent health care workers.
The mission of the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College is to increase the diversity of health policy leaders in the social, behavioral, and health sciences, particularly sociology, economics, and political science, who will one day influence health policy at the national level.