Cultural Competency in an Osteopathic Curriculum Presented by: Mary Pat Wohlford-Wessels, Ph.D. Vice President for Institutional Research and Effectiveness KCUMB Carolyn M.D., M.P.H. Associate Professor, Family Medicine Director of Community Health Services DMU-COM

Purpose The purpose of this presentation is to share DMU-COM’s process for assessing and further developing its curriculum regarding cultural competency. DMU received a grant from the American Medical Student Association Foundation to complete this project. DMU was one of three funded osteopathic medical schools.

Background Faculty in the College of Medicine began talking about the inclusion of enhanced curricular components related to cultural competency and health literacy several years ago. Those engaged in this project clearly understand that assessing and developing curricular content is an enabling task.

Background The terminal objective of the project was to ensure that all DMU graduates would be able to demonstrate the ability to interact with a diverse patient population. Students were also challenged to become more aware of their own cultural practices and bias.

Objectives The specific training objectives of the project are to develop high quality educational experiences, both in and out of the classroom, that will lead to wider understanding about:  religious and cultural beliefs and their influence on health and disease  the relationship between health care barriers and race and ethnicity  patient behavior and its influence on health patterns  health policy, health access and socio-economic barriers and much more…….

Project Consisted of two phases  Assessment of the existing curriculum  Development of content and evaluation methods for future consideration Began with the development of a definition of cultural competence (Dr. T.L. Cross) The next task was to determine where instruction in cultural competency occurred in the curriculum (cultural competence continuum)

Project In addition to identifying content that existed in the curriculum, the team also identified:  the accuracy of the information presented  the qualifications of the faculty engaged in teaching and  last but not least – what content areas are insufficiently addressed or missing altogether.

Project The early phase of assessment was conducted internally by a self directed committee of interested faculty. The second phase consisted involved engaging two experts in cultural competency

Consultants Dr. Michelle Yehieli, Director Iowa Center on Health Disparities, University of Northern Iowa & Dr. Mark Grey, Director Iowa Center for Immigrant Leadership and Integration, University of Northern Iowa

What We Learned Driving curricular change requires leadership, expertise, time and $$. Curricular change needs to be well planned and must include more than content inclusion – it requires attention to evaluation and outcomes. Hitting the target in terms of cultural competency may mean developing required and elective curricular experiences

What We Learned Cultural Competence needs to be modeled by the faculty. A commitment to improving outcomes related to cultural competence needs to be imbedded into the fabric of the institution. Utilizing the AAMC’s Tool for Assessing Cultural Competence Training is a great place to begin along with the AAMC’s statement on Communication in a Medical School Curriculum

What We Learned Students should be trained in understanding the 14 Culturally and Linguistically Appropriate Service (CLAS) Standards that have been established by the federal Office of Minority Health.

Conclusion Teaching cultural competence is a large task, that cannot be addressed through a series of lectures. The Osteopathic schools that received funding from AMSA would be well served by sharing their projects and outcomes with others.