Park Elyse R, Betancourt Joseph R, Kim Minah K, Maina Angela W, Blumenthal David, Weissman Joel S
Massachusetts General Hospital / Harvard Medical School, 50 Staniford Street, 9th floor, Boston, MA 02114, USA.
Acad Med. 2005 Sep;80(9):874-80. doi: 10.1097/00001888-200509000-00019.
An Institute of Medicine report issued in 2002 cited cross-cultural training as a mechanism to address racial and ethnic disparities in health care, but little is known about residents' training and capabilities to provide quality care to diverse populations. This article explores a select group of residents' perceptions of their preparedness to deliver quality care to diverse populations.
Seven focus groups and ten individual interviews were conducted with 68 residents in locations nationwide. Qualitative analysis of focus-group and individual interview transcripts was performed to assess residents' perceptions of (1) preparedness to deliver care to diverse patients; (2) educational climate; and (3) training experiences.
Most residents in this study noted the importance of cross-cultural care yet reported little formal training in this area. Residents wanted more formal training yet expressed concern that culture-specific training could lead to stereotyping. Most residents had developed ad hoc, informal skills to care for diverse patients. Although residents perceived institutional endorsement, they sensed it was a low priority due to lack of time and resources.
Residents in this study reported receiving mixed messages about cross-cultural care. They were told it is important, yet they received little formal training and did not have time to treat diverse patients in a culturally sensitive manner. As a result, many developed coping behaviors rather than skills based on formally taught best practices. Training environments need to increase training to enhance residents' preparedness to deliver high-quality cross-cultural care if the medical profession is to achieve the goals set by the Institute of Medicine.
2002年医学研究所发布的一份报告指出，跨文化培训是解决医疗保健中种族和民族差异的一种机制，但对于住院医师为不同人群提供优质护理的培训情况和能力却知之甚少。本文探讨了一组选定的住院医师对其为不同人群提供优质护理的准备情况的看法。
在全国范围内对68名住院医师进行了7次焦点小组讨论和10次个人访谈。对焦点小组讨论和个人访谈记录进行定性分析，以评估住院医师对以下方面的看法：（1）为不同患者提供护理的准备情况；（2）教育氛围；（3）培训经历。
本研究中的大多数住院医师都指出了跨文化护理的重要性，但表示在这方面接受的正规培训很少。住院医师希望接受更多正规培训，但担心针对特定文化的培训会导致刻板印象。大多数住院医师已经形成了临时的、非正式的护理不同患者的技能。尽管住院医师感受到了机构的支持，但由于缺乏时间和资源，他们觉得这不是优先事项。
本研究中的住院医师报告称，他们在跨文化护理方面收到了相互矛盾的信息。他们被告知这很重要，但他们接受的正规培训很少，也没有时间以文化敏感的方式治疗不同的患者。结果，许多人形成了应对行为，而不是基于正式教授的最佳实践的技能。如果医学专业要实现医学研究所设定的目标，培训环境需要增加培训，以提高住院医师提供高质量跨文化护理的准备情况。
