Cultural competency training has an impact

It doesn't matter whether it's a continuing medical education lecture on cultural competency or a class on medical Spanish. Cultural competency training of any sort makes a difference in physicians' knowledge, skills and attitudes, according to a pair of studies from Johns Hopkins University School of Medicine researchers. It also means patients will be more satisfied with their care.

"The study didn't tell us what the most effective thing to do is, but our study did show that any time you try to bring cultural issues to peoples' awareness, they are better off," said Mary Catherine Beach, MD, MPH, lead author of "Cultural Competence: A Systematic Review of Health Care Provider Educational Interventions" in the April issue of Medical Care.

"This has impacted how I teach students," she said. "I now feel if I bring it up [to medical students] it will actually make a difference."

Dr. Beach and her co-authors sifted through more than 4,000 studies to find 281 relating to cultural competency training. From this they culled 34 studies on cultural competency interventions, most with pre- and post-intervention evaluations, that targeted physicians or nurses and took place in the United States.

The literature review found that 17 of 19 studies evaluating the health professional's knowledge of cultural concepts showed improvement.

Of 25 studies that evaluated the effect of cultural competence training on health professionals' attitudes, 21 showed a beneficial effect, with the most common attitude measured being learner confidence in knowledge and skills related to black, Asian, Latino and Native American patients.

Of the 14 studies evaluating the impact of cultural competency training on health professionals' skills, all demonstrated an improvement.

Participants in one study were given 16 one-hour sessions in which they practiced communication skills with volunteers. By the end, they were significantly more competent interviewing non-English-speaking people.

Three studies evaluated patient outcomes. All three reported favorable patient satisfaction measures, and one demonstrated improved patient compliance.

Further research by Eboni Price, MD, MPH, in "A Systematic Review of the Methodological Rigor of Studies Evaluating Cultural Competence Training of Health Professionals" published in the June issue of Academic Medicine, found that most studies on cultural competence reported on the outcomes for the participating doctors and nurses, not the patients. Few measured patient compliance and health outcomes or what method of cultural competency training worked best.

The AMA's Institute for Ethics recently did a national survey of doctor attitudes regarding racial disparities in health care, finding that 75% of physicians believe they are in a good position to improve minority care.

In January, the American Medical Association, the National Medical Assn., the National Hispanic Medical Assn. and more than 30 other health-related organizations teamed up to form the Commission to End Health Care Disparities.