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How to Address Minority Health Disparities Through Simulation

Diversity in Healthcare Training

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.1As the U.S. becomes increasingly diverse, so too does the patient population.And, this should affect how healthcare professionals train for their roles.

与白人患者相比,种族和少数民族的成员不太可能接受预防性卫生服务,并且经常获得较低质量的护理。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

2x

非裔美国人患者中风的可能性是两倍。

40%

Puerto Ricans report the highest depression rate at 40%.**

57%

Asian American and Pacific Islander men are 57% more likely to die from liver cancer.***

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?

在下面,我们分享模拟如何使您的学习者为治疗属于种族或少数民族的患者做好准备。具体而言,我们专注于发展文化能力和对患者健康素养的敏感性的重要性。通过将您的培训工作集中在治疗少数族裔患者上并提高对现有健康差异的认识,您的学习者将不可避免地提高他们的所有患者的能力。

Developing Cultural Competence in Learners

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.

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.The good news is that developing cultural competence does not require providers to be of the same race or ethnicity as their patients.但是,它确实要求提供者适应他们如何与他们进行沟通,评估和诊断自己的患者。

文化能力培训可以改善:7

A healthcare provider's knowledge, understanding and skills for treating patients

医疗保健专业人员的患者满意度

单独通过教科书和演讲来教授文化能力可能很难。研究表明,随着时间的流逝,它是最好的学习,应该涉及自我反思过程。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.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.

A Successful Simulation...

The simulated patient is a Cherokee Indian woman with a complaint of abnormal menstrual bleeding who is resistant to gynecologic care from male providers. Following the simulation, learners discover that they misdiagnosed and mishandled the patient. They realized their inability to detect cultural cues and the impact that had on their patient’s overall care.10

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.

提高学习者管理低患者健康素养的能力

A message said is not necessarily a message understood。对于患者提供者的互动,医疗保健专业人员通常可以高估患者的健康素养,这可能是非常正确的。根据患者对自己的健康的理解以及提供者以外行术语传达信息的能力,可能会错过许多背景。

From self-reported health knowledge, to preventative behaviors, chronic disease management, and hospitalization,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


An estimated 41% of Latinos lack basic health literacy skills.15


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.

How to Prepare the Next Generation of Healthcare Professionals

美国劳工局预计,到2022年,需求要求110万名新护士,当时人口老龄化还需要57.5万名新职位,除了替代预计将退休的550,000名护士替代。19And, by this time, more than half of the nation’s children are expected to be part of a minority race or ethnic group.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

为了有效地培训下一代医疗保健提供者,并为他们做好准备以治疗所有背景的患者,Laerdal致力于开发我们最受欢迎的模拟解决方案金宝搏188手机登录网站different 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我mpact of their cultural understanding and apply that understanding to their life-saving role.照顾各种种族和种族背景的培训不可避免地改善了所有人的护理。

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参考

  1. 疾病预防与控制中心。(2019)。Minority health。从...获得https://www.cdc.gov/minorityhealth/index.html
  2. Hostetter,M。&Klein,S。(2018)。重点:通过面对种族主义来减少医疗保健中的种族差异。The Commonwealth Fund。从...获得https://www.commonwealthfund.org/publications/newsletter-article/2018/sep/focus-reducing-racial-disparities-health-care-confronting?utm_campaign=tw&utm_source=hs_email&utm_medium=email&utm_content=66476869&_hsenc=p2ANqtz-93AREu3mcWTbSh4JHFNlbvVkjj-sGbEY1fF8IBGhSRITuWF842vYkLO_02Lj4URyZJWbXKEY0JnerP1C33ImkdzEFwlzKOueBxyaDA4F22W-Hph5g&_hsmi=66476869
  3. Ibid.
  4. Ibid.
  5. National Conference of State Legislatures. (2014).劳动力多样性。从...获得http://www.ncsl.org/documents/health/workforcediversity814.pdf
  6. Lau, P., Woodward-Kron, R., Livesay, K., Elliott, K., & Nicholson, P. (2016). Cultural respect encompassing simulation training: Being heard about through broadband.公共卫生研究杂志,5(1), p. 657. DOI:10.4081/jphr.2016.657
  7. Country Health Rankings. (2018).Cultural competence training for health care professionals。从...获得http://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/policies/cultural-competence-training-for-health-care-professionals
  8. Young, S. & Guo, K.L. (2016). Cultural diversity training: The necessity of cultural competence for health care providers in nursing practice.The Health Care Manager, 35(2), p. 94-102. DOI: 10.1097/HCM.0000000000000100.
  9. Grossman, S., Mager, D., Opheim, H.M., & Torbjornsen, A. (2012). A bi-national simulation study to improve cultural awareness in nursing students.Clinical Simulation in Nursing, 8(8), p. 341-346. DOI:https://doi.org/10.1016/j.ecns.2011.01.004
  10. Morell,V.W.,Sharp,P.C。,Crandall,S.J。(2009)。提高学生意识以提高文化能力:创造关键事件。医学老师,24(5). DOI:https://doi.org/10.1080/0142159021000012577
  11. El-Toukhy, S. (2018). Health literacy: Why it matters for minority health and health disparities.U.S. Department of Health and Human Services Office of Minority Health.从...获得https://www.minorityhealth.hhs.gov/Blog/BlogPost.aspx?BlogID=1245
  12. Ibid.
  13. Abderrahman, B. (2017). Health literacy, medication adherence and thriving healthcare systems: Connecting the dots.The Pharmaceutical Journal。从...获得https://www.pharmaceutical-journal.com/opinion/insight/health-literacy-medication-adherence-and-thriving-healthcare-systems-connecting-the-dots/20203831.article?firstPass=false
  14. D.H. Howard,J。Gazmararian和R.M. Parker(2005)。低健康素养对Medicare托管护理人员的医疗费用的影响。The American Journal of Medicine, 118(4),p。371-377。doi:https://doi.org/10.1016/j.amjmed.2005.01.010
  15. Zaggar, M. & Ndefo, U.A. (2017). Medication nonadherence in the latino population: A challenge and an opportunity for specialized services.The Pharmacy Times.从...获得https://www.pharmacytimes.com/news/medication-adherence-in-the-latino-population
  16. El-Toukhy, S. (2018). See reference #14.
  17. Weekes, C.V.N. & Phillips, T.M. (2015). A mile in my patient’s shoes: A health literacy simulation for baccalaureate nursing students.Clinical Simulation in Nursing, 11(11), p.464-468. DOI:https://doi.org/10.1016/j.ecns.2015.09.001
  18. Ozkara San, E. (2015). Using clinical simulation to enhance culturally competent nursing care: A review of the literature.Clinical Simulation in Nursing, 11(4),第228-243页)。doi:https://doi.org/10.1016/j.ecns.2015.01.004
  19. Robeznieks,A。(2015年)。迫在眉睫的护理短缺由教师短缺。Modern Healthcare.从...获得https://www.modernhealthcare.com/article/20150124/MAGAZINE/301249971
  20. 美国人口普查局。(2015)。新人口普查局报告分析了美国人口预测。从...获得https://www.census.gov/newsroom/press-releases/2015/cb15-tps16.html
  21. Altarum. (2019).Looking to the future: Improving the diversity of health care workforce。从...获得https://altarum.org/health-policy-blog/looking-to-to-to-to-te-the-future-improving-the-diversity-the-health-care-workforce

*Office of Minority Health. (2016). Stroke and african americans.U.S. Department of Health and Human Services.从...获得https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=28

** Howard,C。(2018)。少数民族心理健康状况。Mental Health First Aid。从...获得https://www.mentalhealthfirstaid.org/external/2018/04/state-minority-mental-health/

***Families USA. (2019).与非西班牙裔白人相比,有色社区之间的种族和种族健康不平等。从...获得https://familiesusa.org/product/racial-and-cennic-health-inequinity-nealth-realth-mong-communities-color-color-colorpary-non-hispanic-whits

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