Many resident physicians feel unprepared to care for culturally divers...( am mailed surveys to about 3500 reside...),Health

am mailed surveys to about 3,500 residents in the final years of their training programs in seven specialties at 149 academic health centers across the U.S. Of the more than 2,000 respondents, almost all acknowledged the importance of considering a patient's culture when providing care. Many of them agreed that culturally based difficulties could result in such problems as longer office visits and patients' not understanding or complying with instructions.

Although only a few residents indicated that they felt unprepared in response to general questions about caring for patients of different cultures or ethnic and racial minorities, when asked about specific situations such as caring for patients who mistrust the U.S. health system, have health beliefs that conflict with Western medicine or are recent immigrants 20 to 25 percent replied that they felt unprepared. A similar percentage felt they could not recognize mistrust in patients or identify cultural or religious customs that might have an impact on care. As a comparison, only 2 to 3 percent of respondents indicated not feeling ready to handle typical clinical problems.

When questioned about their residency experiences, one third to one half the respondents reported receiving little or no training in handling such situations as properly addressing patients from other cultures, understanding different family decision-making structures, or working with interpreters. Even in programs that offer cross-cultural training, significant numbers of residents reported no instruction in key areas. Lack of time was cited most frequently as a barrier to providing cross-cultural care; and other problems mentioned included poor access to interpreters, absence of written materials in needed languages and limited experience. A lack of good role models or mentors for cross-cultural care was reported by 30 percent of respondents, and more than 60 percent reported not being evaluated on cross-cultural ski
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Contact: Donita Boddie
dboddie@partners.org
617-724-5627
Massachusetts General Hospital
6-Sep-2005

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