STUDENT PHYSICAL THERAPIST PERCEPTIONS OF PREPARATION AND SKILLFULNESS IN TRANS-CULTURAL HEALTHCARE DELIVERY

T. Eckard¹, T. Watson¹, J. Graning¹, E. Wark¹, J. Marion²

¹Western Carolina University, Physical Therapy, Cullowhee, United States, ²North Carolina State University, Raleigh, United States

Background: The continued presence of health disparities along racial, ethnic, and cultural lines in the United States have led to increased awareness among health delivery and educational institutions of the need to deliver culturally appropriate healthcare. The delivery of culturally appropriate healthcare in a trans-cultural (cross-cultural) encounter requires a healthcare provider to possess an adequate degree of trans-cultural knowledge and skillfulness. To date, the degree and timing of the development of these traits in student physical therapists has not been closely examined. Additionally, demographic factors associated with their development have not been identified.

Purpose: The primary purpose was to produce normative values for perceived knowledge, skillfulness, and attitude regarding the delivery of trans-cultural healthcare in first- and second-year Doctor of Physical Therapy (DPT) students on a valid outcome measure.A secondary purpose of this study was to identify demographic factors associated with perceived preparedness to deliver culturally appropriate healthcare.

Methods: Ninety-one (91) first semester first- and second-year DPT students at a regional public university located in the southeastern United States filled out an anonymous, online demographic questionnaire and the Cross-cultural Care Survey (CCCS), a reliable and valid outcome measure created to assess cultural competency/humility and preparedness to treat culturally diverse patients in graduate-level healthcare students. The CCCS consists of 20 items organized into knowledge, skillfulness, and attitude subscales. ANOVA were used to assess differences in mean sub-scale scores by year in program, gender, international experience, Spanish proficiency, and social exposure. Individual CCCS items were parsed into “prepared/skillful” (corresponding with a response of 4 or 5 on a Likert scale) and “unprepared/unskillful” and assessed for association with each demographic variable using Pearson’s chi-square analysis.

Results: Means and standard deviations of each CCCS sub-scale were calculated for each demographic group. There were no significant differences in CCCS knowledge, skillfulness, or attitude sub-scale scores among the examined demographic groups in unadjusted or adjusted analyses. A significantly greater proportion of second-year students reported feeling prepared to care for patients with religious beliefs that affect treatment (p=0.02) and skilled in taking a social history during a trans-cultural healthcare encounter (p=0.04).

Conclusions: In our sample, first- and second-year DPT students did not differ meaningfully in their perceived preparation to deliver trans-cultural care, with the exceptions of greater perceived skill in taking social history and accounting for religious beliefs. These results may represent the successful cultivation of cultural humility in second-year students rather than lack of development of these skills during the first year of a DPT curriculum. Other demographic factors do not appear to be associated with perceived readiness to deliver trans-cultural care.

Implications: First year DPT students may benefit from didactic work and clinical experiences with a focus on culturally appropriate care. An entry-level physical therapy curriculum sans specified trans-cultural learning experiences may not be sufficient for developing cultural humility rather than delivery of a specified, robust trans-cultural experience.

Funding acknowledgements: ‘This work was supported by the Western Carolina University's Provost's Scholarship Development Award

Keywords:
Education
Trans-cultural
Cultural humility

Topics:
Education
Education: methods of teaching & learning
Professional issues

Did this work require ethics approval? Yes

Institution: Western Carolina University

Committee: Institutional Review Board

Ethics number: 1846749-1