What Do Physicians in Training Think About Cultural Competency in Health Care?

Cultural and linguistic competencies have been shown to enhance quality care delivered to ethnic and racial minorities. Various accreditation bodies such as the Joint Commission of Accreditation of Healthcare Organizations (JCAHO) have called for training in cultural and linguistic diversity. On the policy front, laws mandating cultural competency training of health professionals were enacted in three states (New Jersey, California and Washington) and others have moved to introduce similar legislation. All in all, the subject of mandating health professionals\u27 education has been controversial. Historically traditional measures of continuing education mandate only attendance not learning. While states grapple with the issue of educational mandates of its health ,., workforce related to cultural competency, it is paramount to assess providers\u27 perceptions, knowledge and existing practices related to this issue. Maryland ranks second nationally with respect to active physicians, and 6th in training of resident physicians. The state is highly diverse with its population being 41% racial/ethnic minority, and 12.2% being foreign born in 2006. Maryland has enacted its first law on encouraging training of medical providers on health disparities of minority populations in health in 2003. The state went further in attempting to require cultural competency training as a pre-requisite for medical school graduation, physician licensing and re-licensing in the legislative session of 2006 and 2007. These measures failed as a result of fierce objection by academic institutions and governing boards of health professions. The Office of Minority Health and Health Disparities (OMHHD) within the Maryland Department of Health and Mental Hygiene set out to ascertain issues related to cultural competency training in the state. To that end, OMHHD partnered with four teaching hospitals to investigate existing practices and perceptions related to cultural competency training among internal medicine and anesthesia residents. An electronic survey was developed and disseminated to residency directors in participating hospitals. The survey included the following domains. (1) Participants\u27 demographics; (2) assessment of existing cultural competency training; (3) measure of attitudes and perceptions related to cultural competency training (A four point Likert Scale); and, (4) knowledge of national and state guideline pertaining to cultural competency. A total of fifty-five surveys were completed and analyzed. Analysis included descriptive statistics and bi-variate analysis. Perceptions and attitudes were analyzed for stratified groups of various demographic characteristics