AIM:To assess and teach cultural competency skills at the fellowship training level through the use of objective structured clinical examinations(OSCEs).METHODS:We revised four scenarios to infuse a specific focus on ...AIM:To assess and teach cultural competency skills at the fellowship training level through the use of objective structured clinical examinations(OSCEs).METHODS:We revised four scenarios to infuse a specific focus on cross-cultural care,and to render them appropriate for gastroenterology fellows.Three are discussed here:(1)Poor Health Literacy;(2)Disclosing/Apologizing for a Complication to a Patient Who Mistrusts the Healthcare System;and(3)Breaking Bad News to a Fatalistic Patient.A fourth case emphasizing shared decision-making will be described elsewhere.Four stations were completed by fellows and observed live by four faculty members,and the fellows’performance was assessed.RESULTS:Eleven fellows from four programs participated in the four OSCE.In the"Poor Health Literacy"case,18%(2/11)of participants recognized that the standardized patient(SP)had below-basic health literacy.None successfully evaluated the SP’s reading skills in a culturally-sensitive manner.In"Disclosing/Apologizing for a Complication",4/11(36%)personally apologized for the complication.1/11 recognized the SP’s mistrust of the medical system.With"Breaking Bad News",27%(3/11)explored the patient’s values to identify her fatalistic beliefs.CONCLUSION:OSCEs can be used to assess deficiencies in culturally-competent care at the fellowship level.OSCEs also afford fellowships the opportunity to inform future training curricula.展开更多
文摘AIM:To assess and teach cultural competency skills at the fellowship training level through the use of objective structured clinical examinations(OSCEs).METHODS:We revised four scenarios to infuse a specific focus on cross-cultural care,and to render them appropriate for gastroenterology fellows.Three are discussed here:(1)Poor Health Literacy;(2)Disclosing/Apologizing for a Complication to a Patient Who Mistrusts the Healthcare System;and(3)Breaking Bad News to a Fatalistic Patient.A fourth case emphasizing shared decision-making will be described elsewhere.Four stations were completed by fellows and observed live by four faculty members,and the fellows’performance was assessed.RESULTS:Eleven fellows from four programs participated in the four OSCE.In the"Poor Health Literacy"case,18%(2/11)of participants recognized that the standardized patient(SP)had below-basic health literacy.None successfully evaluated the SP’s reading skills in a culturally-sensitive manner.In"Disclosing/Apologizing for a Complication",4/11(36%)personally apologized for the complication.1/11 recognized the SP’s mistrust of the medical system.With"Breaking Bad News",27%(3/11)explored the patient’s values to identify her fatalistic beliefs.CONCLUSION:OSCEs can be used to assess deficiencies in culturally-competent care at the fellowship level.OSCEs also afford fellowships the opportunity to inform future training curricula.
