Transcript Slide 1

Cultural Competence Clinic:
Effectively Working with Arab American Muslim Patients
Brian D. Smith, Department of Psychiatry, Michigan State University
Results
 Simple t-tests revealed mean differences on two outcome measures,
knowledge (t(197) = 2.32; p < .05; Mean difference = 2.67) and selfefficacy (t(197) = 2.77; p < .01; Mean difference = .36)
 These differences were only found in the experimental group and were
specific to Arab American Muslim cultural competence
 Knowledge -- MTreatment = 24.86; MControl = 22.19
(M stands for mean)
 Self-efficacy -- MTreatment = 2.80; MControl = 2.45
Introduction
 Cultural competence is a set of skills, knowledge and attitudes
that enable effective work in cross-cultural situations.
 There is growing evidence that improving the cultural
competence of healthcare providers reduces health disparities,
including access to and outcomes of care.
 Ours is an increasingly diverse society. Arab Americans, in
particular, are one of the fastest growing populations in the
United States, increasing by more than 43% between 1990 and
2000.
 The largest concentration of Arab Americans in the United
States is in the Metropolitan Detroit area, a population of nearly
half a million.
 Although most Arab Americans practice Christianity, Muslims
represent the fastest growing part of the Arab American
community.
 Research supports the effectiveness of active learning, including
simulation-based training.
 However, the cultural competence curriculum in medical school
has often been limited to more traditional instruction, such as
lectures.
Hypothesis
An online, interactive patient simulation involving the care of an
Arab American Muslim will improve the knowledge, skills and
attitudes of 2nd year medical students regarding culturally
competent healthcare in general and the care of Arab American
Muslim patients, more specifically, beyond the basic cultural
competence curriculum.
Study Design
 Randomized sample of 214 2nd year MSU COM students
 All enrolled in OST 536, a behavioral medicine course that includes readings, a small group
discussion, video, and a panel related to culturally competent healthcare
 199 students volunteered, earning 2 points toward a minimum course requirement of 70
 102 students in the control and 97 in the experimental groups
 All students filled out a modified Clinical Cultural Competence Questionnaire (CCCQ) to
assess their knowledge, skills (self-efficacy), and attitudes about culturally competent
healthcare in general and specific to Arab American Muslim patients
 Experimental group first directed to the online, interactive patient simulation regarding the
care of an Arab American Muslim woman and her family before being directed to the
CCCQ
Conclusion
 An online, interactive patient simulation involving the care of an Arab American Muslim
improves the knowledge and skills of 2nd year medical students regarding the care of Arab
American Muslim patients beyond the basic cultural competence curriculum.
 General culture competence measures were the same for the experimental and control
groups suggesting that training targeting specific relevant patient populations may be most
effective
 Attitudes and comfort variables did not demonstrate clear improvement as a result of the
online experience and it appears likely that repeat and/or real exposures are necessary for
further change in this area.
 Future Directions:
• Assess longer term effects of educational intervention
• Construct similar modules for other cultural groups
• Utilize similar programs for assessing student learning and transfer to actual practice
• Further refinement of controversial cultural content
Acknowledgements: I would like to thank Deb DeZure for taking a special interest in me and my desire to become a Lilly Fellow and both Deb and Cindi Young for making the Lilly Fellowship an exemplary
experience; Jed Magen, Dean Strampel and the Department of Psychiatry and College of Osteopathic Medicine for supporting my Lilly Fellowship; John Williamson of OMERAD for his technological expertise
in constructing the online module; Rose Khalifa and Farha Abbasi for acting as cultural consultants; and Kami Silk for serving as my Lilly Mentor.
 No other post-test measures were significant – outcome variables of
significance outlined in bold in table below
S ex
Male
Female
Total
Race
African American
American Indian/Alaska
Native
Asian American
Latino/Hispanic
Native Hawaiian/Other
P acific Islander
Caucasian
Arab American
Other
Total
Fre qu e n cy(N=199)
Perce n t
100
99
199
50.3
49.7
100
5
1
2.4
0.5
24
3
1
11.6
1.4
0.5
156
7
10
207
75.4
3.4
4.8
100
S pe ak Lan gu ageoth er th an En gli sh
Yes
104
No
95
Total
199
52.3
47.7
100
Descriptive Statistics
Variable
Treatment Condition (N=97)
Mean
SD
General Cultural Competence
Diversity
21.04
5.05
Knowledge
Self-Efficacy -3.33
0.67
Info Elicit
Self-Efficacy -2.84
0.87
Treat Skill
Self-Efficacy -2.70
0.90
Conflict
Comfort
3.09
0.79
Arab American Cultural Competence
Comfort
2.96
0.92
Arab American
Arab American
24.86
7.33
Knowledge
Self-Efficacy
2.80
0.86
Arab American
Control Condition (N=102)
Mean
SD
20.67
4.34
3.21
0.65
2.66
0.86
2.67
0.87
3.03
0.65
2.89
0.94
22.19
8.79
2.45
0.95
Outcome Variables: Means and Standard Deviations