P3.Q335: Breaking Down Barriers: Enhancing Cross-Cultural Communication Skills for Pediatric Residents Utilizing Patient Simulation

Background: In a rapidly diversifying population, effective cross-cultural communication serves as the cornerstone of culturally sensitive care. While the Accreditation Council for Graduate Medical Education (ACGME) defines communication with families across cultural backgrounds as a core competency, formal curricula across residency programs are lacking. Our objective was to assess and enhance pediatric resident cross-cultural communication skills by implementing a novel curriculum utilizing patient simulation.

Methods: We systematically developed a cross-cultural communication curriculum for our program, which involved conducting a needs assessment, setting goals and objectives, and identifying resources. After this initial phase, we implemented and evaluated our educational strategy. As a portion of our curriculum, we conducted baseline and three-month follow-up (3mf/u) assessments with residents using individual SP (standardized patient) encounters. These encounters simulated clinical scenarios aimed at eliciting cultural perspectives in medical decision-making (Figure 1A). The scenarios were developed by our research team and reviewed by two experienced general pediatricians for validity. Trained by our team, SPs evaluated residents using a communication checklist (Figure 1B). Following baseline assessments, residents participated in one or both of the following interventions: a communication workshop (lecture and standardized patient encounter with debrief session) and/or a summary worksheet of key concepts related to cross-cultural communication. We compared the differences between baseline and follow-up assessments using an unpaired t-test.

Results: A total of 23 pediatric residents participated in our standardized patient encounters at baseline or 3mf/u, the majority of which were female (n= 9, 60%), white/non-Hispanic (n= 10, 66%), and first-year pediatrics residents (n=8, 53%). Eleven residents attended the communication workshop and all residents received the communication key concepts summary sheet. We observed a statistically significant increase in average communication SP checklist scores from Mean (M)=72%, Standard Deviation (SD)=17 to M=86%, SD=12 between baseline and 3mf/u respectively, (t(21)=2.18, p=0.041, Figure 2). Among residents, 5 of 23 attended both the baseline and follow up SP evaluation sessions and 1 of 23 residents attended both SP evaluations and the communication workshop.

Conclusion: Our cross-cultural communication curriculum for pediatric learners, incorporating patient simulation, demonstrated success in enhancing skills crucial for providing culturally sensitive healthcare. While many aspects of our methodology proved feasible and sustainable, challenges in scheduling hindered comprehensive evaluation, with the majority of residents unable to undergo both baseline and follow-up SP assessments. In the short term, refining our curriculum will prioritize uniform exposure to the communication curriculum with SPs throughout residency. Longitudinally, we endeavor to identify the most effective method of teaching and evaluating pediatric trainees on culturally sensitive healthcare delivery in an effort to impact patient care outcomes across diverse populations.