NHLBI Cultural Competence Collaborative

National Consortium on Multicultural Education for Health Professionals

Conference CallMinutes

Monday, June 11th, 2007

12:00-1:00pm PDT

Attendees: David Acosta, Sylvia Bereknyei, Lynn Bickley, Clarence Braddock, Sonia Crandall, Chris DeGannes, Kristin Fabbro, Jorge Girotti, Paul Haidet, Lisa Hark, Kofi Kondwani, Elizabeth Lee-Rey, Desiree Lie

1)Updates and Group Announcements

Note that progress report due dates are approaching for some institutions/cycles.

2)Face to Face 2007:

Updates from small group planning committee
Meeting will be held at the Bethesda Hyatt Regency close to shops, restaurants, etc. We have reserved 1 conference room and 1-3 breakout rooms.
Registration information is on our website (see below).Link is:
The next F2F planning call is Wednesday afternoon 6/13; Paul will send an email with call-in number.

3)Consortium Website – is live!

We will review current changes for feedback and input from the consortium
Currently in progress for updates and usability
Changes include: large text blocks reduced to increase readability; home page title changed to reflect new consortium name; format more similar to the TB project website; “About Us” map will have links to each institution/program; resources for education are grouped thematically.
Feedback from Consortium
Looks fantastic. Can color choices be revisited, something more vivid?
Are we going to include links to OMH curriculum, NYU model, etc? (Yes, Sylvia working on getting permission.)
CB and Sylvia will work on creating more streamlined access to the online curricula without going into each thematic area under “Resources for Educators”.
IT: meta tagging, track visitors to site, color change (pale green, the grey surrounding the page)
Marketing the Website: How will we get the word out that the site is up and running?
Getting other relevant websites to crosslink our site:
NHLBI
AACH (Paul to give Sylvia a contact)
SGIM – cultural competence interest group
STFM
GEA/GSA of AAMC
SDRME (Society of Directors of Research in Medical Education)
NCA (National Communication Association)
EACH (European Association for Communication in Healthcare
Curricular Databases: MedEd Portal, SMDRL
AAMC Meeting – booth/table with laptop in display hall. Sylvia will submit request (deadline June 22, $300 fee). Consortium members to sign up for time slots to staff the table.
ICHC Forum in October ??? – booth/table
Listservs: sign up, send out brief announcements to groups, newsletter
AAMC Reporter – blurb
Dean’s Newsletters at each Consortium member’s institution

4)Discussion: Develop a NHLBI Consortium Conference

The intent is to develop a free-standing conference or combine with another existing conference (such as Diversity Rx 2008) to attract medical educators, disseminate Consortium information, and collaborate on future research projects.
Part of the coordinating centers’ responsibilities is a mandate for dissemination through a conference.
Discussion
The group unanimously agreed that the concept is good; details are still fuzzy.
Coordinating centers do have some additional funding, but not enough to support a free-standing national meeting.
Add a day onto an STFM or AAMC meeting?
Consider the 3 cycles when choosing a date for the meeting – 2008, 2009, or 2010.
Questions to Consider
What will be disseminated? Could be an academic meeting with speakers, presentations; could disseminate products that we’ve created as part of Consortium initiatives.
Who is our target audience? Possibilities: Internal Medicine clerkship directors, residency program directors, academic teachers, teacher of undergraduate/graduate medical education, hospital/health system leadership, associate deans for curriculum.
Where will we get the additional funding? NIH Grant for Conferences? List of organizations from Olivia. As a plan takes form, we can revisit our current budgets and perhaps renew conversations about funding with our project officer.
Goal: Form a Conference Planning Working Group
Research and submit grant opportunities for conferences
Research and collaborate with upcoming conferences
Lynn, Chris, and Lisa expressed interest. CB and/or Paul and David will chair. The group will begin to clarify ideas, and start work on a proposal for additional funding for outside sources.
Please let Sylvia know if you are interested in participating in this working group or if you have any information to develop a conference. Our next conference call is: 6/25 9am PDT.
This topic will be an item of discussion at the F2F in September.

5)Consortium Projects: Progress Reports

We will be asking the Working Groups to report on their projects and any progress with ongoing projects through July, August and September conference calls.
July
“Letters to the Editor”
David and Olivia to present and respond to Academic Medicine article
Determine interest in reviving the “textbook analysis of race and ethnicity as biological constructs”
August
Assessment Tools Working Group
Determine and discuss appropriate definitions of culture and cultural competency that is relevant to the medical educator
Additional discussions on how assessment tools map onto our desired definitions
September
TACCT
Discuss results
Post tools on Website
SP-SI checklist validation and cases
Discuss progress, validation and reliability results, and future studies

6)Upcoming conference call meeting times:

Second Monday of the month from 12:00pm-1:00pm (PDT)
Currently, our next two calls are:
July 9th, 2007
August 13th, 2007
Kristin will be polling the Consortium to determine if these dates will be kept, or if one/both will be postponed to the weeks following (July 16th or 23rd, August 20th, etc.) Please respond to her with your availability ().

Action Items (from Maymeeting):

Note new name: National Consortium on Multicultural Education for Health Professionals.
Please listserv any and all project information you wish to distribute to the group
Please send the titles of published items to Stanford (Sylvia ) and a note as to where we can find these articles

Working Groups:

“Lessons Learned” collaborative manuscript:
Carlos Estrada (lead) ()
Desiree Lie ()
Letters to the editor (responses to current articles):
Olivia Carter-Pokras (co-lead) ()
David Acosta (co-lead) ()
Office for Civil Rights
Partner with OCR to develop a curriculum targeted at emerging physicians. Focus on educating medical students that physicians are an agent for change and are 1) knowledgeable about health disparities and the law, 2) can recognize discrimination, and 3) can act when discrimination occurs.
AAMC GEA submissions include: 1) pilot workshop on curriculum, 2) focus group session on what physicians want to see in curriculum and from the OCR.
Clarence Braddock (lead) ()
Ana Nunez (AAMC focus group lead) ()
Paul Haidet (AAMC workshop lead) ()
Olivia Carter-Pokras ()
David Acosta ()
Sonia Crandall ()
Assessment Tools
Perform a systematic review of current assessment tools. Working group to determine a framework for rating by developing an internal rating scale, followed by psychometric analysis (if appropriate) through a multi-site study.
Clarence Braddock ()
Paul Haidet ()
Carlos Estrada ()
Lynn Bickley ()
David Acosta ()
Sonia Crandall ()
Desiree Lie ()
Ana Nunez ()
Elizabeth Lee-Rey ()
Advocacy at NBME
Collaborative member lead to be determined
General interest from group members
SP Case Bank Development/Trigger Tapes
Collaborative member lead to be determined
General interest from group members

Textbook review of race and ethnicity as biological constructs
Draft abstract of project: Medical schools are now required to provide cultural competency training. According to the Association of American Medical Colleges, cultural competence education for medical students should include epidemiology of health and health care disparities; factors underlying health and health care disparities; and definitions of race, ethnicity, and culture. Medical textbooks also reflect the norms, values and biases of society and medicine. We reviewed fifteen of the latest editions of the most widely used preclinical and reference textbooks in the U.S. for how each addressed race and ethnicity. Medical textbooks were identified for review from several standard lists of texts. Textbooks were individually reviewed using a pre-established set of search criteria: subject headings, definition of race and/or ethnicity, epidemiology, etiology and treatment recommendations. Information indexed by race/ethnicity varied greatly across texts—from chapter excerpts to no information. Few texts addressed the distinction between socio-political or genetically influenced race and ethnicity. Clinical texts mentioned a correlation between race and certain diseases but did not offer specific explanations. Consequently, some clinical references suggested different treatment procedures specific to ethnic groups. The majority of texts provided health statistics by racial/ethnic group and noted several related risk factors, yet offered no specific explanation for racial/ethnic disparities.
Textbook review completed, manuscript development to be pursued
Olivia Carter-Pokras (lead) ()
TACCT
Multi-site administration of TACCT to determine reliability and validity in multiple settings. Responses by students and faculty to individual TACCT items at separate schools may show variability reflecting differences in their respective existing curriculums. TACCT can be used to systematically identify areas of CC education currently under-addressed in the curriculum.
Manuscript currently under review
Desiree Lie (lead) ()
8 participating schools
SP-Interpreter case development and checklist validations
Case development of standardized patient (SP) and standardized interpreter (SI) to validate two checklists: Faculty Observation Rating Scale (FORS) and the Interpreter Impact Rating Scale (IIRS), cross-validated on the Patient-Physician Interaction scale (PPI). The pilot was done with Spanish-speaking SP-SI pairs for a smoking cessation case during a CPX exam for MS3 students. We compared the IIRS, FORS, and PPI for four faculty observers, two SP-SI pairs, and the student’s PPI scores.
In use at UCI (MS2) and Stanford (MS1)
Currently, we are undergoing manuscript revision for submission to JGIM.
Future studies will include: multi-site, multi-language, multi-academic year students (comparison of reliability and validity of IIRS/FORS); as well as usability of scales in general clinical settings.
Desiree Lie (lead) ()
Sylvia Bereknyei ()
Sonia Crandall