Measuring residents' perceived preparedness and skillfulness to deliver cross-cultural care

Abstract

BACKGROUND: As patient populations become increasingly diverse, we need to be able to measure residents' preparedness and skillfulness to provide cross-cultural care. OBJECTIVE: To develop a measure that assesses residents' perceived readiness and abilities to provide cross-cultural care. DESIGN: Survey items were developed based on an extensive literature review, interviews with experts, and seven focus groups and ten individual interviews, as part of a larger national mailed survey effort of graduating residents in seven specialties. Reliability and weighted principal components analyses were performed with items that assessed perceived preparedness and skillfulness to provide cross-cultural care. Construct validity was assessed. PARTICIPANTS: A total of 2,047 of 3,435 eligible residents participated (response rate = 60%). MEASUREMENTS AND MAIN RESULTS: The final scale consisted of 18 items and 3 components (general cross-cultural preparedness, general cross-cultural skillfulness, and cross-cultural language preparedness and skillfulness), and yielded a Cronbach's alpha = 0.92. Construct validity was supported; the scale total was inversely correlated with a measure of helplessness when providing care to patients of a different culture (p < 0.001). CONCLUSIONS: We developed a three-component cross-cultural preparedness and skillfulness scale that was internally consistent and demonstrated construct validity. This measure can be used to evaluate residents' perceived effectiveness of cross-cultural medical training programs and could be used in future work to validate residents' self assessments with objective assessments. © 2009 Society of General Internal Medicine.