Cultural Competency Education for Health Care Providers: A Literature Review to Guide Canadian Pharmacy Residency Programs

Background

The need for cultural competency education has been emphasized for health care professionals in Canada. According to the Canadian Pharmacy Residency Board accreditation standards, pharmacy residents must be able to provide culturally competent care for their patients, further building upon the education received during their undergraduate pharmacy programs. Although these standards exist, guidance for their implementation in pharmacy residency programs is lacking.

Objectives

To review the available literature and develop recommendations for pharmacy residency coordinators and directors on cultural competency training for pharmacy residents.

Data Sources

A literature search was conducted to explore the literature concerning cultural competency education for pharmacy residents. The search was expanded to encompass literature involving pharmacy students and medical residents for information that could be applied to pharmacy residents.

Data Synthesis

The initial literature search did not yield any results for cultural competency education provided to pharmacy residents. The expanded search yielded information about methods used to educate pharmacy students and medical residents, including didactic lectures, online modules, experiential learning rotations, seminars, workshops, patient simulations and case discussions, and guest lectures by experts in the field or by patients.

Conclusions

It is recommended that interactive education methods be used to train pharmacy residents in cultural competency, to match the experiential learning structure of residency training programs. Methods that could be implemented include offering online modules or readings, arranging for guest speakers, contacting local experts and community members for guidance on creation of a suitable curriculum, and providing immersive rotations focused on diverse populations.

Effectiveness of various health education methods amongst primary healthcare workers of western Uttar Pradesh, Delhi (National Capital Region), India: A promotive intervention study

Objectives:

The purpose of this study was to assess the effectiveness of various health education methods for improving oral health knowledge of accredited social health activists (ASHA) and Anganwadi workers of Muradnagar Block, Ghaziabad-Delhi NCR.

Methods:

A promotive interventional study was conducted amongst 301 ASHA and Anganwadi workers of Muradnagar block at three steps such as baseline, oral health education programme (OHEP), and reinforcement to assess their oral health knowledge using predesigned, close-ended, validated, questionnaire. Four different methods were used in OHEP to disseminate knowledge, namely, health talks, posters, and pamphlets, PowerPoint presentations, and a combination of all methods. Post-assessment was done one week after OHEP followed by reinforcement after 1 month which was followed by final post-assessment after 1 week. Students’ independent t-test and one-way ANOVA were used for analysing data.

Results:

At baseline, primary healthcare workers had mean knowledge scores as 14.67 ± 1.152 which was increased to 20.96 ± 1.053 after the intervention and 27.6 ± 0.762 after reinforcement. There was an increase of 7.6% and 14.3% of primary healthcare workers giving correct responses after OHEP and reinforcement, respectively.

Conclusions:

The combination method was the most effective in improving oral health knowledge of study population followed by posters and pamphlets and the least effective method was PowerPoint presentation. Dentists can play a vital role in mobilising the primary healthcare workers by consequently contributing towards improving the oral health status of the community.

An Objective Structured Clinical Examination for Medical Student Radiology Clerkships: Reproducibility Study

BACKGROUND

Objective structured clinical examinations (OSCEs) are a useful method to evaluate medical students' performance in the clerkship years. OSCEs are designed to assess skills and knowledge in a standardized clinical setting and through use of a preset standard grading sheet, so that clinical knowledge can be evaluated at a high level and in a reproducible way.

OBJECTIVE

This study aimed to present our OSCE assessment tool designed specifically for radiology clerkship medical students, which we called the objective structured radiology examination (OSRE), with the intent to advance the assessment of clerkship medical students by providing an objective, structured, reproducible, and low-cost method to evaluate medical students' radiology knowledge and the reproducibility of this assessment tool.

METHODS

We designed 9 different OSRE cases for radiology clerkship classes with participating third- and fourth-year medical students. Each examination comprises 1 to 3 images, a clinical scenario, and structured questions, along with a standardized scoring sheet that allows for an objective and low-cost assessment. Each medical student completed 3 of 9 random examination cases during their rotation. To evaluate for reproducibility of our scoring sheet assessment tool, we used 5 examiners to grade the same students. Reproducibility for each case and consistency for each grader were assessed with a two-way mixed effects intraclass correlation coefficient (ICC). An ICC below 0.4 was deemed poor to fair, an ICC of 0.41 to 0.60 was moderate, an ICC of 0.6 to 0.8 was substantial, and an ICC greater than 0.8 was almost perfect. We also assessed the correlation of scores and the students' clinical experience with a linear regression model and compared mean grades between third- and fourth-year students.

RESULTS

A total of 181 students (156 third- and 25 fourth-year students) were included in the study for a full academic year. Moreover, 6 of 9 cases demonstrated average ICCs more than 0.6 (substantial correlation), and the average ICCs ranged from 0.36 to 0.80 (P<.001 for all the cases). The average ICC for each grader was more than 0.60 (substantial correlation). The average grade among the third-year students was 11.9 (SD 4.9), compared with 12.8 (SD 5) among the fourth-year students (P=.005). There was no correlation between clinical experience and OSRE grade (-0.02; P=.48), adjusting for the medical school year.

CONCLUSIONS

Our OSRE is a reproducible assessment tool with most of our OSRE cases showing substantial correlation, except for 3 cases. No expertise in radiology is needed to grade these examinations using our scoring sheet. There was no correlation between scores and the clinical experience of the medical students tested.

Use of Social Media for Out-of-Class Communication to Enhance Learning: A pilot study

Purpose: Higher education teaching has been traditionally delivered through a lecture format, limiting the opportunities for interpersonal communication between faculty and students. The purpose of this study was to determine whether entry-level dental hygiene (DH) students and faculty perceive social media (SM) applications as an effective out-of-class communication (OCC) tool for enhancing learning in a dental hygiene program.Methods: A cross-sectional, comparative research design was used for this pilot study. An investigator-designed, paper survey was administered to a convenience sample of entry-level DH students and faculty from nine dental hygiene programs in Utah, Idaho, Oregon, Washington, and California. Data were analyzed using descriptive and inferential statistics (p=0.05).Results: A total of 418 students and 149 faculty members met the eligibility criteria; 325 DH students (n=325) and 77 faculty completed the surveys (n=77) for a combined response rate of 70.9%. While most faculty and DH students agreed SM could enhance learning for OCC, their level of comfort using these applications varied. Both faculty and DH students use SM applications for questions about assignments, clarification on lecture topics, and feedback on assignments. Statistical significance was found for the frequency of using SM applications for OCC (X² =16.92; df =4; p =.002). Learning management systems were used and preferred most by both groups followed by Facebook. Statistical significance was found between both groups when ranking electronic devices for OCC.Conclusion: Dental hygiene students and faculty differ in their frequency and levels of comfort in using SM for out-of-class communication. Additional research related to the phenomenon of social media and communication to enhance learning in dental hygiene should be explored.

Bringing back the body into the mind: gestures enhance word learning in foreign language

Foreign language education in the twenty-first century still teaches vocabulary mainly through reading and listening activities. This is due to the link between teaching practice and traditional philosophy of language, where language is considered to be an abstract phenomenon of the mind. However, a number of studies have shown that accompanying words or phrases of a foreign language with gestures leads to better memory results. In this paper, I review behavioral research on the positive effects of gestures on memory. Then I move to the factors that have been addressed as contributing to the effect, and I embed the reviewed evidence in the theoretical framework of embodiment. Finally, I argue that gestures accompanying foreign language vocabulary learning create embodied representations of those words. I conclude by advocating the use of gestures in future language education as a learning tool that enhances the mind.

Making long-term memories in minutes: a spaced learning pattern from memory research in education

Memory systems select from environmental stimuli those to encode permanently. Repeated stimuli separated by timed spaces without stimuli can initiate Long-Term Potentiation (LTP) and long-term memory (LTM) encoding. These processes occur in time scales of minutes, and have been demonstrated in many species. This study reports on using a specific timed pattern of three repeated stimuli separated by 10 min spaces drawn from both behavioral and laboratory studies of LTP and LTM encoding. A technique was developed based on this pattern to test whether encoding complex information into LTM in students was possible using the pattern within a very short time scale. In an educational context, stimuli were periods of highly compressed instruction, and spaces were created through 10 min distractor activities. Spaced Learning in this form was used as the only means of instruction for a national curriculum Biology course, and led to very rapid LTM encoding as measured by the high-stakes test for the course. Remarkably, learning at a greatly increased speed and in a pattern that included deliberate distraction produced significantly higher scores than random answers (p < 0.00001) and scores were not significantly different for experimental groups (one hour spaced learning) and control groups (four months teaching). Thus learning per hour of instruction, as measured by the test, was significantly higher for the spaced learning groups (p < 0.00001). In a third condition, spaced learning was used to replace the end of course review for one of two examinations. Results showed significantly higher outcomes for the course using spaced learning (p < 0.0005). The implications of these findings and further areas for research are briefly considered.