Session Design Submission Review

No

Yes

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.

90-minute workshop

Yes

Yes

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

Articulate understanding of the PACTS curriculum components.

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