Clinical Gastroenterology and Hepatology
Volume 7, Issue 3 , Pages 279-284, March 2009

Integration of Racial, Cultural, Ethnic, and Socioeconomic Factors Into a Gastrointestinal Pathophysiology Course

  • Helen M. Shields

      Affiliations

    • Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
    • Harvard Medical School, Boston, Massachusetts
    • Corresponding Author InformationReprint requests Address requests for reprints to: Helen M. Shields, MD, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts 02215. fax: (617) 667-5826
  • ,
  • Daniel A. Leffler

      Affiliations

    • Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
    • Harvard Medical School, Boston, Massachusetts
  • ,
  • Augustus A. White III

      Affiliations

    • Harvard Medical School, Boston, Massachusetts
  • ,
  • Janet P. Hafler

      Affiliations

    • Tufts University Medical School, Boston, Massachusetts
  • ,
  • Stephen R. Pelletier

      Affiliations

    • Harvard Medical School, Boston, Massachusetts
  • ,
  • Richard P. O'Farrell

      Affiliations

    • Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
    • Harvard Medical School, Boston, Massachusetts
  • ,
  • Roxana Llerena–Quinn

      Affiliations

    • The Academy Center for Teaching and Learning, Boston, Massachusetts
  • ,
  • Jane N. Hayward

      Affiliations

    • Media Services, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • ,
  • Sheila Salamone

      Affiliations

    • Office of Curriculum Resources, Boston, Massachusetts
  • ,
  • Andrea M. Lenco

      Affiliations

    • Office of Curriculum Resources, Boston, Massachusetts
  • ,
  • Paola G. Blanco

      Affiliations

    • Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
    • Harvard Medical School, Boston, Massachusetts
  • ,
  • Antoinette S. Peters

      Affiliations

    • Harvard Medical School, Boston, Massachusetts
    • The Academy Center for Teaching and Learning, Boston, Massachusetts
    • Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care, Boston, Massachusetts

published online 16 October 2008.

Background & Aims

Our study describes a faculty development program to encourage the integration of racial, cultural, ethnic, and socioeconomic factors such as obesity, inability to pay for essential medications, the use of alternative medicine, dietary preferences, and alcoholism in a gastrointestinal pathophysiology course.

Methods

We designed a 1-hour faculty development session with longitudinal reinforcement of concepts. The session focused on showing the relevance of racial, ethnic, cultural, and socioeconomic factors to gastrointestinal diseases, and encouraged tutors to take an active and pivotal role in discussion of these factors. The study outcome was student responses to course evaluation questions concerning the teaching of cultural and ethnic issues in the course as a whole and by individual tutorials in 2004 (pre-faculty development) and in 2006 to 2008 (post-faculty development).

Results

Between 2004 and 2008, the proportion of students reporting that “Issues of culture and ethnicity as they affect topics in this course were addressed” increased significantly (P = .000). From 2006 to 2008, compared with 2004, there was a significant increase in the number of tutors who “frequently” taught culturally competent care according to 60% or greater of their tutorial students (P = .003). The tutor's age, gender, prior tutor experience, rank, and specialty did not significantly impact results.

Conclusions

An innovative faculty development session that encourages tutors to discuss racial, cultural, ethnic, and socioeconomic issues relevant to both care of the whole patient and to the pathophysiology of illness is both effective and applicable to other preclinical and clinical courses.

Abbreviation used in this paper: CCC, cross-cultural care

 

 Conflicts of interest The authors disclose the following: Dr Shields received support for this project from the Leo E. Wolf and Natalie W. Wolf Fund at Beth Israel Deaconess Medical Center. Dr White received support for this project from Blue Cross and Blue Shield of Massachusetts. The remaining authors disclose no conflicts.

PII: S1542-3565(08)01037-9

doi:10.1016/j.cgh.2008.10.012

Clinical Gastroenterology and Hepatology
Volume 7, Issue 3 , Pages 279-284, March 2009