Cultural Sensitivity and End-of-Life Care

描述（由申请人提供）：文化和生命结束电子学习课程介绍了一个逐步的过程，用于理解和纳入文化的病人护理沿着六个案例研究与来自不同文化的病人。介绍之后是灵性和宗教，补充和替代医学，以及道德困境的模块。所有模块都基于案例研究，反映了患者和医疗服务提供者的多样性，并结合了基于流程的工具，以实现文化上的医疗保健。在第二阶段，我们建议1）扩展和增强基于病例的电子学习课程，2）开发和试点测试文化能力和临终关怀的交互式视频评估，3）提交完整的课程进行正式的可用性测试，以及4）评估电子学习课程的有效性，住院医师在三组中使用多种措施，前后随机试验我们打算为文化能力培训和临终教育提供一种方便、低成本的资源。我们希望研究生医学教育项目、医疗保健组织、会员组织和继续医学教育（CME）供应商将为其医生和其他临床工作人员购买Culture & End-of-Life。我们的目标是通过提高提供者的知识，态度和技能，提高临终关怀的质量。摘要/相关性今天，人们在生命的尽头是老年人和更多样化比他们只是二十年前。在健康状况较差的情况下，需要更多的服务，老年人正在重塑美国的临终关怀，对大多数人来说，生命的结束是在一系列关于医疗保健的决定之后，最终包括终止或停止进一步干预的决定。“与死亡共存”以及在此过程中沿着做出的决定对患者和医疗保健提供者都提出了新的挑战。医疗保健提供者被要求就日益多样化的患者群体对临终关怀的偏好进行早期和有意义的讨论。文化与生命结束电子学习课程教授提供文化敏感的生命结束护理的技能，不需要事先了解特定的文化。

DESCRIPTION (provided by applicant): The Culture & End-of-Life e-learning course introduces a step-wise process for understanding and incorporating culture in patient care along with six case studies with patients from diverse cultures. The introduction is followed by modules on spirituality and religion, complementary and alternative medicine, and ethical dilemmas. All modules are based on case studies reflecting diversity in patients and healthcare providers and incorporate process-based tools for culturally competent healthcare. In Phase II, we propose to 1) expand and enhance the case-based e-learning course, 2) develop and pilot test an Interactive Video Assessment for cultural competency and end- of-life care, 3) submit the full course to formal usability testing, and 4) evaluate the effectiveness of the e-learning course, resident physicians using multiple measures in a three-group, pre-post randomized trial We intend to produce a convenient, low-cost resource for cultural competency training and end-of-life education. We expect that Graduate Medical Education programs, , healthcare organizations, membership organizations, and continuing medical education (C.M.E.) vendors will purchase Culture & End-of-Life for their physicians and other clinical staff. Our goal is to improve the quality of end-of-life care by enhancing providers' knowledge, attitudes skills for culturally-competent care. Abstract/Relevance Today, people at the end-of-life are older and more diverse than they were just twenty years ago. In poorer health, and needing more services, the elderly are reshaping end- of-life care in the U.S. For most individuals, the end of life comes after a series of decisions about medical care, ultimately including decisions to terminate or withhold further interventions. "Living with dying" and the decisions to be made along the way pose new challenges for both patients and health care providers. Health care providers are being asked to initiate early and meaningful discussions about preferences for end- of-life care with an increasingly diverse patient population. The Culture & End of Life e- learning course teaches skills for providing culturally sensitive end-of-life care that do not require prior knowledge of specific cultures.