Cultural humility as a framework to teach cross-cultural communication in pediatric residency training

Abstract

North America is an expansive territory with an increasingly culturally diverse population. There is an ever-growing need for patient-centered cross-cultural care delivery. Effective communication has long been associated with positive patient outcomes while poor communication across cultures has been shown to significantly increase health inequities. Although medical education organizations recognize the need for formal training in providing cross-cultural care, little time is allotted to the development and assessment of these aptitudes in residency curricula. Cultural humility (CH) has recently allowed for the establishment of a common language to better support the discussion around effective cross-cultural communication (CCC). CH offers a conceptual framework to ground the development of patient-centered CCC training interventions. The purpose of this study was to assess the impact of a simulation-based curriculum (SBC) to teach CCC on effective care delivery. Using expert consensus and collaboration with community patient partners, we developed a SBC on CCC using CH as a conceptual framework. Medical pediatric trainees (3 junior residents, 18 senior residents and fellows) from Sainte-Justine University Health Center participated in the CCC SBC between October and December 2023. Participants’ self-perceived level of preparedness and skills in delivering culturally effective clinical care significantly improved after taking part in the SBC (p 0.001) and positive outcomes persisted through time (p 0.001). By the end of the SBC, trainees demonstrated a sound understanding of CH principles and a more nuanced approach to their delivery of cross-cultural care. This novel teaching intervention on CCC led to meaningful learning and positive behavioral changes in trainees’ clinical practice in this area of care. A cross-cultural communication curriculum which uses simulation-based teaching is an effective educational intervention. This project shows a potential avenue to close the gap in cross-cultural communication teaching in residency training.