Teamwork training as part of patient safety and error disclosure curriculum

1. Teaching Cultural Competency – or Humility – through InteractionMartha Illige MDRose Family Medicine Residency and University of Colorado DenverOctober 2012 Summary   Interactive experiences in teaching about culture demonstrate to students in professional training the power of understanding context, circumstance, and holism. While recipients of care are diverse, often health professionals are less so. Care improves when we acknowledge that we have deeply embedded assumptions and strive to understand them. Curiosity about differences in body language, “the way things work” or “the way things are” helps ongoing professional development, satisfaction with care, and community health outcomes. As a teacher who wishes to enhance knowledge and attitudes about the “other” in the professional-patient relationship, what sparks will you add to activities to your training? Community engagement Large group grand rounds Community center for recovering addicts with their babies. Note four babies and four mothers per room: high infection risk ameliorated with teaching about contagion and hygiene plus early immunization during the fall-winter season with antibodies to Respiratory Syncytial Virus. 7 admissions the year before implementation and 0 the year after. You are eating your lunch of naan and tea and besh barmak in a sidewalk café in the capitol city, Bishkek, Kyrgyz Republic, in Central Asia. Watch the people on the sidewalk. What do you observe? What does eye contact mean? What does a smile mean? Structuring experiences Transportation Continuing growth Analyze assumptions: Socioeconomic? Ethnic? Gender or sexuality? What else? How can the learner “walk in the shoes” of the other? Small group focus Teamwork training as part of patient safety and error disclosure curriculum References • American Institutes for Research Teaching cultural competence in health care: a review of current concepts, policies, and practices 2002 Office of Minority Health, Washington DC USA • Boutin-Foster et al Physician, know thyself: the professional culture of medicine as a framework for teaching cultural competence Academic Medicine 2008 • Lockhart & ResickThe value of experiential learning and community resources Nurse Educator 1997 What about generational differences? How do you regard information technology? When are you finished with work, what do you do? Shift work? Hand-offs? Ask and answer daily patient-centered clinically relevant questions? How do you travel? Have you always had a car? Do you know how to use public transportation? [In the western US, many middle class people do not.] How many buses do your patients have to take to get to the office to see you? Could you arrive on time if you had to take two or more buses? Learners go into the community to meet with homeless teens or with immigrants from a different continent. They travel by bus. How much does it cost? Where do you wait? Do you have to signal for the bus to stop? What if it passes you by – what does that mean? If you were in a different country, would the bus system be the same? Thank you! Merci! Gracias! Спасибо! A board is balanced on a concrete block. Under each end of the board are raw eggs. How do all six team members get on and off the board without breaking the eggs? Who is the leader? Who plans? Who communicates? How do you learn from this? One participant noted that he learned the most from failure – in getting off the board team members got overconfident, did not communicate about moving off, and the board almost crushed the eggs. Acknowledgements What does history mean to you? “Winners” and “losers”? “Good nations” and “bad”? Was the past a time of trouble or a better time? I would like to acknowledge the following for their help and support: Brian Bacak, program director, Erika Wentarmini and Myra Bogedahl, social workers, Vanessa Rollins, psychologist and all the faculty and residents at RFMR, as well as the Department of Family Medicine, University of Colorado Denver. Martha.illige@healthonecares.com