Tang Tricia S, Bozynski Mary Ellen A, Mitchell Joyce M, Haftel Hilary M, Vanston Sarah A, Anderson Robert M
Department of Medical Education, University of Michigan Medical School, G1206 Towsley Center, Box 0201, Ann Arbor, MI 48109, USA.
Acad Med. 2003 Jun;78(6):629-33. doi: 10.1097/00001888-200306000-00014.
Sociocultural medicine is a growing curricular area in medical education. Because faculty members and residents will teach these curricula and model these skills in patient care, it is important to assess their attitudes toward diversity. This study examined faculty members' and residents' attitudes toward sociocultural issues in medicine.
In November 2000, 198 physicians from the Department of Pediatrics at the University of Michigan Medical School completed a questionnaire on demographics and sociocultural attitudes in medicine while they attended a department-wide retreat on cultural competency. A factor analysis of the sociocultural attitudes measure yielded five dimensions accounting for 70% of the variance. These factors included sexual orientation, diversity in professional functions, discussing race/ethnicity in teaching forums, clinical skills, and alternative medicine.
Significant differences were found between faculty members and residents for sexual orientation issues (t = 2.76, p <.01) and alternative medicine (t = 2.84, p <.01), with residents endorsing greater comfort in these areas of patient care. When controlling for demographic/background variables, group differences disappeared. Past exposure to multiculturalism emerged as a significant predictor for both sociocultural attitude dimensions.
Findings suggested while residents felt more comfortable than faculty members did with sexual orientation and alternative medicine issues in medicine, attitudes may have been related more to previous diversity education than to seniority of the physician. Integrating diversity education within departments and across the medical education continuum likely benefits all physicians. In the area of sociocultural medicine, both faculty members and residents can offer perspectives valuable to medical students, colleagues, and the larger medical community.
社会文化医学是医学教育中一个不断发展的课程领域。由于教员和住院医师将教授这些课程并在患者护理中示范这些技能,因此评估他们对多样性的态度很重要。本研究调查了教员和住院医师对医学中社会文化问题的态度。
2000年11月,来自密歇根大学医学院儿科学系的198名医生在参加关于文化能力的全系务虚会时,完成了一份关于人口统计学和医学社会文化态度的问卷。对社会文化态度测量进行因子分析,得出五个维度,占方差的70%。这些因素包括性取向、专业职能的多样性、在教学论坛中讨论种族/民族、临床技能和替代医学。
在性取向问题(t = 2.76,p <.01)和替代医学(t = 2.84,p <.01)方面,教员和住院医师之间存在显著差异,住院医师在这些患者护理领域表现出更高的舒适度。在控制人口统计学/背景变量后,组间差异消失。过去接触多元文化主义成为社会文化态度两个维度的重要预测因素。
研究结果表明,虽然住院医师在医学中的性取向和替代医学问题上比教员感觉更自在,但态度可能更多地与以前的多样性教育有关,而不是与医生的资历有关。将多样性教育整合到各部门以及整个医学教育连续过程中可能会使所有医生受益。在社会文化医学领域,教员和住院医师都可以为医学生、同事以及更广泛的医学社区提供有价值的观点。