Angela Peterman Mihalic, MD; Alison E. Dobbie, MD; Scott Kinkade, MD University of Texas Southwestern Medical School at Dallas, Dallas, Texas
Objective: Cultural sensitivity may be especially important in the care of children, and national pediatric associations have issued policy statements promoting cultural competence in medical education. Yet, a 2006 PubMed search revealed no manuscripts describing cultural teaching and learning within US pediatric clerkships.
Methods: The authors surveyed 125 US pediatric clerkship directors concerning the teaching of culturally competent pediatric care within their clerkships and medical schools.
Results: Of 100 respondents (80% response rate), most agreed or strongly agreed that teaching culturally competent care is important (91%), enhances the physician/patient/family relationship (99%), and improves patient outcomes (90%). Twenty four respondents (25%) offered cultural teaching encompassing a wide content range. The most common teaching methods were didactic lectures (63%), experiential learning through community activities (58%), and small group discussions (54%). Only 14 respondents reported any curricular evaluation, the commonest methods being student surveys, clinical case presentations, and standardized patient experiences. Top factors facilitating curriculum development included culturally diverse populations of patients, students, faculty and hospital staff, and faculty interest and expertise. Top challenges included lack of protected time for program development, funding, and faculty expertise.
Conclusions: Despite national policy statements promoting the teaching of culturally effective pediatric care, few US pediatric clerkships currently provide such teaching. Suggestions to promote cultural teaching include providing faculty development opportunities and developing and disseminating teaching materials and evaluation tools. Such dissemination is important in order to graduate physicians who are competent to provide culturally sensitive pediatric care to the changing US population.