Providing culturally competent care: residents in HRSA Title VII funded residency programs feel better prepared

Acad Med. 2008 Nov;83(11):1071-9. doi: 10.1097/ACM.0b013e3181890b16.


Background: The Health Resources and Services Administration (HRSA) funds primary care residency programs through its Title VII training grants, with a goal of ensuring a well-prepared, culturally competent physician workforce. The authors sought to determine whether primary care residents in Title VII-funded training programs feel better prepared than those in nonfunded programs to provide care to culturally diverse patients.

Method: The authors analyzed data from a national mailed survey of senior resident physicians conducted in 2003-2004. Of 1,467 randomly selected family medicine, internal medicine, and pediatrics residents, 866 responded--403 in Title VII-funded programs and 463 in nonfunded programs (response rate = 59%). The survey included 28 Likert-response questions about residents' preparedness and perceived skills to provide cross-cultural care, sociodemographics, and residency characteristics.

Results: Residents in Title VII-funded programs were more likely than others to report being prepared to provide cross-cultural care across all 8 measures (odds ratio [OR] = 1.54-2.61, P < .01) and feeling more skilled in cross-cultural care for 6 of 10 measures (OR = 1.30-1.95, P < .05). Regression analyses showed that characteristics of the Title VII-funded residency training experience related to cross-cultural care (e.g., role models, cross-cultural training, and attitudes of attending physicians) accounted for many of the differences in self-reported preparedness and skills.

Conclusions: Senior residents in HRSA Title VII-funded primary care residency training programs feel better prepared than others to provide culturally competent care. This may be partially explained by better cross-cultural training experiences in HRSA Title VII-funded programs.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.

MeSH terms

  • Attitude of Health Personnel
  • Cultural Competency / education*
  • Data Collection
  • Education, Medical, Graduate / economics*
  • Family Practice
  • Female
  • Financing, Government / economics
  • Financing, Government / legislation & jurisprudence
  • Humans
  • Internal Medicine
  • Internship and Residency*
  • Male
  • Pediatrics
  • Physicians, Family / education*
  • Professional Competence
  • Program Evaluation*
  • Training Support / economics
  • Training Support / legislation & jurisprudence
  • United States
  • United States Health Resources and Services Administration / economics
  • United States Health Resources and Services Administration / legislation & jurisprudence