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接纳与承诺疗法(ACT)文化谦逊教学框架:将 ACT 从治疗环境转化为医学教育课程的指南。

An Acceptance and Commitment Training (ACT) Framework for Teaching Cultural Humility: A Guide for Translating ACT from a Therapeutic Context into a Medical Education Curriculum.

机构信息

Department of Psychiatry and Behavioral Sciences, University of Nevada, Reno, School of Medicine, 5190 Neil Road Suite 215/MS0354, Reno, NV, 89502-0354, USA.

Behavior Analysis Program, Department of Psychology, University of Nevada, Reno, Reno, NV, USA.

出版信息

J Clin Psychol Med Settings. 2023 Jun;30(2):261-273. doi: 10.1007/s10880-022-09909-1. Epub 2022 Sep 2.

Abstract

The objective of this project was to train future physicians to work effectively and thoughtfully with diverse populations by teaching them to employ Acceptance and Commitment Training (ACT) skills to increase cultural humility, with the goal of improving attitudes, knowledge, and beliefs about working with diverse patients. We developed ACT for cultural humility online interactive modules as part of an elective course to teach Medical Spanish to 4th-year medical students. Pre- and post-pilot data pertaining to the cultural humility training modules on the Work-Related Acceptance and Action questionnaire, Multidimensional Cultural Humility Scale, knowledge, attitudes, and beliefs were analyzed using paired samples t-tests and Wilcoxon signed-rank tests. We also included descriptive data pertaining to overall satisfaction with the cultural humility modules and intent to apply the material learned to patient care. Our data showed a significant increase in the cultural humility of our participants as well as an increase in psychological flexibility, a higher favorability rating toward various ethnicities, improvements in attitude, and positive changes in beliefs and knowledge following completion of the modules. The modules were well received by the medical students, with high social validity ratings. The ACT for cultural humility curriculum has great potential to enhance medical education in diversity, equity, and inclusion by increasing both the understanding and the cultural humility of medical students and future professionals to work with diverse populations. The current paper provides a framework that can be used by other programs to shape the education of the future medical workforce to help promote culturally humble care.

摘要

本项目的目标是通过教授未来的医生使用接纳与承诺疗法(ACT)技能来提高文化谦逊度,从而有效地、深思熟虑地与不同人群合作,以此来改善他们对与不同患者合作的态度、知识和信念。我们开发了用于文化谦逊的 ACT 在线互动模块,作为向四年级医学生教授医学西班牙语选修课程的一部分。在试点之前和之后,我们使用配对样本 t 检验和 Wilcoxon 符号秩检验,对与文化谦逊培训模块相关的工作相关接纳和行动问卷、多维文化谦逊量表、知识、态度和信念进行了数据分析。我们还包括了对文化谦逊模块的整体满意度以及将所学内容应用于患者护理的意愿的描述性数据。我们的数据表明,参与者的文化谦逊程度显著提高,心理灵活性增强,对各种族裔的评价更加有利,态度得到改善,信念和知识也发生了积极变化。这些模块受到医学生的欢迎,具有很高的社会有效性评价。ACT 文化谦逊课程具有很大的潜力,可以通过提高医学生和未来专业人士对不同人群的理解和文化谦逊度,来增强多样性、公平性和包容性的医学教育。本文提供了一个框架,其他项目可以使用该框架来塑造未来医疗劳动力的教育,以帮助促进文化谦逊的护理。

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本文引用的文献

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Exploring US internal medicine resident career preferences: a Q-methodology study.探索美国内科住院医师的职业偏好:一项 Q 方法学研究。
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A Theory of Cultural Humility.一种文化谦逊理论。
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Quality of Care and Disparities in Obstetrics.产科护理质量与差异
Obstet Gynecol Clin North Am. 2017 Mar;44(1):13-25. doi: 10.1016/j.ogc.2016.10.002.
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A deeper look at implicit weight bias in medical students.深入探讨医学生的隐性体重偏见。
Adv Health Sci Educ Theory Pract. 2017 Oct;22(4):889-900. doi: 10.1007/s10459-016-9718-1. Epub 2016 Oct 12.
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Cultural Humility: A Concept Analysis.文化谦逊:一项概念分析
J Transcult Nurs. 2016 May;27(3):210-7. doi: 10.1177/1043659615592677. Epub 2015 Jun 28.
7
Cultural humility: essential foundation for clinical researchers.文化谦逊:临床研究人员的必备基础。
Appl Nurs Res. 2013 Nov;26(4):251-6. doi: 10.1016/j.apnr.2013.06.008. Epub 2013 Aug 12.
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Psychological flexibility as a fundamental aspect of health.心理灵活性是健康的基本方面。
Clin Psychol Rev. 2010 Nov;30(7):865-78. doi: 10.1016/j.cpr.2010.03.001. Epub 2010 Mar 12.

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