The cultural competence of health care professionals: conceptual analysis using the results from a national pilot study of training and assessment

Abstract

The cultural competence of health professionals affects the satisfaction with, and outcomes of, patient care. Patient-centered cultural training was implemented with 76 trainees. Four months later, they were assessed using standardized patient scenarios and their performance compared to a control group. A questionnaire was used to evaluate the training. Assessment scores were analyzed using t tests to compare groups. Interrater reliability was calculated for individual scenarios. The cultural training received positive evaluations with many trainees indicating their intention to change future practice. Those who received cultural training gained higher scores upon assessment than those who had not. This difference was significant for three scenarios with nonclinical evaluators. Interrater reliability ranged from .913 to .427. The significant difference in performance between the groups supports the validity and educational impact of this approach. However, variable reliability highlights the difficulties with developing robust assessments in this area that are feasible within resource constraints.

Keywords: OSCE; assessment; cultural competence; globalization; training.