An examination of Cultural Competence Training in US Medical Education Guided by the Tool for Assessing Cultural Competence Training

In the United States, medical students must demonstrate a standard level of “cultural competence,” upon graduation. Cultural competence is most often defined as a set of congruent behaviors, attitudes, and policies that come together in systems, organizations, and among professionals to enable effective work in cross-cultural situations. The Association of American Medical Colleges developed the Tool for Assessing Cultural Competence Training (TACCT) to assist schools in developing and evaluating cultural competence curricula to meet these requirements. This review uses the TACCT as a guideline to describe and assess pedagogical approaches to cultural competence training in US medical education and identify content gaps and opportunities for curriculum improvement. A total of 18 programs are assessed. Findings support previous research that cultural competence training can improve the knowledge, attitudes, and skills of medical trainees. However, wide variation in the conceptualization, implementation, and evaluation of cultural competence training programs exists, leading to differences in training quality and outcomes. More research is needed to establish optimal approaches to implementing and evaluating cultural competence training that incorporate cultural humility, the social determinants of health, and broader structural competency within the medical system

East Norfolk Sixth Form College: report from the Inspectorate (FEFC inspection report; 72/97 and 05/01)

Comprises two Further Education Funding Council (FEFC) inspection reports for the periods 1996-97 and 2000-0

The treatment of depression and simple phobia through an interpreter in the North East of England : a case study.

A 35-year-old Middle Eastern woman, experiencing moderate depression compounded by animal phobia was referred to an Improving Access to Psychological Therapies (IAPT) service. Shared understandings were gradually developed using written functional analyses translated in session. Activity scheduling was integrated with graded exposure to increase access to positive reinforcement. Questionnaires and subjective data indicated a reduction in phobic avoidance and functioning increased. Despite the complexity of working as a triad, a positive therapeutic relationship was achieved with increased mutual cultural understanding. Indirect communication led to difficulties maintaining guided discovery and focus. There is limited evidence to support CBT when delivered through an interpreter. IAPT recommendations suggest staff reflect the community; the North East has one of the lowest foreign-born populations in the UK indicating that IAPT services may be ill prepared to work with ethnic minorities. Learning points for the therapist were: maintain simplicity, take time to formulate incorporation of cultural difference, and use transcultural interventions. The interpreter brought advantages; providing means of communication and understanding of cultural differences. Disadvantages were the potential for bias or lost information, increased time and complexity of delivering therapy. This case indicates a deficit in high intensity training and lack of literature to support therapists

Nursing Students\u27 Self-Efficacy and Attitude: Examining the Influence ofthe Omaha System In Nurse Managed Centers

Self-efficacy, or confidence, as an outcome behavior has been identified as influencing nursing job satisfaction and retention. Clinical learning environments and teaching strategies that build and support perceived self-efficacy are critical aspects of preparing new nurses for their entry and continuing role as professional nurses in today\u27s information-intensive data-management healthcare environment. The purpose of this pre-test post-test study is to measure, using the C-scale (Grundy, 1992), nursing students\u27 self-efficacy to perform patient assessment in Nurse Managed Centers (NMC) after one semester of using the Omaha System documentation framework. Nursing students\u27 attitudes of preparation for using Standardized Nursing Languages (SNL) in the future was also examined. Bandura\u27s (1977, 19986) theoretical model of self-efficacy provided the conceptual framework. Students\u27 overall self-efficacy scores increased significantly over the 12 week study. Use of the Omaha System \u27prepared a little\u27 to \u27very prepared\u27 90% of student nurses for future use of SNL. Continued use of the Omaha System documentation framework in Nurse Managed Center clinicals as a tool for understanding SNL is recommended.