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The Third National
Conference on |
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October
2 - 4, 2002, Chicago, IL |
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Preconference | Wed., October 2nd | Th., October 3rd | Fr., October 4th | | ||||||||||
Session A-3: Setting standards for cultural competence trainingThe Principles and Recommended Standards for Cultural Competence Education of Healthcare ProfessionalsRecent events, including the Institute of Medicine Report, Unequal Treatment, and additional evidence of the lack of recognition of unequal treatment of minorities in healthcare delivery made clear by the Kaiser Family Foundation report, National Survey of Physicians, Part I: Doctors on disparities in Medical Care, have resulted in a call for more in-depth education of healthcare professionals in the area of cultural competence. The rapidly diversifying patient population and a variety of regulations and standards, such as the MediCal Managed Care requirements and the Office of Minority Health’s Cultural and Linguistic Appropriate Services (CLAS) standards had already contained recommendations relating to the need for cultural competence education in healthcare. While there has been an increase in the number of residency programs, as well as medical and nursing school curricula that offer cultural competence education, the objectives, content, duration, teaching methodologies and evaluation of such programs have varied significantly, e.g., from a few brown bag lectures to fully integrated and multifaceted educational programs. Additionally, workshops and conferences that aim to educate practicing professionals in the intricacies of cultural competence have also been highly varied. As a field of educational focus matures, there is a need for consensus around what constitutes appropriate and effective curricular design and content. This presentation will discuss the project, sponsored by The California Endowment, which successfully produced a consensus document reflecting the views and expertise of numerous educators and healthcare professionals on cultural competence education for healthcare professionals. The challenge was, of course, to achieve agreement across disciplines and different perspectives. The presentation will discuss the process of achieving consensus as well as present an overview of the Principles and Recommended Standards .The document is written at a level of generality that addresses cultural competence education for all healthcare professionals, but is sufficiently specific around descrete elements of education to provide guidance in curriculum and program design. The guiding Principles may be reviewed in the Resource Binder. M. Jean Gilbert, PhD is a medical anthropologist with a specialization in social epidemiology and prevention research. Her initial studies in California and Mexico examined family structure and familial relationships in the two countries. She was Scholar in Latino Alcohol Studies at the University of California, Los Angeles from 1984 to 1990 and a member of the Epidemiology and Prevention Study Group, National Institute of Alcohol Abuse and Alcoholism. She served on the National Research Council, Institute of Medicine Committee on Alcoholism Prevention Research in 1989-1991. Her major publications are in the field of cross-cultural addictions research, emphasizing gender and family roles as they relate to use of alcohol and use of addictions services. From 1990-2000 she was the Director of Cultural Competence for Kaiser Permanente California where she collaborated in the design of cultural competency curricula for health care professionals and provided expert consulting in the structuring of service delivery to special populations. She was series editor for Kaiser Permanente’s physician handbooks on delivering culturally competent care to specific groups. She worked with the Cultural and Linguistics Task Force for MediCal Managed Care, chairing the linguistics committee and was on the National Advisory Committee for the CLAS Standards. Presently, she serves on the Community Advisory Group for LA Care, the Los Angeles County Cultural and Linguistic Standards Workgroup, and the National Advisory Committee to the Robert Wood Johnson Hablamos Juntos Initiative. Currently a Visiting Professor in anthropology at California State University, Long Beach, she teaches courses in medical anthropology and conducts research on the use of interpreters in clinical settings.
Julia Puebla Fortier has more than 14 years experience working in and writing about health care and specializes in linguistic and cultural competence in health care and Federal health policy analysis. As founder and director of Resources for Cross Cultural Health Care, she manages an international alliance of individuals and organizations in ethnic communities and health care organized to offer information and technical assistance on linguistic and cultural competence in health care. Activities include program design, policy development and analysis, research, and community advocacy. RCCHC is a coproducer of the national conference series, "Quality Health Care for Culturally Diverse Populations. Ms. Fortier has developed and manages the DiversityRx website—a comprehensive clearinghouse of information on model programs, policies and legal issues related to cross cultural health—and its listserv of over 400 participants. She was the principal investigator and author of the HHS-sponsored The National Standards on Culturally and Linguistically Appropriate Services (CLAS) in Health Care, and an accompanying research agenda, and co-author of model contract language on cultural competence for managed care organizations.
HRSA Bureau of Primary Health Care/Institute for Healthcare Improvement: Cultural Competence in the Clinical Care Of Patients With Diabetes and Cardiovascular DiseaseAs health care practitioners deliver health care services to an increasingly diverse population it is often necessary to adapt standard clinical practices to ones that are culturally accepted by the patient. Against this backdrop, an inter-disciplinary team of national consultants was funded by the Bureau of Primary Health Care through the Institute for Health Care Improvement’s Health Disparities Collaboratives, to develop a framework for culturally competent practice guidelines for the care of patients with diabetes and cardiovascular diseases. The result of this work is a curriculum intended to provide useful material that can guide and inform discussions on culture and health in clinical settings, in the context of actual cases, situations and problems that health teams work with on a daily basis. The goal of the curriculum is to assist health center interdisciplinary teams in improving the quality of health care services by embedding the concepts of quality improvement and cultural competence in clinical care. The materials are organized into 6 main sections or modules, plus a resource section, which build sequentially upon each other. Each module can, however, stand alone as an educational piece. In this session, Joseph Betancourt, MD and Melanie Tervalon, MD two of the members of the eight member team interdisciplinary team, will present and discuss the process and content of this product as well as the challenges that remain in disseminating this curriculum. They will also link their comments to the presentation by Dr. Jean Gilbert on Principles and Recommended Standards for Cultural Competence Education of Health care Professionals occurring in this same session. Melanie Tervalon MD, MPH is a pediatrician, consultant, UCSF School of Medicine Faculty member, and a 30-year resident of Oakland, California. Dr. Tervalon brings twenty years of rich, textured health care experiences to her practice. Her work for clients includes: guiding leaders and teams from ideas to products as a project director and facilitator, crafting funding initiatives, writing position papers, and providing expert knowledge in public health, pediatrics, and culture in health. In January 2000, Dr. Tervalon joined Dr. Nancy Adler, a behavioral scientist, as co-coordinator of the faculty work of integrating issues of culture, community and behavior into the UCSF School of Medicine curriculum redesign. Prior to this, Dr. Tervalon served as Senior Advisor, Special Projects, in the Office of the President at The California Endowment, from 1998-1999. In that capacity, Dr. Tervalon provided analysis and recommendations, at the request of the President, for achieving internal and external goals. From 1992 through 1998, Dr. Tervalon was employed at Children’s Hospital Oakland where she provided direct patient care and instruction to pediatric interns and residents. In April 1994, under her direction, the Multicultural Curriculum Program was created at Children’s Hospital Oakland, a program based on a teaching partnership, which places community scholarship and leadership at the center of health care education and practice. In 1998, she co-authored the article: Cultural Humility versus Cultural Competence: A Critical Distinction in Defining Physician Training versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education. Dr. Tervalon completed her medical degree at the University of California, San Francisco, a pediatric residency-training program at Children’s Hospital Oakland, a Masters degree in Public Health at the University of California, Berkeley, and a Pew Fellowship in Health Policy studies at the Institute of Health Policy Studies, University of California, San Francisco. Dr. Tervalon currently serves as Vice Chair of Alameda County’s Children and Families Commission.
Joseph R. Betancourt, MD, MPH is Senior Scientist, Institute for Health Policy in Medicine, and Director for Multicultural Education at Massachusetts General Hospital-Harvard Medical School. Dr. Betancourt’s primary interests include cross-cultural medicine, minority recruitment into the health professions, and minority health/health policy research. He is currently a Principal Investigator on grants from the Center for Medicare & Medicaid Services and the Commonwealth Fund, in addition to being co-investigator on a project funded by the National Cancer Institute. Dr. Betancourt is a graduate of the New Jersey Medical School, Cornell Medical Center, and the Harvard School of Public Health. Dr. Betancourt served on the New York Academy of Medicine’s Racial/Ethnic Disparities Working Group and the Greater New York Hospital Association’s Steering Committee on Racial/Ethnic Disparities. He is on the CDC’s National Expert Council for the Diabetes Today Program, and is a reviewer for the American Medical Association’s Journal Consortium and Annals of Internal Medicine. Dr. Betancourt served on the Institute of Medicine’s (IOM) Committee on Understanding and Eliminating Racial/Ethnic Disparities in Health Care and Physician’s for Human Rights Blue Ribbon Panel on Racial/Ethnic Disparities in Health. He was recently named to an IOM Committee on developing a national health care disparities report. He is the author of several publications on issues such as hypertension in minority communities, cross-cultural care, ethics, workforce diversity, and the impact of language barriers on health care. Dr. Betancourt also teaches cross-cultural medicine to medical students and residents at MGH-Harvard Medical School.
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| As with the rest of Diversity Rx, this section
is a work in progress and we welcome information on other efforts, programs,
and reports that will expand upon the information offered here. Please
let us know if you have other examples to include here. |
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essentials | models and practices | policy | legal issues
| networking | table
of contents | contact us
| who we are |
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Diversity Rx is sponsored by: |
 The National Conference of State Legislatures |
 Resources for Cross Cultural Health Care |
 Henry J. Kaiser Family Foundation |
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