Date of Award

12-2018

Degree Name

Doctor of Philosophy

Department

Counselor Education and Counseling Psychology

First Advisor

Dr. Joseph R. Morris

Second Advisor

Dr. Jennifer Foster

Third Advisor

Dr. Mary L. Wassink

Keywords

multicultural, cultural competency, medical school education, multicultural curriculum, health disparities, physician training

Abstract

Health disparities disproportionately affect the lives of racial and ethnic minorities in the United States (Agency for Healthcare Research and Quality, 2015; U.S. Department of Health and Human Services NHQR, 2013). Social conditions, social determinants, and structural inequities have been acknowledged as influential forces on minority health (Link & Phelan, 1995; World Health Organization, 2011). Focusing on eliminating environmental and social conditions affecting the health status of racial and ethnic minorities should be a prerogative for healthcare professionals in reducing health disparities. The purpose of this study is to examine the relationship between color-blind racial ideology and social justice attitudes on the self-reporting of cultural competency in U.S. medical students and resident physicians. Research on the social and cultural attitudes of medical students and resident physicians is needed to help improve the cultural competency curriculum in medical schools and training programs so that health disparities may be reduced. The present study uses quantitative analyses to explore hypotheses regarding the relationship between demographic variables, educational variables, color-blind racial ideology, social justice attitudes, and cultural competency among U.S. medical students and resident physicians.

Participants were recruited from email list-servs from medical schools and residency training programs in the Midwest. A total of 153 surveys were used in the analyses. The measures used included the Color-Blind Racial Ideology Scale (CoBRAS; Neville, Lilly, Duran, Lee & Browne, 2000), the Social Justice Scale (SJS; Torres-Harding, Siers, & Olson, 2012), and the Cultural Competence Assessment (CCA; Schim, Doorenboos, & Borse, 2005). Primary analyses were multiple and hierarchical linear regression.

The findings indicate that number of cultural diversity training experiences predict self-reported cultural competency in U.S. medical students and resident physicians when demographic variables (age, gender, race/ethnicity, and sexual orientation) are controlled. Color-blind racial attitudes, specifically those on institutional discrimination, are a significant predictor of self-reported cultural competency, with gender as a possible moderator. The findings indicate that social justice attitudes, specifically those related to perceived behavioral control, are a significant predictor of self-reported cultural competency. The best predictor of self-reported cultural competency appears to be number of cultural diversity training experiences and social justice attitudes, above demographic variables, number of years in school/training, and color-blind racial ideology. The findings of this study may be helpful when developing medical student curriculum and training materials, and indicates a need for material on racial color-blindness and racism.

Access Setting

Dissertation-Open Access

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