Greenberg Marna Rayl, Pierog Jessica Ellen
Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania 18103, USA.
Gend Med. 2009 Dec;6(4):604-13. doi: 10.1016/j.genm.2009.11.002.
Given the race and gender disparities in cardiac care for women and minorities, it is important to evaluate how we teach in this content area, because it may influence this bias.
We assessed the American Heart Association's Advanced Cardiac Life Support (ACLS) materials, published in 2006, for examples of race and gender sensitivity that depicted culturally competent health education.
Precourse materials, manuals, illustrations, case vignettes, compact discs (CDs), algorithms, and tests were evaluated for culturally competent opportunities. An opportunity was defined as each question or scenario that could have been edited to reflect race or gender. Minority status was interpreted as skin color other than white. Each individual component was counted separately. After the quantitative tally, an analysis was performed using simple percentile comparisons. Interpretations were based on these percentages.
The majority of teaching opportunities (54%) did not reflect race or gender. Of 149 patient opportunities to adequately represent those at risk, none clearly represented a minority female. In the simulated cases on the provider CD, all patients were white males. The mannequin had a male haircut and an open shirt. No mannequin had female characteristics (eg, earrings, breasts, or women's clothing). None of the provider CD cases illustrated patients or mannequins with skin color other than white.
The current ACLS provider and instructor materials do not maximize opportunities to illustrate vulnerable segments of the population. Future studies designed to evaluate the effect of improved representation of women and minorities in teaching models should be considered.
鉴于在女性和少数族裔心脏护理方面存在种族和性别差异,评估我们在这一领域的教学方式非常重要,因为这可能会影响这种偏见。
我们评估了美国心脏协会2006年发布的高级心血管生命支持(ACLS)材料,以寻找体现具有文化胜任力的健康教育的种族和性别敏感性示例。
对课前材料、手册、插图、病例 vignettes、光盘(CD)、算法和测试进行具有文化胜任力机会的评估。一个机会被定义为每个可以编辑以反映种族或性别的问题或场景。少数族裔身份被解释为非白色肤色。每个单独的组件分别计数。在进行定量统计后,使用简单的百分位数比较进行分析。解释基于这些百分比。
大多数教学机会(54%)没有反映种族或性别。在149个充分代表高危人群的患者机会中,没有一个明确代表少数族裔女性。在提供者CD上的模拟病例中,所有患者都是白人男性。人体模型有男性发型和敞开的衬衫。没有人体模型具有女性特征(如耳环、乳房或女性服装)。提供者CD病例中没有一个展示非白色肤色的患者或人体模型。
当前的ACLS提供者和教师材料没有最大限度地利用机会来展示人群中的弱势群体。应考虑未来旨在评估在教学模型中改善女性和少数族裔代表性效果的研究。