Cultural competency of GP trainees and GP trainers: a cross-sectional survey study

Abstract

Objective

To assess the cultural competence (CC) of GP trainees and GP trainers.

Design and setting: A cross-sectional survey study was conducted at the GP Training Institute of Amsterdam UMC.

Subjects

We included 92 GP trainees and 186 GP trainers.

Main outcome measures

We measured the three domains of cultural competency: 1) knowledge, 2) culturally competent attitudes and 3) culturally competent skills. Regression models were used to identify factors associated with levels of CC. Participants rated their self-perceived CC at the beginning and end of the survey, and the correlation between self-perceived and measured CC was assessed.

Results

Approximately 94% of the GP trainees and 81% of the GP trainers scored low on knowledge; 45% and 42%, respectively, scored low on culturally competent attitudes. The level of culturally competent skills was moderate (54.3%) or low (48.4%) for most GP trainees and GP trainers. The year of residency and the GP training institute were significantly associated with one or more (sub-)domains of CC in GP trainees. Having >10% migrant patients and experience as a GP trainer were positively associated with one or more (sub-) domains of cultural competence in GP trainers. The correlation between measured and self-perceived CC was positive overall but very weak (Spearman correlation coefficient ranging from −0.1–0.3).

Conclusion

The level of cultural competence was low in both groups, especially in the knowledge scores. Cultural competence increased with experience and exposure to an ethnically diverse patient population. Our study highlights the need for cultural competence training in the GP training curricula.

KEY POINTS

General practitioner (GP) trainees find cross-cultural consultations stressful due to a self-perceived lack of cultural competence (CC). The level of CC in general practice is as yet unknown.

• On average, the level of CC was low for the majority of GP trainees and GP trainers, especially for the scores on knowledge.

• CC increased with experience and exposure to an ethnically diverse patient population.

• GP trainees and trainers perceived a lack of covered education on various topics related to the care of migrants.

• Our study highlights the need for cultural competence training in the GP training curricula.

Keywords:

• Cultural competence
• general practice
• migrants
• GP trainees
• GP trainers
• survey

Acknowledgements

We would like to thank all respondents for participating in this study, including those who took part in the think-aloud session. We also wish to thank the secretariat of the GP training institutes of Amsterdam UMC for their support. We thank Ralph de Vries for his help with the extensive literature search and Conny Seeleman for her consultation and thank her and her colleagues for making their questionnaire available to us. This research was supported by the Department of General Practice, Amsterdam UMC.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the department of general practice, Amsterdam UMC.