A Randomized Crossover Trial Evaluating the Impact of Cultural Dexterity Training on Surgical Residents' Knowledge, Cross-Cultural Care, Skills, and Beliefs: The Provider Awareness and Cultural dexterity Training for Surgeons (PACTS) Trial.

Smink, Douglas S; Ortega, Gezzer; Dacier, Brittany M; Petrusa, Emil R; Chen, Yu-Jen; Shaikh, Namra Q; Allar, Benjamin G; Chun, Maria B J; Green, Alexander R; Caldwell, Katharine E; Atkinson, Rachel B; Reidy, Emma; Olufajo, Olubode A; Britt, L D; Brittain, Molly A; Zárate Rodriguez, Jorge; Swoboda, Sandra M; Cornwell, Edward E; Lynch, Kenneth A; Wise, Paul E; Harrington, David T; Kent, Tara S; Mullen, John T; Lipsett, Pamela A; Haider, Adil H

Smink, Douglas S; Ortega, Gezzer; Dacier, Brittany M; Petrusa, Emil R; Chen, Yu-Jen; Shaikh, Namra Q; Allar, Benjamin G; Chun, Maria B J; Green, Alexander R; Caldwell, Katharine E; Atkinson, Rachel B; Reidy, Emma; Olufajo, Olubode A; Britt, L D; Brittain, Molly A; Zárate Rodriguez, Jorge; Swoboda, Sandra M; Cornwell, Edward E; Lynch, Kenneth A; Wise, Paul E; Harrington, David T; Kent, Tara S; Mullen, John T; Lipsett, Pamela A; Haider, Adil H.

Afiliação

Smink DS; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Ortega G; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Dacier BM; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Petrusa ER; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Chen YJ; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Shaikh NQ; Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Allar BG; Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Chun MBJ; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Green AR; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Caldwell KE; Department of Surgery, Aga Khan University, Karachi, Sindh, Pakistan.
Atkinson RB; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Reidy E; Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Olufajo OA; Department of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii.
Britt LD; Massachusetts General Hospital, Boston, Massachusetts.
Brittain MA; Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
Zárate Rodriguez J; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Swoboda SM; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Cornwell EE; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Lynch KA; Department of Surgery, Howard University College of Medicine, Washington, DC.
Wise PE; Department of Surgery, Eastern Virginia University, Norfolk, Virginia.
Harrington DT; Department of Surgery, Eastern Virginia University, Norfolk, Virginia.
Kent TS; Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
Mullen JT; Johns Hopkins University School of Medicine, Baltimore, Maryland.
Lipsett PA; Department of Surgery, Howard University College of Medicine, Washington, DC.
Haider AH; Department of Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Ann Surg ; 2024 Jun 26.

Article em En | MEDLINE | ID: mdl-38921829

ABSTRACT

ABSTRACT

OBJECTIVES:

This trial examines the impact of the Provider Awareness and Cultural dexterity Toolkit for Surgeons (PACTS) curriculum on surgical residents' knowledge, cross-cultural care, skills, and beliefs. SUMMARY BACKGROUND DATA Cross-cultural training of providers may reduce healthcare outcome disparities, but its effectiveness in surgical trainees is unknown.

METHODS:

PACTS focuses on developing skills needed for building trust, working with patients with limited English proficiency, optimizing informed consent, and managing pain. The PACTS trial was a randomized crossover trial of 8 academic general surgery programs in the United States The Early group ("Early") received PACTS between Periods 1 and 2, while the Delayed group ("Delayed") received PACTS between Periods 2 and 3. Residents were assessed pre- and post-intervention on Knowledge, Cross-Cultural Care, Self-Assessed Skills, and Beliefs. Chi-square and Fisher's exact tests were conducted to evaluate within- and between-intervention group differences.

RESULTS:

Of 406 residents enrolled, 315 were exposed to the complete PACTS curriculum. Early residents' Cross-Cultural Care (79.6% to 88.2%, P<0.0001), Self-Assessed Skills (74.5% to 85.0%, P<0.0001), and Beliefs (89.6% to 92.4%, P=0.0028) improved after PACTS; Knowledge scores (71.3% to 74.3%, P=0.0661) were unchanged. Delayed resident scores pre- to post-PACTS showed minimal improvements in all domains. When comparing the two groups at Period 2, Early residents had modest improvement in all 4 assessment areas, with statistically significant increase in Beliefs (92.4% vs 89.9%, P=0.0199).

CONCLUSION:

The PACTS curriculum is a comprehensive tool that improved surgical residents' knowledge, preparedness, skills, and beliefs, which will help with caring for diverse patient populations.

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Texto completo: 1 Bases de dados: MEDLINE Idioma: En Revista: Ann Surg Ano de publicação: 2024 Tipo de documento: Article