JAMA Study: Many Resident Physicians Are Not Well Prepared to Provide Cross-Cultural Care

Half Have Not Been Trained in Key Skills, Though Wide Majority Say Cultural Competency Is Important

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New York City, September 6, 2005—Tomorrow's doctors may not be prepared to care for an increasingly racially and ethnically diverse U.S. population, according to an article published in the September 7th issue of the Journal of the American Medical Association. The research was supported by The Commonwealth Fund and The California Endowment.

The nationally representative survey of resident physicians in their final year of training reveals that about half had received little or no training during their residency in specific areas related to providing culturally competent care, including understanding how to address patients from different cultures (50%), how to identify patient mistrust (56%), and understanding relevant religious beliefs (50%) or relevant cultural customs (48%) that impact care.

"If our goal is a health system that provides safe, effective, and patient-centered health care to all Americans, we must address these gaps in training," said Commonwealth Fund senior program officer, Anne Beal, M.D.

In contrast to their reported experience, nearly all residents said it was important to consider a patient's culture when providing care. Seventy percent said it was "very important" and one-quarter (26%) said it was "moderately important." Residents' reported ability to provide cross-cultural care lags behind their preparedness in clinical and technical areas, according to the study, "Resident Physicians' Preparedness to Provide Cross-Cultural Care," by lead author Joel S. Weissman, of the Institute for Health Policy at Massachusetts General Hospital, and others.

About one-quarter of residents felt unprepared to deal with patients whose health beliefs are at odds with Western medicine (25%), patients who have mistrust in Western medicine (28%), or patients who are new immigrants (25%). One-fifth of residents said they were not prepared to deal with patients whose religious beliefs may affect care (20%).

"Although physicians recognize that cultural competency is a necessary component of high-quality health care, they are not being given the tools they need to provide this care," said Stephen C. Schoenbaum, M.D., executive vice president at The Commonwealth Fund. "We are shortchanging physicians and patients by not preparing doctors with the interpersonal and communication skills they will need to provide the best care to all their patients."

Publication Details

Publication Date: September 6, 2005

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