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01.05.2010 | Innovations in Education

Treating and Precepting with RESPECT: A Relational Model Addressing Race, Ethnicity, and Culture in Medical Training

verfasst von: Carol Mostow, LICSW, Julie Crosson, MD, Sandra Gordon, MD, Sheila Chapman, MD, Peter Gonzalez, MD, Eric Hardt, MD, Leyda Delgado, MD, Thea James, MD, Michele David, MD, MPH, MBA

Erschienen in: Journal of General Internal Medicine | Sonderheft 2/2010

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Abstract

BACKGROUND

In 2000 a diverse group of clinicians/educators at an inner-city safety-net hospital identified relational skills to reduce disparities at the point of care.

DESCRIPTION

The resulting interviewing and precepting model helps build trust with patients as well as with learners. RESPECT adds attention to the relational dimension, addressing documented disparities in respect, empathy, power-sharing, and trust while incorporating prior cross-cultural models. Specific behavioral descriptions for each component make RESPECT a concrete, practical, integrated model for teaching patient care.

CONCLUSIONS

Precepting with RESPECT fosters a safe climate for residents to partner with faculty, address challenges with patients at risk, and improve outcomes.

Fuertes JN, Boylan LS, Fontanella JA. Behavioral indices in medical care outcome: the working alliance, adherence and related factors. JGIM. 2009;24(1):80–5.CrossRefPubMed

Bellini LM, Baime M, Shea JA. Variation of mood and empathy during internship. JAMA. 2002;287(23):3143–6.CrossRefPubMed

Bellini LM, Shea JA. Mood change and empathy decline persist during 3 years of internal medicine training. Acad Med. 2005;80(2):164–7.CrossRefPubMed

ACGME competencies Available at: http://www.acgme.org/outcome/Comp/compFull.asp Accessed January 2010.

Bigby JA, ed. Cross-Cultural Medicine. Philadelphia, PA: American College of Physicians; 2003. Chapter One: Beyond Culture: Strategies for Caring for Patients from Diverse Racial, Ethnic, and Cultural Groups. pp 20–21

Smedley BD, Stith AY, Nelson AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academy Press; 2002. Chapter 4: Assessing Potential Sources of Racial and Ethnic Disparities in Care: The Clinical Encounter.

Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. 1978;88(2):251–8.PubMed

Berlin EA, Fowkes WC. A teaching framework for cross-cultural health care: application in family practice. West J Med. 1983;139(6):934–8.PubMed

Levin S, Like R, Gottlieb J. ETHNIC: a framework for culturally competent clinical practice. In Appendix: useful clinical interviewing mnemonics. Patient Care. 2000;34(9):188–9.

10.

Betancourt J, Carrillo J, Green A. Hypertension in multicultural and minority populations: linking communication to compliance. Curr Hypertens Rep. 1999;1(6):482–8.PubMed

11.

Pinderhughes E. Understanding Race, Ethnicity and Power: The Key to Efficacy in Clinical Practice. New York: Free Press; 1989.

12.

Dobbie A, Medrano M, Tysinger J, et al. The BELIEF instrument: a preclinical teaching tool to elicit patients’ health beliefs. Fam Med. 2003;35(5):316–9.PubMed

13.

Kumagai AK, Lypson ML. Beyond cultural competence: critical consciousness, social justice, and multicultural education. Acad Med. 2009;84(6):782–7.CrossRefPubMed

14.

Saha S, Beach MC, Cooper L. Patient centeredness, cultural competence and healthcare quality. J Nat Med Assoc. 2008;100(11):1275.

15.

Teal CR, Street RL. Critical elements of culturally competent communication in the medical encounter: a review and model. Soc Sci Med. 2009;68:533–43.CrossRefPubMed

16.

Cooper L, Roter DL. Patient-provider communication: the effect of race and ethnicity on process and outcomes of healthcare in Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Smedly BC, Stith AY, Nelson AR, eds. Institute of Medicine. 2002:552–93

17.

The Commonwealth Fund 2001 Health Care Quality Survey. [cited 2009; Available at: http://www.commonwealthfund.org/Content/Surveys/2001/2001-Health-Care-Quality-Survey.aspx. Accessed January 2010.

18.

Neeraj KA, Gustafson DH. Perceived helpfulness of physicians’ communication behavior and breast cancer patients’ level of trust over time. J Clin Oncol. 2009;24(2):252–5.

19.

Washington D, Bowles J, Saha S, et al. Transforming clinical practice to eliminate racial and ethnic disparities in health care. JGIM. 2008;23(5):685–91.CrossRefPubMed

20.

Lang F, Floyd MR, Beine KL, et al. Sequenced questioning to elicit the patient’s perspective on illness: effects on information disclosure, patient satisfaction, and time expenditure. Fam Med. 2002;34(5):325–30.PubMed

21.

Mookadam F, Arthur HM. Social support and its relationship to morbidity and mortality after acute myocardial infarction: systematic overview. Arch Intern Med. 2004;164(14):1514–8.CrossRefPubMed

22.

Pennebaker J, O’Hearn R. Confidants’ feedback and traumatic life events. J Trauma Stress. 1995;8(1).

23.

DiClemente C, Prochaska J, Gibertini M. Self-efficacy and the stages of self-change of smoking. Cogn Ther Res. 1985;9(2).

24.

Haidet P, Paterniti DA. “Building” a history rather than “taking” one: a perspective on information sharing during the medical interview. Arch Intern Med. 2003;163(10):1134–40.CrossRefPubMed

25.

Dyche L, Swiderski D. The effect of physician solicitation approaches on ability to identify patient concerns. J Gen Intern Med. 2005;20(3):267–70.CrossRefPubMed

26.

Corbie-Smith G, Thomas SB, St. George DMM. Distrust, race, and research. Arch Intern Med. 2002;162(21):2458–63.CrossRefPubMed

27.

Gordon HS, Street RL Jr, Sharf FM, et al. Racial differences in trust and lung cancer patients’ perceptions of physician comunication. J Cln Oncol. 2006;24(6):904–9.CrossRef

28.

The Kaiser Family Foundation National Survey of Physicians Part 1: Doctors on Disparities in Medical Care. March 2002 http://www.kff.org/minorityhealth/20020321a-index.cfm Accessed January 2010.

29.

Cooper LA, Roter DL, Johnson RL, et al. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Int Med. 2003;139(11):907–15.PubMed

30.

Blanchard J, Nayar S, Lurie N. Patient-provider and patient-staff racial concordance and perceptions of mistreatment in the health care setting. JGIM. 2007;22(8):1184–9.CrossRefPubMed

31.

Casagrande SS, Gary TL, LaVeist DJ, et al. Perceived discrimination and adherence to medical care in a racially integrated community. JGIM. 2007;22(3):389–95.CrossRefPubMed

32.

Boulware LE, Cooper LA, Ratner LE, et al. Race and trust in the health care system. Public Health Rep. 2003;118(4):358–65.PubMed

33.

Cooper LA, Beach MC, Johnson RL, et al. Delving below the surface. Understanding how race and ethnicity influence relationships in health care. JGIM. 2006;21(Suppl 1):S21–7.CrossRefPubMed

34.

Blanchard J, Lurie N. R-E-S-P-E-C-T: patient reports of disrespect in the health care setting and its impact on care. J Fam Pract. 2004;53(9):721–30.PubMed

35.

Corbie-Smith G. The continuing legacy of the Tuskegee Syphilis Study: considerations for clinical investigation. Am J Med Sci. 1999;317(1):5–8.CrossRefPubMed

36.

Johnson RL, Roter D, Powe NR, et al. Patient race/ethnicity and quality of patient-physician communication during medical visits. Am J Publ Health. 2004;94(12):2084–90.CrossRef

37.

Mast MS, Hall JA, Roter DL. Caring and dominance affect participants’ perceptions and behaviors during a virtual medical visit. JGIM. 2008;23(5):523–7.CrossRef

38.

Green AR, Betancourt JR, Carrillo JE. Integrating social factors into cross-cultural medical education. Acad Med. 2002;77(3):193–7.CrossRefPubMed

39.

Spiegel D. Healing words: emotional expression and disease outcome. JAMA. 1999;281(14):1328–9.CrossRefPubMed

40.

Smyth JM, Stone AA, Hurewietz A, Kaell A. Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: a randomized trial. JAMA. 1999;281(14):1304–9.CrossRefPubMed

41.

Mauksch LB, Dugdale D, Dodson S, Epstein R. Relationship, communication and efficiency in the medical encounter: creating a clinical model from a literature review. Arch Intern Med. 2008;168(13):1387–95.CrossRefPubMed

42.

Hafferty FW. Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med. 1998;74(3):403–7.CrossRef

43.

Hafferty FW, Frank R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med. 1994;69(11):861–71.CrossRefPubMed

44.

Braddock CH, Eckstrom E, Haidet P. The "New Revolution" in medical education: fostering professionalism and patient-centered communication in the contemporary environment. JGIM 2004;19(5 part 2):610–11.CrossRefPubMed

45.

Murray-Garcia JL, Garcia J. The institutional context of multicultural education: what is your institutional curriculum? Acad Med. 2008;83(7):646–66.CrossRefPubMed

46.

Hojat M, Vergare MJ, Maxwell K, Brainard G, Herrine SK, Isenberg GA, Veloski J, Gonnella JS. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Academic Medicine. 2009;84(9):1182–1191.CrossRefPubMed

47.

Lurie N, Yergan J. Teaching residents to care for vulnerable populations in the out-patient setting. JGIM. 1990;5:527–34.CrossRef

48.

Bosk CL. Forgive and Remember: Managing Medical Failure. 2nd ed. Chicago: University of Chicago Press; 2003.

49.

Kohn LT, Corrigan JM, Donaldson MS, eds. To Err is Human: Building A Safer Health System. Committee on Quality of Health Care in America, Institute of Medicine; 1999.

50.

Branch WT Jr, Kern D, Haidet P, et al. Teaching the human dimensions of care in clinical settings. JAMA. 2001;286(9):1067–74.CrossRefPubMed

51.

Haidet P, Stein H. The role of the student-teacher relationship in the formation of physicians. JGIM. 2006;21(S1):S16–S20.CrossRefPubMed

52.

Kern DE, Branch WT Jr, Jackson JL, Brady BW, Feldman MD, Levinson W, Lipkin M Jr. Teaching the psychosocial aspects of care in the clinical setting: practical recommendations. Acad Med. 2005;80(1):8–20.CrossRefPubMed

53.

Bigby J, Ko LK, Johnson N, David MM, Ferrer B, REACH Boston 2010. Breast and cervical cancer coalition: a community approach to addressing excess breast and cervical cancer mortality among women of African descent in Boston. Public Health Reports. 2003;118(4):334.

54.

Saitz R, et al. Alcohol Clinical Training Project, Implementation and evaluation report. supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) R25 AA013822, www.alcoholtraining.org, July,2007:25-9.

55.

Denial A, Hoppe E, Carlson N. Assessing cultural competence in optometric faculty. Optom Educ. 2006;92-5.

56.

Assessing competence in communication and interpersonal skills: The Kalamazoo II Report. Acad Med. 2004;79:495-507.

57.

Parrot S, et al. Evidence-based office teaching: the five-step microskills model of clinical teaching. Fam Med. 2006;38(3):164–7.PubMed

58.

Neher J. A five-step “microskills” model of clinical teaching. J Am Board Fam Pract. 1992;5(4):419–24.PubMed

59.

Mostow C, Principal investigator; Gordon S, Co-principal investigator. Precepting for Cultural Competence. BCBSM Medical Foundation 2004-5.

60.

www.aachonline.org Accessed January 2010.

61.

Campinha-Bacote J. The process of cultural competence in the delivery of healthcare services: a model of care. J Transcult Nurs. 2002 Jul;13(3):181-4; 200-1.

62.

Jones C. Confronting Institutionalized Racism. Phylon 2002 (1960-) 50(1/2):7-22 Also available at http://www.jstor.org/stable/4149999

63.

Stern DT. In search of the informal curriculum: when and where professional values are taught. Acad Med. 1998;73(suppl 20):S38–30.

64.

Suchman AL, Williamson PR, Litzelman DK, et al. The Relationship-centered discovery team: toward an informal curriculum that teaches professionalism: transforming the social environment of a medical school. J Gen Intern Med. 2004;19(5 pt2):501–4.CrossRefPubMed

65.

Snyder L, Leffler C, Ethics and Human Rights Committee, American College of Physicians. Ethics Manual, 5th ed. Ann Intern Med. 2005;142:560–82.

Titel: Treating and Precepting with RESPECT: A Relational Model Addressing Race, Ethnicity, and Culture in Medical Training
verfasst von: Carol Mostow, LICSW
Julie Crosson, MD
Sandra Gordon, MD
Sheila Chapman, MD
Peter Gonzalez, MD
Eric Hardt, MD
Leyda Delgado, MD
Thea James, MD
Michele David, MD, MPH, MBA
Publikationsdatum: 01.05.2010
Verlag: Springer-Verlag
Erschienen in: Journal of General Internal Medicine / Ausgabe Sonderheft 2/2010
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-010-1274-4

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