Cultural Competency in Medical Education: Demographic Differences Associated With Medical Student Communication Styles and Clinical Clerkship Feedback
Cultural Competency in Medical Education: Demographic Differences Associated With Medical Student Communication Styles and Clinical Clerkship Feedback
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DOI：
10.1016/s0027-9684(15)30823-3
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发表时间：
2009-02-01
影响因子：
3.3
通讯作者：
Jeffe, Donna B.
中科院分区：
文献类型：
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作者：
Lee, Katherine B.;Vaishnavi, Sanjeev N.;Jeffe, Donna B.
目的：我们测试了学生的人口统计学，沟通方式，并在clerishships.Methods收到的反馈之间的关联的意义：美国医学生谁完成了至少一个所需的临床clerships. Methods的邀请在2006年4月至7月之间完成一个匿名的，在线调查询问人口统计学，沟通方式（自信和沉默），反馈（积极和消极），和实习成绩。自我认同的种族/民族，性别，一代（移民，第一代或第二代美国人）和他们的双向互动的自信，沉默，总的积极和总的消极反馈意见的影响进行了测试，使用协方差因子分析，控制年龄，实习成绩，母亲和父亲的教育，成对比较使用简单的对比。结果：来自105所学校的医学生做出了回应（N = 2395; 55%为女性; 57%为白色）。男性比女性更自信（P = 0.001）。沉默（P <0.001）总的积极评价（P = 0.006）不同种族/民族;在两两对比中，黑人、东亚人和美洲原住民/阿拉斯加人的学生比白色学生报告了更大的沉默（P < .001），和白色学生报告收到更多的积极评价比块，和南亚和东亚学生，按世代划分的种族/族裔（P = .022）和按代分列的性别（P = 0.025）总的负面评论观察到交互作用;白色第一代美国人报告收到最少的负面评论，男性移民报告收到最多的负面评论。在学生的沟通风格和反馈，他们收到的人口统计学差异突出了文化能力培训，以改善医学师生互动的需要，类似于目前提倡的培训，以改善医患互动。
Purpose: We tested the significance of associations among students' demographics, communication styles, and feedback received during clerkships.Methods: US medical students who completed at least one required clinical clerkship were invited between April and July 2006 to complete an anonymous, online survey inquiring about demographics, communication styles (assertiveness and reticence), feedback (positive and negative), and clerkship grades. The effects of self-identified race/ethnicity, gender, and generation (immigrant, first- or second-generation American) and their 2-way interactions on assertiveness, reticence, total positive and total negative feedback comments were tested using factorial analysis of covariance, controlling for age, clerkship grades, and mother's and father's education; pairwise comparisons used simple contrasts. Two-sided P values < .05 were considered significant.Results: Medical students from 105 schools responded (N = 2395; 55% women; 57% white). Men reported more assertiveness than women (P = .001). Reticence (P < .001) and total positive comments (P = .006) differed by race/ethnicity; in pairwise contrasts, black, East Asian, and Native American/Alaskan students reported greater reticence than white students (P < .001), and white students reported receiving more positive comments than block, and South and East Asian students, Race/ethnicity-by-generation (P = .022) and gender-by-generation (P = .025) interaction effects were observed for total negative comments; white first-generation Americans reported receiving the fewest and male immigrants reported receiving the most negative comments.Conclusions: Demographic differences in students' communication styles and feedback they received highlight a need for cultural competency training to improve medical student-teacher interactions, analogous to training currently advocated to improve physician-patient interactions.