Navin R Changoor1,2, Nidhi R Udyavar1, Megan A Morris1, Maya Torain1, John T Mullen3, Tara S Kent4, Douglas S Smink1,5, Alexander Green6, Adil H Haider1,5. 1. Center for Surgery and Public Health, Harvard Medical School and Harvard School of Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, MA. 2. Department of Surgery, Howard University College of Medicine, Washington, DC. 3. Department of Surgery, Massachusetts General Hospital, Boston, MA. 4. Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA. 5. Department of Surgery, Brigham and Women's Hospital, Boston, MA. 6. Department of Internal Medicine, Massachusetts General Hospital, Boston, MA.
Abstract
OBJECTIVE: We sought to understand the experiences of surgical residents and faculty with treating culturally diverse patients, and identify recommendations for establishing and implementing structured cultural competency training. SUMMARY BACKGROUND DATA: Cultural competency training for medical professionals could reduce healthcare disparities, yet is currently not a standard part of surgical residency training. Few studies have explored the perspectives of surgical residents and faculty on the skills needed to provide cross-cultural care. STUDY DESIGN: A purposeful sample of surgical residents and faculty from 4 academic institutions was recruited for semistructured qualitative interviews. We developed an in-depth interview guide and performed interviews to thematic saturation. Interviews were audio-recorded, transcribed, and analyzed using grounded theory methodology. RESULTS: We interviewed 16 attending surgeons and 15 surgical residents. Participant demographics were: male (51.6%), White (58.1%), Black (9.7%), Asian (22.5%), and Hispanic (9.7%). Four main themes emerged from the data: 1) aspects of culture that can inform patient care; 2) specific cultural challenges related to surgical care, including informed consent, pain management, difficult diagnoses and refusal of treatment, emergency situations, and end-of-life issues; 3) need for culturally competent care in surgery to navigate cultural differences; 4) perceived challenges and facilitators to incorporating cultural competency into the current training paradigm. CONCLUSIONS: Surgeons identified the need to provide better cross-cultural care and proposed tenets for training. Based on these findings, we suggest the development and dissemination of a cultural dexterity training program that will provide surgeons with specific knowledge and skills to care for patients from diverse sociocultural backgrounds.
OBJECTIVE: We sought to understand the experiences of surgical residents and faculty with treating culturally diverse patients, and identify recommendations for establishing and implementing structured cultural competency training. SUMMARY BACKGROUND DATA: Cultural competency training for medical professionals could reduce healthcare disparities, yet is currently not a standard part of surgical residency training. Few studies have explored the perspectives of surgical residents and faculty on the skills needed to provide cross-cultural care. STUDY DESIGN: A purposeful sample of surgical residents and faculty from 4 academic institutions was recruited for semistructured qualitative interviews. We developed an in-depth interview guide and performed interviews to thematic saturation. Interviews were audio-recorded, transcribed, and analyzed using grounded theory methodology. RESULTS: We interviewed 16 attending surgeons and 15 surgical residents. Participant demographics were: male (51.6%), White (58.1%), Black (9.7%), Asian (22.5%), and Hispanic (9.7%). Four main themes emerged from the data: 1) aspects of culture that can inform patient care; 2) specific cultural challenges related to surgical care, including informed consent, pain management, difficult diagnoses and refusal of treatment, emergency situations, and end-of-life issues; 3) need for culturally competent care in surgery to navigate cultural differences; 4) perceived challenges and facilitators to incorporating cultural competency into the current training paradigm. CONCLUSIONS: Surgeons identified the need to provide better cross-cultural care and proposed tenets for training. Based on these findings, we suggest the development and dissemination of a cultural dexterity training program that will provide surgeons with specific knowledge and skills to care for patients from diverse sociocultural backgrounds.
Authors: Numa P Perez; Maggie L Westfal; Sahael M Stapleton; Fatima Cody Stanford; Cornelia L Griggs; Janey S Pratt; David C Chang; Cassandra M Kelleher Journal: Surg Obes Relat Dis Date: 2019-12-04 Impact factor: 4.734
Authors: Rachel B Atkinson; Gezzer Ortega; Alexander R Green; Maria B J Chun; David T Harrington; Pamela A Lipsett; John T Mullen; Emil Petrusa; Emma Reidy; Adil H Haider; Douglas S Smink Journal: J Surg Educ Date: 2020-07-30 Impact factor: 2.891
Authors: Jasmine A Khubchandani; Rachel B Atkinson; Gezzer Ortega; Emma Reidy; John T Mullen; Douglas S Smink Journal: J Surg Res Date: 2021-12-20 Impact factor: 2.192
Authors: Meera Joshi; Stephanie Archer; Abigail Morbi; Hutan Ashrafian; Sonal Arora; Sadia Khan; Graham Cooke; Ara Darzi Journal: JMIR Form Res Date: 2022-02-11
Authors: Adil Haider; Rachel R Adler; Eric Schneider; Tarsicio Uribe Leitz; Anju Ranjit; Christina Ta; Adele Levine; Omar Harfouch; Danielle Pelaez; Lisa Kodadek; Laura Vail; Claire Snyder; Danielle German; Susan Peterson; Jeremiah D Schuur; Brandyn D Lau Journal: JAMA Netw Open Date: 2018-12-07