Readiness of Medical Students to Care for Diverse Patients: A Validated Assessment of Cross-Cultural Preparedness, Skills, and Curriculum

Andrew D P Prince; Alexander R Green; David J Brown; Michael J Brenner

doi:10.1089/heq.2023.0142

Readiness of Medical Students to Care for Diverse Patients: A Validated Assessment of Cross-Cultural Preparedness, Skills, and Curriculum

Health Equity. 2023 Sep 13;7(1):612-620. doi: 10.1089/heq.2023.0142. eCollection 2023.

Authors

Andrew D P Prince¹, Alexander R Green², David J Brown^{1

3

4}, Michael J Brenner^{1

3}

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA.
² Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
³ Office of Medical Student Education, University of Michigan Medical School, Ann Arbor, Michigan, USA.
⁴ Office for Health Equity and Inclusion, Ann Arbor, Michigan, USA.

Abstract

Introduction: Effective cross-cultural care is foundational for mitigating health inequities and providing high-quality care to diverse populations. However, medical school teaching practices vary widely, and learners have limited opportunities to develop these critical skills. To understand the current state of cross-cultural education and to identify potential opportunities for improvement, we disseminated a validated survey instrument among medical students at a single institution.

Methods: Learners across 4 years of medical school participated in the cross-cultural care assessment, using a tool previously validated with resident physicians and modified for medical students. The survey assessed medical student perspectives on (1) preparedness, (2) skillfulness, and (3) educational curriculum and learning environment. Cross-sectional data were analyzed by class year, comparing trends between school years.

Results: Of 700 possible survey responses, we received 260 (37% response rate). Fourth-year students had significantly higher scores than first-year students (p<0.05) for 7 of 12 preparedness items and 4 of 9 skillfulness items. Less than 50% of students indicated readiness to deliver cross-cultural care by their fourth year in 9 of 12 preparedness items and 6 of 9 skillfulness items. Respondents identified inadequate cross-cultural education as the primary barrier.

Discussion: Medical students reported a lack of readiness to provide cross-cultural care, with self-assessed deficiencies persisting through the fourth year of medical school. Medical educators can use data from the cross-cultural care survey to longitudinally assess students and enhance curricular exposures where deficiencies exist. Optimizing cross-cultural education has the potential to improve the learning environment and overall patient care.

Keywords: cultural competency; diversity; health disparities; medical education; social inequities.