Cultural competency of GP trainees and GP trainers: a cross-sectional survey study.

OBJECTIVE: To assess the cultural competence (CC) of GP trainees and GP trainers.Design and setting: A cross-sectional survey study was conducted at the GP Training Institute of Amsterdam UMC. SUBJECTS: We included 92 GP trainees and 186 GP trainers. MAIN OUTCOME MEASURES: We measured the three domains of cultural competency: 1) knowledge, 2) culturally competent attitudes and 3) culturally competent skills. Regression models were used to identify factors associated with levels of CC. Participants rated their self-perceived CC at the beginning and end of the survey, and the correlation between self-perceived and measured CC was assessed. RESULTS: Approximately 94% of the GP trainees and 81% of the GP trainers scored low on knowledge; 45% and 42%, respectively, scored low on culturally competent attitudes. The level of culturally competent skills was moderate (54.3%) or low (48.4%) for most GP trainees and GP trainers. The year of residency and the GP training institute were significantly associated with one or more (sub-)domains of CC in GP trainees. Having >10% migrant patients and experience as a GP trainer were positively associated with one or more (sub-) domains of cultural competence in GP trainers. The correlation between measured and self-perceived CC was positive overall but very weak (Spearman correlation coefficient ranging from -0.1-0.3). CONCLUSION: The level of cultural competence was low in both groups, especially in the knowledge scores. Cultural competence increased with experience and exposure to an ethnically diverse patient population. Our study highlights the need for cultural competence training in the GP training curricula.

General practitioner (GP) trainees find cross-cultural consultations stressful due to a self-perceived lack of cultural competence (CC). The level of CC in general practice is as yet unknown.On average, the level of CC was low for the majority of GP trainees and GP trainers, especially for the scores on knowledge.CC increased with experience and exposure to an ethnically diverse patient population.GP trainees and trainers perceived a lack of covered education on various topics related to the care of migrants.Our study highlights the need for cultural competence training in the GP training curricula.

Early prediction of seizure remission in children with occipital lobe epilepsy.

The purpose of this study was to identify early predictors of seizure remission in occipital lobe epilepsy irrespective of syndrome classification i.e. idiopathic or symptomatic occipital lobe epilepsy. Forty-three children with occipital lobe epilepsy had taken part in an earlier study of seizure semiology, neurological deficits, psychomotor/cognitive status, electroencephalography (EEG) and neuroimaging. On the basis of the results of a questionnaire on the state of their epilepsy in 2000, two groups were composed. One group (n=17) consisted of the children with a complete seizure remission of 5 years or more, and the other (n=26) comprised children whose last seizure occurred less than 5 years ago. Our findings indicate that neurological deficit and EEG characteristics can predict 5 year outcome of occipital lobe epilepsy. Neuroradiological abnormality, psychomotor/cognitive status and seizure semiology appear to be of more limited value.