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.

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

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？

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。

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.

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.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

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.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。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。

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.

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。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

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。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。