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Providing Culturally Competent Care: Residents in HRSA Title VII Funded Residency Programs Feel Better Prepared

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Abstract

Background

The Health Resources and Services Administration (HRSA) funds primary care residency programs through its Title VII training grants, with a goal of ensuring a well-prepared, culturally competent physician workforce. The authors sought to determine whether primary care residents in Title VII-funded training programs feel better prepared than those in nonfunded programs to provide care to culturally diverse patients.

Method

The authors analyzed data from a national mailed survey of senior resident physicians conducted in 2003–2004. Of 1,467 randomly selected family medicine, internal medicine, and pediatrics residents, 866 responded—403 in Title VII-funded programs and 463 in nonfunded programs (response rate = 59%). The survey included 28 Likert-response questions about residents' preparedness and perceived skills to provide cross-cultural care, sociodemographics, and residency characteristics.

Results

Residents in Title VII-funded programs were more likely than others to report being prepared to provide cross-cultural care across all 8 measures (odds ratio [OR] = 1.54–2.61, P < .01) and feeling more skilled in cross-cultural care for 6 of 10 measures (OR = 1.30–1.95, P < .05). Regression analyses showed that characteristics of the Title VII-funded residency training experience related to cross-cultural care (e.g., role models, cross-cultural training, and attitudes of attending physicians) accounted for many of the differences in self-reported preparedness and skills.

Conclusions

Senior residents in HRSA Title VII-funded primary care residency training programs feel better prepared than others to provide culturally competent care. This may be partially explained by better cross-cultural training experiences in HRSA Title VII-funded programs.

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