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Randomized Controlled Trial
. 2024 Sep 1;280(3):403-413.
doi: 10.1097/SLA.0000000000006408. Epub 2024 Jun 26.

A Randomized Crossover Trial Evaluating the Impact of Cultural Dexterity Training on Surgical Residents' Knowledge, Cross-Cultural Care, Skills, and Beliefs: The Provider Awareness and Cultural Dexterity Training for Surgeons (PACTS) Trial

Douglas S Smink  1   2 , Gezzer Ortega  1   2 , Brittany M Dacier  2   3 , Emil R Petrusa  4 , Yu-Jen Chen  2 , Namra Q Shaikh  2   5 , Benjamin G Allar  2   6 , Maria B J Chun  7 , Alexander R Green  8 , Katharine E Caldwell  9 , Rachel B Atkinson  1   2 , Emma Reidy  2 , Olubode A Olufajo  10 , L D Britt  11 , Molly A Brittain  11 , Jorge Zárate Rodriguez  9 , Sandra M Swoboda  12 , Edward E Cornwell  10 , Kenneth A Lynch  13 , Paul E Wise  9 , David T Harrington  13 , Tara S Kent  6 , John T Mullen  4 , Pamela A Lipsett  14 , Adil H Haider  2   15 ; and the PACTS Trial Group
Affiliations
Randomized Controlled Trial

A Randomized Crossover Trial Evaluating the Impact of Cultural Dexterity Training on Surgical Residents' Knowledge, Cross-Cultural Care, Skills, and Beliefs: The Provider Awareness and Cultural Dexterity Training for Surgeons (PACTS) Trial

Douglas S Smink et al. Ann Surg. .

Abstract

Objectives: This trial examines the impact of the Provider Awareness and Cultural dexterity Toolkit for Surgeons (PACTS) curriculum on surgical residents' knowledge, cross-cultural care, skills, and beliefs.

Background: Cross-cultural training of providers may reduce health care outcome disparities, but its effectiveness in surgical trainees is unknown.

Methods: PACTS focuses on developing skills needed for building trust, working with patients with limited English proficiency, optimizing informed consent, and managing pain. The PACTS trial was a randomized crossover trial of 8 academic general surgery programs in the United States: The Early group ("Early") received PACTS between periods 1 and 2, while the Delayed group ("Delayed") received PACTS between periods 2 and 3. Residents were assessed preintervention and postintervention on Knowledge, Cross-Cultural Care, Self-Assessed Skills, and Beliefs. χ 2 and Fisher exact tests were conducted to evaluate within-intervention and between-intervention group differences.

Results: Of 406 residents enrolled, 315 were exposed to the complete PACTS curriculum. Early residents' Cross-Cultural Care (79.6%-88.2%, P <0.0001), Self-Assessed Skills (74.5%--85.0%, P <0.0001), and Beliefs (89.6%-92.4%, P =0.0028) improved after PACTS; knowledge scores (71.3%-74.3%, P =0.0661) were unchanged. Delayed resident scores pre-PACTS to post-PACTS showed minimal improvements in all domains. When comparing the 2 groups in period 2, Early residents had modest improvement in all 4 assessment areas, with a statistically significant increase in Beliefs (92.4% vs 89.9%, P =0.0199).

Conclusions: The PACTS curriculum is a comprehensive tool that improved surgical residents' knowledge, preparedness, skills, and beliefs, which will help with caring for diverse patient populations.

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Conflict of interest statement

The authors report no conflicts of interest.

References

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