Assessing medical students' awareness of and sensitivity to diverse healthbeliefs using a standardized patient station

Purpose. To assess students' performances on a health-beliefs communication OSCE station to determine whether there were differences in cultural compe tence based on the students' ethnic backgrounds. Method. A total of 71 students completed a health-beliefs communication OSC E station in which they were required to address the health beliefs and cul tural concerns of a standardized patient (SP) portraying an African America n woman with diabetes, The SPs rated students' performances on a ten-item i nterview assessment checklist. Scores on the station were standardized with in SPs to adjust for differences in their use of the rating scale. A factor analysis was performed to determine conceptual constructs on the interview assessment checklist, Subscale means were computed for each student. T-tes ts of these subscale scores were conducted to investigate gender and ethnic differences between subgroups of students. The underrepresented minority ( URM) students (five African Americans and three Mexican Americans) were com pared with all other students, and the white students were compared with al l others. To assess the magnitudes of the differences between subgroups, ef fect sizes (ES,) were computed for means comparisons. Results. Factor analysis formed two factors: Disease Beliefs and Management , and Cultural Concerns. Two remaining items loaded on a third factor that had reliability too low to support further analysis. Meaningful differences were found in cultural sensitivity based on students' ethnic backgrounds, The URM students performed better than did all other students in addressing the patient's concerns about altering culturally-based dietary behaviors f or diabetes self-care [URM students' mean standardized score (SD) = 0.42 (0 .15); all others = -0.01 (.67); ESm = 1.05]. White students performed bette r than did all other students in assessing the patient's concerns about usi ng insulin to control her blood sugar levels [white students' mean standard ized score (SD) = 0.13 (0.40); all others = -0.10 (.64); ESm = .4] Conclusion. Cultural competency deficits and differences were measurable us ing a health-beliefs communications station, and these differences were mea ningful enough to warrant faculty discussion and research about how to ensu re that students master this competency.