Beling J.1, Adame J.1, Kwok A.1, Rado D.1, Sklarew A.1, Koehler J.1, Korson J.1, Venezia N.1
1California State University, Northridge, Physical Therapy, Northridge, United States
Background: Ethnic minorities constitute over 1/3 of the US population. Health care providers are more likely than they were in the past to interact with clients who speak a different language or have different health beliefs. Culturally competent care has been linked to improved health outcomes and the elimination of health disparities. The Blueprint for Teaching Cultural Competence in Physical Therapy, the Task Force to Develop a Cultural Competence Curriculum and the Committee on Cultural Competence have adopted the Campinha-Bacote model of cultural competence. The 5 constructs of this model include: Cultural awareness, Cultural knowledge, Cultural skill, Cultural encounters, and, Cultural desire.
Purpose: The purpose of this study was to determine the effect of a cultural competence education course on the cultural competence of physical therapist students.
Methods: Forty-eight physical therapist students in the last semester of their physical therapist education program at one of the largest public universities in the USA participated in this study. The experimental group (n=24) were students who elected to take a 15 week Cultural Competence course with a capstone 2-3 week service-learning project at a rehabilitation hospital in Vietnam following the 15-week semester. The course met two hours per week for 15 weeks and used a variety of activities such as self-reflection, lecture, diversity service-learning, case studies, videos, and discussion. The 2-3 week service-learning project at the rehabilitation hospital integrated physical therapy while addressing a community need. The control group (n=24) did not take the elective. The primary outcome was cultural competence as measured by the Campinha-Bacotes Inventory for Assessing the Process of Cultural Competence Among Health Care Professionals Revised (IAPCC-R). The IAPCC-R is 25 questions and uses a 4-point Likert Scale. Pre and post measurements were taken the first week of the semester in which the elective was taught and either at the end of the international experience (the experimental group) or the last week of the semester (control group). All data were analyzed using SPSS 23.0. A 2 (intervention) X 2 (time) mixed ANOVA with repeated measures on the last factor was used to investigate the effect of a cultural competence educational intervention on IAPCC-R scores. All statistical tests were conducted at the P .05.
Results: There was a statistically significant interaction between the intervention and time on total IAPCC-R score, F (1,47)=19.916, P .001, partial eta=.298. The IAPCC-R score was statistically greater in the experimental group (M=74.9+7.8, P .05) compared to the control group (M=66.6+7.3, P .05) at the end of the semester. IAPCC-R improved significantly over time in the experimental group (increased 9.3 points), F(1,23)=28.27, partial eta squared=.551, P .001, but, not in the control group (increased 2.4 points), F(1,24)=3.833, P≥.05.
Conclusion(s): This study shows preliminary evidence that a cultural competence educational course with international community service may assist with improving student physical therapists cultural competence.
Implications: Physical therapist students changed from culturally aware (51-74 points) to culturally competent (75-90 points) as measured on the IAPCC-R after taking an elective which included international community service.
Funding acknowledgements: Funding was provided by the CSUN Office of Research and Graduate Studies grants and a private foundation for student travel.
Topic: Education: methods of teaching & learning
Ethics approval: This project was approved by the Office of Research and Sponsored Projects at California State University, Northridge, California, USA.
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