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Session Design Submission Review

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Implementing a Cultural Dexterity Curriculum in Surgical Residencies: Facilitator Training and Lessons Learned from the PACTS Trial

Session TypeWorkshop

Is this submission from an ASE Committee, Task Force, or Working Group?

No

Are you a member of ASE?

Yes

Session Information

Session Description

Health inequities, although present throughout our healthcare system since its inception, have come to the forefront of medicine in recent years through the COVID-19 pandemic and Black Lives Matter movement in the United States. Strategies to mitigate racial and ethnic disparities in surgical care include diversifying the surgical workforce, which is essential for diversity and inclusivity, however, the surgical pipeline is long, and it will take decades for the surgical workforce to reflect the US population. To overcome this delay, we must concurrently provide cross-cultural training to meet our patients’ needs.

The ACGME requires health equity education and resident competency in communicating effectively with patients from various cultural backgrounds and with different language capabilities, however, there currently is not a formalized cultural competency curriculum that is implemented across all residencies. Cultural dexterity is an innovative paradigm shift from cultural competency training that transitions from one of understanding the importance of cultural influences on patients’ beliefs and behaviors to the cognitive and social skills needed to provide high quality, patient centered care.

The Provider Awareness and Cultural dexterity Toolkit for Surgeons (PACTS) trial, a NIH National Institute on Minority Health and Health Disparities R01 randomized crossover trial that took place at 8 academic surgical residency programs between 2019-2022, was developed to improve knowledge, skills and attitudes for surgical residents caring for patients of diverse cultural backgrounds. The PACTS curriculum mitigates disparities by focusing on surgical residents, and teaches them to recognize their biases, develop a set of tools to use in four key areas of surgical care, and empower them to engage in mindful encounters with diverse patients. The four key areas of focus are: 1) Building Trust and Effective Cross-Cultural Communication; 2) Optimizing Communication with Patients with Limited English Proficiency; 3) Informed Consent in Cross-Cultural Surgeon-Patient Relationships; and 4) Management of Pain in Cross-Cultural Surgical Care. These skills for situational awareness and adaptability in patient encounters are delivered through e-learning, case explorations, spaced learning, and clinical assessments of the surgical residents.

Results from the PACTS trial demonstrated improvement in resident knowledge, skills, and beliefs in cross-cultural care encounters, and positively impacted patients’ overall experience. Intended for both faculty and residents, this workshop trains facilitators on implementation of the PACTS curriculum in their own program. We will instruct attendees on the components of the PACTS curriculum and work through a case-exploration, emphasizing methods to adapt the curriculum to the specific needs of participants’ surgical training programs.

Workshop Length

90-minute workshop

If a similar workshop is submitted, would you be willing to combine workshops into one session?

Yes

Would you be open to presenting a workshop of a different duration than selected above if needed?

Yes

Session Objective 1

Demonstrate understanding of the concept of cultural dexterity and its application to surgical care and caring for cross-cultural patients.

Session Objective 2

Articulate understanding of the PACTS curriculum components.

Session Objective 3

Apply best practices for implementation of the PACTS curriculum at surgical residency training programs.

Session Outline
Activity Order Title of Presentation or Activity Presenter/Faculty Name Presenter/Faculty Email Time allotted in minutes for activity

1

Introduction to Cultural Dexterity and Fundamental Principles of Culturally Dexterous Care

Doug Smink

[email protected]

5

2

The PACTS Curriculum

Gezzer Ortega

[email protected]

15

3

Case Exploration: Building Trust

Kenneth Lynch

[email protected]

30

4

Large Group Discussion – Lessons Learned from Building Trust Case Exploration

Brittany Dacier

[email protected]

10

5

Implementing PACTS in Your Program

Maria Chun

[email protected]

20

6

Question & Answer

Doug Smink

[email protected]

10

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