How to Address Minority Health Disparities Through Simulation

在美国，大约36％的人口属于种族或少数民族群体 - 这一百分比只有预计会增长。¹As the U.S. becomes increasingly diverse, so too does the patient population.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.为什么不使用完整的患者形象来增强这种现实主义 - 包括种族，种族，社会经济，地理和宗教差异？

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.⁵而医疗系统是敏锐地意识到diversifying staff and leadership positions is critical, experts also point to a need to educateallproviders to recognize why cultural differences matter.

具有文化能力的，以患者为中心的护理重点是每个患者的文化差异，需求，价值，偏好和个性化护理条款，作为达到最佳患者结果的一种方法。⁶这并不是一个努力的终点，因为它是医疗保健专业人员的持续学习过程。The good news is that developing cultural competence does not require providers to be of the same race or ethnicity as their patients.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.⁸Simulation can help to create a learning environment that is representative of the diverse society learners will be serving. And, simulation debrief can provide a setting that is conducive for each learner to reflect on their attitudes and behaviors.

A bi-national study showed that nursing students improved in their cultural awareness after participating in a simulation experience.⁹在这项研究中，学习者使用评估清单作为了解模拟患者的指南。虽然清单的加强问题和观察在跨文化（或任何）患者的互动中很重要，但模拟本身为实践提供了机会。

Simulation can help create an eye-opening learning experience, leading to greater self-awareness in students who might otherwise be hard to reach. The cultural competence they can glean from simulation training can ultimately save the lives of minority patients.

一条消息说不一定是一条消息。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.

从自我报告的健康知识到预防行为，慢性病管理和住院，individuals with limited health literacy fare worse than health literate ones.¹¹Even more unsettling is that minority racial and ethnic groups, and those who are socioeconomically disadvantaged, elderly or immigrants, are disproportionately limited in their health literacy.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.¹⁷A separate study showed that clinical simulation can be used to elicit students’ attitudes toward cross-cultural situations and subsequently improve communication and nursing skills.¹⁸通过开发学习者移情和技能,提供者s are better prepared to interview, communicate medical information, and provide treatment to patients from diverse ethnic and racial backgrounds.

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.¹⁹而且，到这个时候，预计全国一半以上的孩子将成为少数族裔或族裔的一部分。²⁰This means that increasing the number of providers and diversifying providers are important goals for healthcare. However, experts say that it is equally (if not more) important to increase the diversity and cultural competency of those providers.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 indifferent skin tones。When using simulation to train for diverse patient bodies, learners should know the impact of cultural characteristics on a patient’s care. A simulator in a darker skin tone serves to add realism to the situation, rather than relying on sole imagination.

Above all things, simulation can help to develop your learners into vigilant healthcare professionals who are meticulous in their observations. First, you must bring learners from a state of “unconscious incompetence” to “conscious incompetence”; only then can you coach them to become fully-competent healthcare providers.

学习者可以开始重视他们的文化理解的影响，并将这种理解应用于挽救生命的角色。Training to care for various ethnic and racial backgrounds inevitably improves care for all.