How to Address Minority Health Disparities Through Simulation

In the United States, approximately 36% of the population belongs to a racial or ethnic minority group – and this percentage is only expected to grow.¹随着美国的越来越多样化，患者人数也是如此。And, this should affect how healthcare professionals train for their roles.

Compared with white patients, members of racial and ethnic minorities are less likely to receive preventative health services and often receive lower-quality care.²Even after considering income, neighborhood, and health insurance – factors typically used to explain racial disparities – black patients still had poorer health outcomes than white patients.³To combat health disparities, experts say that providers must acknowledge that both structural racism and implicit biases exist in healthcare.⁴

The data shows that the U.S. population will only continue to become more diverse, and this means that the method of treating all patients the same is expected to dissolve entirely. Simulation training is often praised for the opportunity it gives learners to interact with a “real” patient.Why not enhance this realism by using a patient profile that is whole – complete with racial, ethnic, socioeconomic, geographical, and religious differences?

Below, we share how simulation can prepare your learners to treat patients who are part of a racial or ethnic minority. Specifically, we focus on the importance of developing cultural competence and a sensitivity to health literacy in patients. By focusing your training efforts on treating minority patients and creating an awareness of existing health disparities, your learners will inevitably improve in their ability to treat all patients.

Racial and ethnic minorities represent more than 25% of the total U.S. population, but only 10% of the nation’s healthcare providers.⁵While healthcare systems are keenly aware that diversifying staff and leadership positions is critical, experts also point to a need to educateallproviders to recognize why cultural differences matter.

Culturally-competent, patient-centered care focuses on each patient’s cultural differences, needs, values, preferences, and individualized care provisions as a method of reaching the best possible patient outcome.⁶It is not so much an end-point to strive for as it is an ongoing learning process for healthcare professionals.好消息是，发展文化能力并不需要提供者与患者的种族或种族相同。It does, however, require that providers adapt how they communicate with, assess, and diagnose their individual patients.

Cultural competence training can improve:⁷

It can be difficult to teach cultural competence through textbooks and lecture alone. Research shows that it is best learned over time and should involve a self-reflection process.⁸模拟可以帮助创建代表多元化社会学习者将服务的学习环境。并且，模拟汇报可以提供一个有利于每个学习者反思其态度和行为的环境。

A bi-national study showed that nursing students improved in their cultural awareness after participating in a simulation experience.⁹In this study, learners used an assessment checklist as a guide to understand their simulated patients. While the checklist reinforced questions and observations that are important in a cross-cultural (or any) patient interaction, the simulation itself provided the opportunity to put theory into practice.

仿真可以帮助创造令人大开眼界的学习经验，从而使学生更加自我意识，否则他们可能难以实现。他们可以通过模拟培训获得的文化能力最终可以挽救少数族裔患者的生命。

A message said is not necessarily a message understood。For patient-provider interactions, in which healthcare professionals can often overestimate a patient’s health literacy, this can be very true. Depending on a patient’s understanding of their own health and a provider’s ability to communicate information in laymen terms, a lot of context can be missed.

From self-reported health knowledge, to preventative behaviors, chronic disease management, and hospitalization,individuals with limited health literacy fare worse than health literate ones.¹¹更令人不安的是，少数族裔和种族以及那些在社会经济上处于不利地位，老年人或移民的人的健康素养限制不成比例地受到限制。¹²This can lead to patients avoiding care entirely, non-adherence to medication, higher medical costs, and an inefficient path to recovery.^13,14

For healthcare professionals (currently practicing or in-training), this is an area that simulation training can offer vast improvement. In addition to developing cultural competence, learners can deliberately work to strengthen their interpersonal communication skills to facilitate healthy patient-provider conversations. This can include earning a patient’s trust, helping a patient communicate his or her needs, and facilitating shared decision-making when weighing treatment options.¹⁶

Research of baccalaureate nursing students showed that simulation evoked learners’ empathy and impacted their future communication with patients.¹⁷另一项研究表明，临床模拟可用于引起学生对跨文化情况的态度，并随后提高沟通和护理技能。¹⁸通过发展学习者的同理心和技能，提供者可以更好地准备面试，传达医疗信息并为来自不同种族和种族背景的患者提供治疗。

If you’re looking at ways for your learners to develop in their sensitivity toward patients of a racial or ethnic minority, you may want to consider simulation training as a solution. Learners can enhance their patient assessment skills by taking a mindful approach to health literacy, which may lead to more accurate diagnoses, better medication adherence, and more lives saved.

The U.S. Bureau of Labor projects a demand for 1.1 million new nurses by 2022, when the aging population will require 575,000 newly created positions in addition to replacements for the 550,000 nurses expected to retire.¹⁹And, by this time, more than half of the nation’s children are expected to be part of a minority race or ethnic group.²⁰这意味着增加提供者的数量和多元化提供者是医疗保健的重要目标。但是，专家说，提高这些提供者的多样性和文化能力同样重要（如果不是更多）。²¹

To effectively train the next generation of healthcare providers, and to prepare them to treat patients of all backgrounds, Laerdal is committed to developing our most popular simulation solutions in不同的肤色。当使用模拟训练多种患者身体时，学习者应该知道文化特征对患者护理的影响。深色肤色的模拟器可以为情况增加现实主义，而不是依靠唯一的想象力。

最重要的是，模拟可以帮助您将学习者发展成警惕的医疗保健专业人员，这些专业人员的观察很细致。首先，您必须将学习者从“无意识无能的状态”中带给“有意识的无能”。只有这样，您才能指导他们成为完全能力的医疗保健提供者。

学习者可以开始重视我mpact of their cultural understanding and apply that understanding to their life-saving role.Training to care for various ethnic and racial backgrounds inevitably improves care for all.