A Tool for Assessing Cultural and Structural Competence in Medical Students and Professionals

• In Event: 3129 - Section on Medical Sociology Refereed Roundtables (1 hour)
  In Refereed Roundtable 60min: Table 8. Culture and Community in Care Delivery

Abstract

Purpose: Cultural competence curricula have increasingly been implemented in medical schools with the goal of improving healthcare for marginalized patients. However, the current tools available to medical educators and practitioners that measure individuals’ cultural competence are inadequate. While there are a number of tools available that measure cultural competence using participants’ self-reported assessments, these tools rarely ask participants to demonstrate the competence itself. Further, most tools designed to explore cultural competence have not taken into account critiques of the construct that highlight its narrow focus on race/ethnicity and lack of attention to structural factors.
Method: This study describes the development and validation of a comprehensive measure of cultural competence (the CC* tool) that may be used to assess medical trainees’ and physicians’ cultural competence. After the initial survey generation, questions were refined using cognitive interviews and formal pretests. Preliminary validity evidence supporting content, internal structure, and relations to other variables were examined using descriptive statistics (mean and SD), psychometric analyses (item analysis and Cronbach’s alpha), and predictive association with patient-reported outcomes data (mixed-effects regression), respectively.
Results: The CC* tool measures cultural and structural competence, including attitudes, knowledge, and skills. Scores from the CC* tool demonstrate sufficient reliability and item characteristics; moreover, they are significantly associated with patient satisfaction ratings.
Conclusions: These results demonstrate preliminary validity evidence of the CC* tool. The CC* tool is currently being adapted for research about undergraduate medical education populations and its uses are being explored for assessment purposes, as well.

Authors

• Laura Ellen Hirshfield, University of Illinois-Chicago

• Yoon Soo Park, University of Illinois-Chicago