TY - JOUR
T1 - A Randomized Crossover Trial Evaluating the Impact of Cultural Dexterity Training on Surgical Residents' Knowledge, Cross-Cultural Care, Skills, and Beliefs
T2 - The Provider Awareness and Cultural Dexterity Training for Surgeons (PACTS) Trial
AU - Smink, Douglas S.
AU - Ortega, Gezzer
AU - Dacier, Brittany M.
AU - Petrusa, Emil R.
AU - Chen, Yu Jen
AU - Shaikh, Namra Q.
AU - Allar, Benjamin G.
AU - Chun, Maria B.J.
AU - Green, Alexander R.
AU - Caldwell, Katharine E.
AU - Atkinson, Rachel B.
AU - Reidy, Emma
AU - Olufajo, Olubode A.
AU - Britt, L. D.
AU - Brittain, Molly A.
AU - Zárate Rodriguez, Jorge
AU - Swoboda, Sandra M.
AU - Cornwell, Edward E.
AU - Lynch, Kenneth A.
AU - Wise, Paul E.
AU - Harrington, David T.
AU - Kent, Tara S.
AU - Mullen, John T.
AU - Lipsett, Pamela A.
AU - Haider, Adil H.
N1 - Publisher Copyright:
© 2024 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2024/9/1
Y1 - 2024/9/1
N2 - 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. Background: Cross-cultural training of providers may reduce health care 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 preintervention and postintervention on Knowledge, Cross-Cultural Care, Self-Assessed Skills, and Beliefs. χ2 and Fisher exact tests were conducted to evaluate within-intervention 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%-88.2%, P<0.0001), Self-Assessed Skills (74.5% - 85.0%, P<0.0001), and Beliefs (89.6%-92.4%, P=0.0028) improved after PACTS; knowledge scores (71.3%-74.3%, P=0.0661) were unchanged. Delayed resident scores pre-PACTS to post-PACTS showed minimal improvements in all domains. When comparing the 2 groups in period 2, Early residents had modest improvement in all 4 assessment areas, with a statistically significant increase in Beliefs (92.4% vs 89.9%, P=0.0199). Conclusions: 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.
AB - 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. Background: Cross-cultural training of providers may reduce health care 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 preintervention and postintervention on Knowledge, Cross-Cultural Care, Self-Assessed Skills, and Beliefs. χ2 and Fisher exact tests were conducted to evaluate within-intervention 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%-88.2%, P<0.0001), Self-Assessed Skills (74.5% - 85.0%, P<0.0001), and Beliefs (89.6%-92.4%, P=0.0028) improved after PACTS; knowledge scores (71.3%-74.3%, P=0.0661) were unchanged. Delayed resident scores pre-PACTS to post-PACTS showed minimal improvements in all domains. When comparing the 2 groups in period 2, Early residents had modest improvement in all 4 assessment areas, with a statistically significant increase in Beliefs (92.4% vs 89.9%, P=0.0199). Conclusions: 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.
KW - cultural dexterity
KW - health equity
KW - surgical disparities
KW - surgical education
UR - https://www.scopus.com/pages/publications/85201104966
U2 - 10.1097/SLA.0000000000006408
DO - 10.1097/SLA.0000000000006408
M3 - Article
C2 - 38921829
AN - SCOPUS:85201104966
SN - 0003-4932
VL - 280
SP - 403
EP - 413
JO - Annals of surgery
JF - Annals of surgery
IS - 3
ER -