Greer Joseph A, Park Elyse R, Green Alexander R, Betancourt Joseph R, Weissman Joel S
Harvard Medical School, Massachusetts General Hospital, Boston, Mass, USA.
J Gen Intern Med. 2007 Aug;22(8):1107-13. doi: 10.1007/s11606-007-0229-x. Epub 2007 May 22.
Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents' perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties.
Cross-sectional, national mail survey of resident physicians in their last year of training.
Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%).
Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty.
Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents' preparedness to provide cross-cultural care.
以往研究表明，住院医师报告了不同初级保健专业之间的培训差异，尽管关于提供跨文化护理教育的数据有限。本研究的目的是确定与初级保健住院医师对提供跨文化护理的感知准备程度相关的因素，并探讨这些感知在不同初级保健专业之间的差异程度。
对处于培训最后一年的住院医师进行全国性横断面邮件调查。
1150名初级保健住院医师，分别专攻家庭医学（27%）、内科（23%）、儿科（26%）和妇产科（24%）。
男性住院医师以及那些报告毕业于美国医学院、有榜样可学以及在住院实习期间接触更多跨文化病例组合的住院医师，感觉更有准备提供跨文化护理。在对这些人口统计学和临床因素进行调整后，与内科、儿科和妇产科住院医师相比，家庭医学住院医师更有可能感觉有准备提供跨文化护理。然而，当将住院医师报告接受的提供跨文化护理的指导量作为预测因素加入时，专业差异变得不显著，这表明培训机会比专业更能解释感知准备程度的差异。
在各个初级保健专业中，住院医师报告了对提供跨文化护理准备程度的不同看法。然而，这种差异与培训因素（如医生接受的提供此类护理的指导量）的关系更为密切，而非专业归属。这些发现强调了正规教育对于提高住院医师提供跨文化护理准备程度的重要性。
