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医师文化能力培训及其对行为的影响:来自 2016 年全国门诊医疗服务调查的证据。

Physician Cultural Competency Training and Impact on Behavior: Evidence From the 2016 National Ambulatory Medical Care Survey.

机构信息

Department of Health Services Research, Management and Policy, University of Florida.

and Department of Community Health and Family Medicine, University of Florida, Gainesville, FL.

出版信息

Fam Med. 2020 Sep;52(8):562-569. doi: 10.22454/FamMed.2020.163135.

Abstract

BACKGROUND AND OBJECTIVES

The number of racially and culturally diverse patients in the medical practices of US physicians is increasing. It is unclear how well culturally and linguistically appropriate services (CLAS) standards have been integrated into physician practice. The objective of this study was to determine the prevalence of US-based physicians who received training in cultural competency and describe their behavior.

METHODS

This survey study utilized data from a supplement of the 2016 National Ambulatory Medical Care Survey (NAMCS). The NAMCS Supplement on CLAS for Office-based Physicians (National CLAS Physician Survey) is a nationally representative survey of ambulatory physicians. We determined the proportion and characteristics of physicians who reported receiving cultural competency training in medical school or in practice.

RESULTS

The unweighted sample of 363 yielded a weighted sample of 290,109 physicians, 66.3% of whom reported that they had received cultural competence training at some point. Only 35.5% of the sample had ever heard of the CLAS standards, suggesting a low level of awareness of the standards. Further, only 18.7% reported that training in cultural competency is required for newly hired physicians who join their practice. There were no statistically significant differences between those who had been trained and those who had not in terms of self-reported consideration of race/ethnicity or culture in assessing patient needs, diagnosis, treatment and patient education (P>.05).

CONCLUSIONS

Fewer than half of practicing physicians reported receiving cultural and linguistic competency training in medical school or residency. It is possible that cultural competence training is being seamlessly integrated into medical education.

摘要

背景和目的

美国医生的医疗实践中,不同种族和文化背景的患者数量正在增加。目前尚不清楚文化和语言适应性服务(CLAS)标准在多大程度上融入了医生的实践。本研究的目的是确定接受文化能力培训的美国医生的比例,并描述他们的行为。

方法

本调查研究利用了 2016 年国家门诊医疗保健调查(NAMCS)补充数据。NAMCS 办公室医生 CLAS 补充调查(全国 CLAS 医生调查)是对门诊医生的一项全国代表性调查。我们确定了报告在医学院或实践中接受过文化能力培训的医生的比例和特征。

结果

未加权样本为 363 名,加权样本为 290109 名医生,其中 66.3%的医生报告在某个时候接受过文化能力培训。只有 35.5%的样本听说过 CLAS 标准,这表明对标准的认识程度较低。此外,只有 18.7%的医生报告说,新加入他们诊所的医生需要接受文化能力培训。在考虑种族/民族或文化来评估患者需求、诊断、治疗和患者教育方面,接受过培训和未接受过培训的医生之间没有统计学上的显著差异(P>.05)。

结论

不到一半的执业医生报告在医学院或住院医师培训期间接受过文化和语言能力培训。文化能力培训可能已无缝融入医学教育。

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