In the past ten years, a tremendous amount of scholarly work has been done that demonstrates that -while progress has been made to ensure that Americans have the best possible medical care-those benefits have not permeated to all segments of the US population. Members of certain ethnic/racial groups (e.g., American Indians, African Americans, Hispanics, Asians and Pacific Islanders) continue to show disparate outcomes, even when some factors like insurance coverage and socio-economic status are taken into account. Also significant are the studies that have begun to illustrate the benefits associated with having health care professionals who are attuned to the impact that cultural and socio-economic background may have on the way that individuals approach their access and utilization of health services. The main objective of this five-year educational development study is to determine whether a longitudinal curriculum that utilizes didactic and experiential approaches can improve the level of cultural competence of medical school graduates and their readiness to address the medical needs of diverse patient populations, regardless of specialty or practice location. The long-term goal is to reduce health disparities that may arise from a lack of knowledge or cultural skills on the part of physicians. The program has three specific aims: (1) Medical students will learn how to become cultural competent practitioners; (2) Residents will put into practice cultural competence skills and knowledge in their learning process: and (3) Physicians will incorporate cultural competence skills and knowledge in their everyday practice. Project years 1 and 2 are to plan and test: To successfully incorporate cultural competence into the curriculum will take time and thought. The two planning years are designed to achieve six purposes: (1) design and test the blueprint for the four-year undergraduate curriculum; (2) identify, recruit, and when necessary provide supplemental development for faculty experts to teach content over the four-year program; (3) identify and recruit individuals to create materials and resources to supplement course content; (4) define and refine our evaluation plan and measurement tools; (5) design and test the blueprint for GME and CME curricula; and (6) deal with institutional requirements that are part of initiating a major curricular change. Years 3, 4 and 5 are for implementing and evaluating: In year 3 of the project we expect to implement the following curriculum components: (1) first-year curriculum for the new entering class (class of 2010); (2) expanded module on cultural competence for residents; and (3) at least one continuing medical education conference for physicians. In year 4 of the project we expect to implement the following: (1) first-year curriculum (second iteration) for new entering class (class of 2011); (2) second-year curriculum for class of 2010; (3) expanded module on cultural competence for residents (second iteration); (4) resident as teacher module incorporating cultural competence principles; (5) at least two CME conferences for physicians; and (6) at least one grand rounds for UIC clinicians that incorporates cultural competence principles. In year 5 of the project (final year of NHLBI funds) we expect to implement the following: (1) first-year curriculum (third iteration) for new entering class (class of 2012); (2) second-year curriculum (second iteration) for class of 2011; (3) third-year curriculum for class of 2010; (4) expanded module on cultural competence for residents (third iteration); (4) resident as teacher module (second iteration) incorporating cultural competence principles; (5) at least two CME conferences for physicians; and (6) at least two grand rounds for UIC clinicians that incorporate cultural competence principles.
