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通过结构化互动研讨会将文化谦逊融入医学教育

Integrating Cultural Humility into Medical Education Using a Structured and Interactive Workshop.

作者信息

Ogunyemi Dotun, Thind Birpartap S, Teixeira Amir, Sams Clarence M, Ojo Matthias, Dinkins Grace Anne E, Serseni Dragos

机构信息

DIO, Associate Dean of Graduate Medical Education; Charles R Drew University, College of Medicine, Los Angeles, CA, USA.

Medical Student, California University of Science and Medicine, Colton, CA, USA.

出版信息

Adv Med Educ Pract. 2024 Jun 18;15:575-583. doi: 10.2147/AMEP.S460970. eCollection 2024.

Abstract

BACKGROUND

Cultural humility is a lifelong commitment to self-evaluation, redressing power imbalances in patient-physician relationships and developing mutually trusting beneficial partnerships.

OBJECTIVE

The objective of this study was to determine the feasibility and efficacy of cultural humility training.

METHODS

From July 2020-March 2021, 90-minute educational workshops attended by 133 medical students, resident physicians and medical education faculty included 1) pre- and post- intervention surveys; 2) interactive presentation on equity and cultural humility principles; 3) participants explored sociocultural identities and power; and 4) reflective group discussions.

RESULTS

There were significant increases from pre to post intervention assessments for perception scores (3.89 [SEM= 0.04] versus 4.22 [0.08], p<0.001) and knowledge scores (0.52 [0.02] versus 0.67 [0.02], p<0.001). Commonest identities participants recognized as changing over time were personality = 40%, appearance = 36%, and age =35%. Commonest identities experienced as oppressed/subjugated were race/ethnicity = 54%, gender = 40% and religion = 28%; whilst commonest identities experienced as privileged were gender= 49%, race/ethnicity = 42% and appearance= 25%. Male participants assigned mean power score of 73% to gender identity compared to mean power score of -8% by female participants (P<0.001). Non-Hispanic Whites had mean power score for race identity of 62% compared to 13% for non-white participants (p<0.001). English as a second language was only acknowledged as an oppressed/subjugated identity by those born outside the United States (p<0.001).

CONCLUSION

An interactive educational workshop can increase participants' knowledge and perceptions regarding cultural humility. Participants can self-reflect to recognize sociocultural identities that are oppressed/subjugated or privileged.

摘要

背景

文化谦逊是一种对自我评估的终身承诺,旨在纠正医患关系中的权力不平衡,并建立相互信任的有益伙伴关系。

目的

本研究的目的是确定文化谦逊培训的可行性和有效性。

方法

2020年7月至2021年3月,133名医学生、住院医师和医学教育教员参加了90分钟的教育工作坊,包括:1)干预前后的调查;2)关于公平和文化谦逊原则的互动式讲座;3)参与者探索社会文化身份和权力;4)反思性小组讨论。

结果

干预前后评估的认知得分(3.89[标准误=0.04]对4.22[0.08],p<0.001)和知识得分(0.52[0.02]对0.67[0.02],p<0.001)有显著提高。参与者认为随时间变化最常见的身份是性格=40%,外貌=36%,年龄=35%。被认为受到压迫/压制的最常见身份是种族/族裔=54%,性别=40%,宗教=28%;而被认为享有特权的最常见身份是性别=49%,种族/族裔=42%,外貌=25%。男性参与者将性别身份的平均权力得分定为73%,而女性参与者的平均权力得分是-8%(P<0.001)。非西班牙裔白人的种族身份平均权力得分为62%,而非白人参与者为13%(p<0.001)。只有在美国境外出生的人将英语作为第二语言视为受压迫/压制的身份(p<0.001)。

结论

互动式教育工作坊可以增加参与者关于文化谦逊的知识和认知。参与者可以通过自我反思来认识到那些受到压迫/压制或享有特权的社会文化身份。

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