Promoting Physicians' Cultural Competence Through Reflective Practice

通过反思实践提升医生文化能力

• 批准号: 7139824
• 负责人: PAUL M. HAIDET
• 金额: $ 17.46万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-05 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7139824
• 关键词: behavioral /social science research tag; clinical research; culture; curriculum; education evaluation /planning; educational resource design /development; health disparity; human subject; information dissemination; medical education; method development; patient care management

DESCRIPTION (provided by applicant): A large body of research documents disparities in cardiovascular and pulmonary diseases, despite major improvements in the overall national health. In an attempt to reduce disparities, educational governing bodies have called for interventions to improve culturally appropriate care for patients with diverse values, beliefs, and behaviors. While many innovations exist to foster cultural competence, there is very little data to guide incorporation of such innovations across the continuum of medical education, or to evaluate their effectiveness. Further, many efforts to promote cultural competence have been limited by modest scope or a lack of a guiding conceptual framework. In this project, we will use the framework of 'reflective practice' to guide implementation of an integrated curriculum in cultural competence at Baylor and to help ensure the institutional environment reinforces students' acquisition of knowledge, skills, and attitudes. Reflective practice represents an awareness of the basis for and impact of ones' actions before, during, and after interpersonal encounters. In educating for cultural competence, reflective practice is particularly important, because of the many implicit attitudes that drive behaviors. In order for a physician to alter their behaviors, they need to have an understanding of their own baseline attitudes, an ability to hear and understand the patient's perspective, and be able to weigh the effects of their own behaviors as they are enacting them. Our project team consists of a multicultural, multidisciplinary group of investigators, internationally recognized 'expert coaches,' and a national advisory panel, all committed to modeling reflective practice in the execution of our project initiatives. Our first aim is to bring the content of Baylor's curriculum up to the standard for cultural competence curricula recently published by the AAMC, and to strengthen this curriculum with a consistent focus on cross-cultural reflective practice. By building partnerships with curriculum leaders, our team will, identify curricular gaps and adopt and/or design interventions to address those gaps. Our second aim is to build on our prior work to implement valid tools to assess learners' achievement of cultural competence. A primary purpose of these assessments will be to provide constructive feedback to inform and guide learners' self-reflections. Our third aim is to measure and positively influence the 'hidden curriculum.' The hidden curriculum refers to the supportiveness of the informal institutional environment with respect to teaching cultural competence, and, if ignored, may undermine even the most effective formal teaching activities. Consistent with a commitment to reflective practice, we will continually use evaluation data to refine grant activities. We will actively disseminate lessons learned, including innovative products such as assessment tools. We will partner with leaders at Baylor, national advisory panel members, and the Texas Medical Association to assure widespread dissemination. (End of Abstract)

描述（由申请人提供）： 尽管国民整体健康状况有了重大改善，但大量研究记录了心血管和肺部疾病的差异。为了减少差异，教育管理机构呼吁采取干预措施，改善对具有不同价值观、信仰和行为的患者的文化上适当的护理。尽管存在许多创新来培养文化能力，但很少有数据可以指导这些创新在整个医学教育中的应用，或评估其有效性。此外，许多提升文化能力的努力都因范围有限或缺乏指导概念框架而受到限制。在这个项目中，我们将利用“反思性实践”的框架来指导贝勒大学文化能力综合课程的实施，并帮助确保制度环境加强学生对知识、技能和态度的获取。反思性实践代表了对人际交往之前、之中和之后的行为基础和影响的认识。在文化能力教育中，反思实践尤为重要，因为有许多隐含的态度驱动着行为。为了让医生改变自己的行为，他们需要了解自己的基本态度，能够倾听和理解患者的观点，并能够在实施行为时权衡自己行为的影响。我们的项目团队由一个多文化、多学科的研究人员小组、国际公认的“专家教练”和一个国家顾问小组组成，他们都致力于在项目计划的执行中建立反思性实践模型。我们的首要目标是使贝勒大学的课程内容达到 AAMC 最近发布的文化能力课程标准，并以 一贯注重跨文化反思实践。通过与课程负责人建立合作伙伴关系，我们的团队将确定课程差距并采取和/或设计干预措施来解决这些差距。我们的第二个目标是在我们之前的工作基础上实施有效的工具来评估学习者文化能力的成就。这些评估的主要目的是提供建设性反馈，以告知和指导学习者的自我反思。我们的第三个目标是衡量并积极影响“隐藏课程”。隐性课程是指非正式制度环境对文化能力教学的支持，如果忽视，甚至可能破坏最有效的正式教学活动。与反思实践的承诺相一致，我们将不断使用评估数据来完善资助活动。我们将积极传播经验教训，包括评估工具等创新产品。我们将与贝勒大学的领导、国家顾问小组成员和德克萨斯医学协会合作，确保广泛传播。 （摘要完）