At present, New Jersey requires four CME units of culturally
competent care education for licensure and/or re-licensure and
California mandates every CME course include a culturally competent care component.
Hospitals, too, soon may be accountable for culturally competent care. “The Joint Commission is exploring [culturally
competent care] education for its medical and nursing staffs,”
Haynes says. The organization accredits and certifies more
than 15,000 health care organizations and programs in the
United States.
In addition, the Accreditation Council of Graduate Medical
Education is requiring culturally competent care education for
medical residency programs. While all of the council’s core
competencies are related to culturally competent care, two in
particular focus on it:
• Patient Care: Residents must “demonstrate sensitivity and
responsiveness to patients’ culture, age, gender and disabilities.”
• Professionalism: Residents must “demonstrate sensitivity
and responsiveness to fellow health care professionals’ culture, age, gender and disabilities.”
The AAOS received CME accreditation for the CD and guidebook, and a physician can claim a maximum of six Category 1
credits toward the AMA Physician’s Recognition Award.
TAKING IT TO THE RESIDENTS
Recognizing that directors of orthopaedic residency programs
would appreciate a short, stimulating seminar on culturally competent care targeted to residents, the academy stepped in to
fill the void with “Culturally Competent Care: An Orthopaedist’s
Responsibility,” the third component of the Culturally Competent Care Education Initiative.
Tapping the expertise of the DAB once again, the AAOS
developed a 60- to 90-minute, interactive program, including
a PowerPoint presentation based on case-study patient profiles, statistics and cultural background information. The challenge CD and guidebook also are given to each participant as
additional resources.
While the core content of the seminar is the same, “the
presentations are tailored to the demographics and needs and
requests of each residency program,” Jimenez says.
Key to the success of this program is the academy’s provision of an orthopaedic surgeon, often from the DAB, to serve
as faculty. Residents have the opportunity to ask questions
about the material presented and evaluate the session at its
conclusion.
Having served as seminar faculty, Rao says that residents
often are “pleasantly surprised about the program. They don’t
know what to expect. After we try to heighten their awareness
of various cultures, they realize that their communication with
patients may need to be tweaked. They understand that this
will improve their patient care and the patient’s perception of
them.”
Needing only to supply a lecture or training room with
audiovisual capability, residency directors have heartily welcomed the seminar. Starting in 2007 through the end of
2008, the AAOS will have visited 23 sites, with another 20
scheduled for 2009.
‘BUT I DON’T THINK I’M BIASED’
“Many physicians wonder how they might be capable of
bias and some are skeptical that they might deliver
‘biased’ or inappropriate care … When time and specific
history-taking is limited, we all tend to simplify our deci-sion-making process by using ‘categories …’ These categories, which may include subconscious ways of
interpreting a patient’s symptoms or deciding upon his/her
ability to manage a treatment plan, are sometimes based
on stereotypes about race, class, disability, sexual orientation, immigrants, and so on.”
Excerpt from the Culturally Competent Care Guidebook
FUTURE PLANS
With a CD, a companion guidebook and a seminar for residents,
what’s the next logical extension of this product line and the
DAB?
“We have been thinking about repurposing what we’re
doing,” Hackett says. “Many of the culturally competent care
issues for orthopaedic surgeons are the same for other medical
specialties. Why have everyone reinvent the wheel? We may
want to roll out our culturally competent care products beyond
orthopaedics.”
With “repurposing” in mind, Haynes says that efforts are
under way to move the case-study quiz from CD to an online
platform, which may make it more accessible and possibility
adapt its content to non-orthopaedic medical societies.
In addition to taking the seminar to more residency programs, the AAOS wants to expand its reach with a program targeted to CME course directors.
Also, “we are looking at developing an annual symposium
aimed at CME course directors to help them incorporate relevant culturally competent care issues into their courses,”
Lewis says.
Whatever direction the Culturally Competent Care Education Initiative takes, academy members can be certain that
any new component will help them continue to treat their
patients’ physical ailments in light of their cultural and lifestyle practices, Lewis says.
“After all,” she adds, “our care doesn’t end in the operating room.”
Connie Arkus is a Chicagoland consultant and managing editor of ASGENews.
She may be reached at connie76455@comcast.net.
THE JANUARY 2009 SIGNATURE STORY features the Chicago-based
Medical Library Association, a 4,000-member association of health sciences librarians that has been working with health care providers for
more than a century to improve access to health care information. As
part of an effort to engage and educate patients, it recently completed
the pilot for its Health Information Literacy Research Project, the purpose
of which was to develop a curriculum for training doctors and nurses on
the importance of consumer health education. For more information, visit
www.mlanet.org.
