Fayyaz Jabeen, Jaeger Margret, Takundwa Prisca, Iqbal Ammarah U, Khatri Adeel, Ali Saima, Mukhtar Sama, Saleem Syed Ghazanfar, Whitfill Travis, Ali Inayat, Duff Jonathan P, Kardong-Edgren Suzan Suzie, Gross Isabel Theresia
University of Toronto Toronto Ontario Canada.
The Hospital for Sick Children Toronto Ontario Canada.
AEM Educ Train. 2023 Nov 22;7(6):e10908. doi: 10.1002/aet2.10908. eCollection 2023 Dec.
Cultural sensitivity (CS) training is vital to pediatric emergency medicine (PEM) curricula. This study aimed to explore CS in Yale PEM fellows and emergency medicine (EM) residents at Indus Hospital and Health Network (IHHN) in Pakistan through distance simulation activities.
This mixed-methods analysis of an educational intervention was conducted at Yale University in collaboration with IHHN. We approached seven U.S. PEM fellows and 22 Pakistani EM residents. We performed a baseline CS assessment using the Clinical Cultural Competency Questionnaire (CCCQ). Afterward, the U.S. PEM fellows facilitated the Pakistani EM residents through six distance simulation sessions. Qualitative data were collected through online focus groups. The CCCQ was analyzed using descriptive statistics, and content analysis was used to analyze the data from the focus groups.
Seven U.S. PEM fellows and 18 of 22 Pakistani EM residents responded to the CCCQ at the beginning of the module. The mean (±SD) CCCQ domain scores for the U.S. PEM fellows versus the Pakistani EM residents were 2.56 (±0.37) versus 2.87 (±0.72) for knowledge, 3.02 (±0.41) versus 3.33 (±0.71) for skill, 2.86 (±0.32) versus 3.17 (±0.73) for encounter/situation, and 3.80 (±0.30) versus 3.47 (±0.47) for attitude (each out of 5 points). Our qualitative data analysis showed that intercultural interactions were valuable. There is a common language of medicine among the U.S. PEM fellows and Pakistani EM residents. The data also highlighted a power distance between the facilitators and learners, as the United States was seen as the standard of "how to practice PEM." The challenges identified were time differences, cultural practices such as prayer times, the internet, and technology. The use of local language during debriefing was perceived to enhance engagement.
The distance simulation involving U.S. PEM fellows and Pakistani EM residents was an effective approach in assessing various aspects of intercultural education, such as language barriers, technical challenges, and religious considerations.
文化敏感性（CS）培训对儿科急诊医学（PEM）课程至关重要。本研究旨在通过远程模拟活动，探索耶鲁大学PEM研究员以及巴基斯坦印度河医院与健康网络（IHHN）的急诊医学（EM）住院医师的文化敏感性。
这项对教育干预的混合方法分析是在耶鲁大学与IHHN合作开展的。我们联系了7名美国PEM研究员和22名巴基斯坦EM住院医师。我们使用临床文化能力问卷（CCCQ）进行了文化敏感性基线评估。之后，美国PEM研究员通过6次远程模拟课程对巴基斯坦EM住院医师进行指导。通过在线焦点小组收集定性数据。使用描述性统计分析CCCQ，并使用内容分析来分析焦点小组的数据。
7名美国PEM研究员和22名巴基斯坦EM住院医师中的18人在模块开始时对CCCQ做出了回应。美国PEM研究员与巴基斯坦EM住院医师的CCCQ领域平均得分（±标准差）在知识方面分别为2.56（±0.37）和2.87（±0.72），技能方面分别为3.02（±0.41）和3.33（±0.71），遭遇/情境方面分别为2.86（±0.32）和3.17（±0.73），态度方面分别为3.80（±0.30）和3.47（±0.47）（满分均为5分）。我们的定性数据分析表明，跨文化互动很有价值。美国PEM研究员和巴基斯坦EM住院医师之间存在医学通用语言。数据还突出了指导者与学习者之间的权力距离，因为美国被视为“如何开展PEM”的标准。确定的挑战包括时差、祈祷时间等文化习俗、互联网和技术。反馈过程中使用当地语言被认为可以提高参与度。
涉及美国PEM研究员和巴基斯坦EM住院医师的远程模拟是评估跨文化教育各个方面（如语言障碍、技术挑战和宗教考量）的有效方法。
