Data contained in this manuscript have been presented at the Society of General Internal Medicine and at the Society of Behavioral Medicine annual meetings.
Internal Medicine Residents' Perceptions of Cross-Cultural Training
Barriers, Needs, and Educational Recommendations
Article first published online: 2 MAY 2006
Journal of General Internal Medicine
Volume 21, Issue 5, pages 476–480, May 2006
How to Cite
Park, E. R., Betancourt, J. R., Miller, E., Nathan, M., MacDonald, E., Ananeh-Firempong, O. and Stone, V. E. (2006), Internal Medicine Residents' Perceptions of Cross-Cultural Training. Journal of General Internal Medicine, 21: 476–480. doi: 10.1111/j.1525-1497.2006.00430.x
- Issue published online: 2 MAY 2006
- Article first published online: 2 MAY 2006
- graduate education;
BACKGROUND: Physicians increasingly face the challenge of managing clinical encounters with patients from a range of cultural backgrounds. Despite widespread interest in cross-cultural care, little is known about resident physicians' perceptions of what will best enable them to provide quality care to diverse patient populations.
OBJECTIVES: To assess medicine residents' (1) perceptions of cross-cultural care, (2) barriers to care, and (3) training experiences and recommendations.
DESIGN, SETTING, AND PATIENTS: Qualitative individual interviews were conducted with 26 third-year medicine residents at Massachusetts General Hospital in Boston (response rate=87%). Interviews were recorded, transcribed, and analyzed.
RESULTS: Despite significant interest in cross-cultural care, almost all of the residents reported very little training during residency. Most had gained cross-cultural skills through informal learning. A few were skeptical about formal training, and some expressed concern that it is impossible to understand every culture. Challenges to the delivery of cross-cultural care included managing patients with limited English proficiency, who involve family in critical decision making, and who have beliefs about disease that vary from the biomedical model. Residents cited many implications to these barriers, ranging from negatively impacting the patient-physician relationship to compromised care. Training recommendations included making changes to the educational climate and informal and formal training mechanisms.
CONCLUSIONS: If cross-cultural education is to be successful, it must take into account residents' perspectives and be focused on overcoming residents' cited barriers. It is important to convey that cross-cultural education is a set of skills that can be taught and applied, in a time-efficient manner, rather than requiring an insurmountable knowledge base.