ReCAP: Assessing Cultural Competence Among Oncology Surgeons
Authors: Doorenbos Ardith Z. , Morris Arden M. , Haozous Emily A. , Harris Heather , Flum David R. , Doorenbos Ardith Z. , Morris Arden M. , Haozous Emily A. , Harris Heather , Flum David R. 
Published: January 2016

QUESTION ASKED:

Are there attributes of surgical providers that are associated with culturally congruent care?

SUMMARY ANSWER:

Surgical providers reported treating diverse patient populations; 71% encountered patients from six or more racial/ethnic groups. More than half (58%) reported completing cultural diversity training, with employer-sponsored training the most common type reported (48%; 71 of 147). Cultural Competence Assessment scores ranged from 5.99 to 13.75 of a possible 14 (mean = 10.3; standard deviation ± 1.3), and receipt of diversity training was associated with higher scores than nonreceipt (10.56 v 9.82, respectively; P < .001).

METHODS:

Surgical providers from six hospitals in the Puget Sound region of Washington State were invited to participate. Participants completed a 50-item survey that assessed demographic data and incorporated the Cultural Competence Assessment and the Marlowe-Crowne Social Desirability Scale. Survey response rate was 51.1% (n = 253).

BIAS, CONFOUNDING FACTORS(S), DRAWBACKS:

Our study has several limitations. Although our survey response rate of 51% was better than that of most physician surveys reported in the literature, we acknowledge that our data cannot represent the experience of all surgeons in the United States who care for racial/ethnic minority patients, as our survey was limited to surgeons practicing in the Puget Sound region. Our survey items on the racial/ethnic and special population diversity encountered by providers were limited to experiences in the past 12 months. We might have obtained a more accurate description of providers’ experience by using a more detailed quantitative measure, but we elected not to use this approach in order to limit respondent burden and thereby improve response rates. This study only surveyed surgical providers, which represents only a snapshot of the cancer care continuum. Future research should include medical oncology providers and others oncology providers to provide a more complete picture of cultural competency across the cancer care continuum.

REAL-LIFE IMPLICATIONS:

Culturally competent care is an essential but often overlooked component of high-quality health care. In our study sample, most surgical providers who treated racially and ethnically diverse patients perceived that they had a high level of cultural awareness, and their perceived and measured cultural awareness were highly correlated in our analyses. As US demographics become increasingly diverse, these data provide encouraging evidence that surgical providers are generally culturally sensitive and culturally aware, and perhaps more important, that they place a high value on cultural awareness. Our results also demonstrate that exposure to cultural diversity training was the single most important contributor to culturally congruent care, indicating a substantial need to continue existing diversity training interventions. Future work should compare training offered by various hospital systems. [Table: see text]