Cultural Competency Training and other general resources
The Georgetown University Health Policy Institute has a brief article. CULTURAL COMPETENCE IN HEALTH CARE: IS IT IMPORTANT FOR PEOPLE WITH CHRONIC CONDITIONS? This is from 2004, so some of the statistics are dated. However, it quickly and easily poses the salient cultural issues in the provision of care. If you wanted a module on cultural competency, a paper such as this one might be useful to frame the conversation. The paper suggested common strategies to improve patient-provider interaction and institutionalize changes in a health care setting.
Think Cultural Health Clearinghouse (2013)—A Physician’s Practical Guide to Culturally Competent Care. A Physician’s Practical Guide to Culturally Competent Care is designed for physicians, PAs and NPs (though they only talk about MDs). It focuses on increasing awareness of racial and ethnic disparities in health and about the need for health care systems to accommodate increasingly diverse patient populations. The e-learning program offers case studies as illustration. It requires registration, but is free of charge. It seemed a little superficial, but may be useful for you. Here is the link: https://cccm.thinkculturalhealth.hhs.gov/
Industry Collaboration Effort (n.d.)— Better Communication, Better Care: Provider Tools to Care for Diverse Populations. This toolkit seemed very useful for providers. It offered information on interaction with a diverse patient base: encounter tips for providers and their clinical staff, a mnemonic to assist with patient interviews, help in identifying literacy problems, and an interview guide for hiring clinical staff who have an awareness of diversity issues. Click here to review.
- Communication across language barriers: tips for locating and working with interpreters, common signs and common sentences in many languages, language identification flashcards, and language skill self-assessment tools.
- Understanding patients from various cultural backgrounds: tips for talking with a wide range of people about sex, pain management across cultures, and information about different cultural backgrounds.
- References and resources.
Specific Populations to consider
Care of LGBT persons. There are several useful resources that might increase awareness or provide tools for NP students.
Ten Things: Creating inclusive health care environments for LGBT people. (July, 2015) National LGBT Health Education Center. This Guide is written for those who are leading these efforts at their health center or other health care organization. The Guide presents ten things every health care organization can do to achieve a more inclusive and affirming health care environment. The strategies are meant to be broad enough to be adaptable, yet specific enough to allow for measuring progress. In taking these steps, organizations can make significant strides in providing equitable health care for all. This is mostly background information and would be most useful as a guide for institutional change. Here is the link: http://www.lgbthealtheducation.org/wp-content/uploads/072315-Welcoming-Environment-Brief-WEB.pdf
The Fenway Institute offers several resources for LGBT People
Their National LGBT Health Education Center has two programs on providing LGBT healthcare. Part two of the webinar is the better of the two. Part two also reviews the content in part one, so you could probably skip part 1. The video takes about an hour (47 minutes if you don’t listen to the audience questions). Students must register to view the content. CEs are available.
The National LGBT Health Education Center from the Fenway Institute also offers an easy to read 16-page resource on Providing Affirmative Care for Patients with Non-binary Gender Identities. From my reading so far, this resource seems to offer the most useful information for providers. Here is the link:
Care of transgender persons. WPATH, the World Association of Transgender Health has compiled all versions of the Standards of Care into one document. The cost of the compilation to non-members is US $45.00. Many sites provide guidelines for transgender care at no cost. The UCSF Center for Excellence in Transgender Care has comprehensive guidelines for primary care providers. Here is the link the web page: http://transhealth.ucsf.edu/protocols and here is the link to the pdf of the guidelines:
People with Development Disabilities. The American Academy of Developmental Medicine and Dentistry has webinar series “Nurse Practitioner Education in Developmental Disabilities” This series is designed to enhance the practice skill of nurse practitioners and nurse practitioner students who would like to provide better care to their adult patients with developmental disabilities.
The free, 7.0 credit-hour webinar series based is designed to enhance the practice of nurse practitioners and nurse practitioner students who would like to provide better care to their adult patients with developmental disabilities. The American Association of Nurse Practitioners provides CEUs.
- Introduction to Development Disabilities,
- Health Assessment of Individuals with Neurodevelopmental Disabilities,
- Promoting Successful Aging in Older Adults with Developmental Disabilities,
- Neurologic Complications in Adults with I/DD,
- Gynecology and Sexuality,
- Clinical Pearls in the Assessment and Management of Behavioral Health in Adults with I/DD,
- Ethical and Legal Concerns within the Developmental Disabilities Population, and
- Communicating Effectively with Adults who have Developmental Disabilities
Here is the LINK to the program: https://aadmd.org/npedd-webinar-series
Rural Health. The CDC has webinars on Rural Health at Rural healthcare information hub (2017). RHIhub Webinars. All webinars listed below are located at the Rural health Information Hub https://www.ruralhealthinfo.org/webinars
The webinar series provides a synopsis into community health problems and care issues in the rural US. Presentations provide key indicators that negatively affect quality of life, chronic health conditions, and deter prevention in rural healthcare. Additionally, the webinars provide resources for providers to aid in reducing health disparities and attain health equity in rural communities. All presentations have an audio version and a PowerPoint hand out. Four webinars are summarized here:
Understanding Health Disparities in Rural America – Sixty Minutes. This webinar looks at racial and ethnic health disparities in rural communities. Source material is from Morbidity and Mortality Weekly Report November 17, 2017. James CV, Moonesinghe R, et al. Racial/Ethnic Health Disparities Among Rural Adults — United States, 2012–2015. MMWR Surveill Summ 2017;66(No. SS-23):1–9. DOI: http://dx.doi.org/10.15585/mmwr.ss6623a.
Injury Prevention and Control in Rural America –Ninety Minutes. Unintentional injury is 50% higher in rural areas compared to urban areas and rural residents are more likely to die from a number of these injuries than are their urban counterparts. CDC data on this focuses on three injury-related causes of death: motor vehicle deaths and seat belt use, suicide, and drug overdose. The webinar notes that rates of opioid misuse and overdose are highest among poor and rural populations with escalating heroin and synthetic opioids being used. MMWR companion articles are available in the links above.
Data, Disparities, and Determination – Sixty Minutes. The webinar provide insights into a CDC MMRW report, Invasive Cancer Incidence, 2004-2013, and Deaths, 2006-2015, in Nonmetropolitan and Metropolitan Counties – United States. The report notes that 1) rural counties have a higher incidence of and death rates from cancers related to tobacco use and cancers that can be prevented by screening; 2) People in rural America get cancer less often, but mortality is higher; 3) People in rural areas often delay care longer.
Audio: Listen here
Rural Mortality and Preventable Deaths – 90 minutes. The Webinar discusses inequity in mortality and morbidity in rural populations. Rural Americans are more likely to have a premature death from potentially preventable heart disease, cancer, unintentional deaths, chronic lower respiratory disease and stroke then Urban Americans. Compared to urban areas, percentages of preventable deaths are much higher. Source material is from the MMWR from January of 2017.
Audio: Listen here
This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U77HP03022, for the WWAMI Area Health Education (WWAMI AHEC) Program Office and its five regional Centers in the total amount of $679,700 for the 2019-2020 fiscal year (with a 1:1 total match of $679,700 from non-federally funded governmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.