Using standardized patients to enhance cross-cultural sensitivity Lee Ellen Buenconsejo-Lum, Gregory G. Maskarinec Department of Family Practice and Community Health, University of Hawai’i John A. Burns School of Medicine, Hawai’i, USA Abstract Aim: To prepare family practice residents for an international rotation, and simultaneously to address recent mandates for objective standardized evaluation of residents, the authors have initiated a series of standardized patients (SPs) speciically designed to teach and evaluate cross-cultural issues. These cases supplement the authors’ existing cross-cultural curriculum. Methods: Two SP cases, based on actual presentations of patients from the Marshall Islands who presented to the authors’ outpatient clinic, are used to provide an ethnographic exploration of other cultural models of illness and to examine the narrative foundations of the illness experience. These SPs were piloted on the intern class of 2002–03. Results: Increased cross-cultural sensitivity and improved residents’ communication skills. Conclusion: The authors have found that using standardized patients speciically designed to teach cross- cultural issues, is a very powerful addition to existing evaluation strategies. Standardized patients can be designed not only as evaluation tools, but also as teaching tools and group discussion points for sensitive patient care issues. © 2004 World Organization of Family Doctors Introduction The Family Practice Residency Program at the University of Hawaii requires its residents to undertake two international rotations in the Republic of the Marshall Islands (RMI) during postgraduate years 2 and 3 (PGY-2 and PGY-3). To prepare residents for this international rotation and simultaneously to address recent mandates from the American Association of Medical Colleges (AAMC) 1 and the Accreditation Council for Graduate Medical Education (ACGME) 2 (see Table 1) we have piloted a series of objective standardized learning experiences (OSLEs) that emphasize cross-cultural sensitivity and are intended to supplement our existing cross-cultural curriculum. In doing this we are seeking to supplement indings that standardized patients (SPs, deined as people who are trained to portray a clinical scenario for teaching or research purposes) 3,4 are an effective means to assess components of interviewing, physical examination, communication skills and certain clinical tasks. 5,6 We urge other programs to use OSLEs to address the following important issues: ______________________________________________ Correspondence: Lee Ellen Buenconsejo-Lum, MD, Assistant Professor and Associate Residency Director, University of Hawaii John A. Burns School of Medicine, Department of Family Practice, 95–390 Kuahelani Avenue, Mililani, HI, 96789, US. Email: leblum@uhfpres.org Accepted for publication August 2004. Table 1 Programs that train resident physicians for any specialty are now required by the Accreditation Council for Graduate Medical Education to document educational outcomes and graduate physicians competent in six core areas. 2 A. Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health B. Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care C. Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientiic evidence, and improvements in patient care D. Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals E. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population F. Systems-Based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. ___________________________________________________ Demonstration of competency in these six areas will help assure that physicians are prepared to practice medicine in the changing health care delivery system. Asia Paciic Family Medicine 2004;3: 23-27 Original Article http://www.apfmj.com 23