As the associate dean for resident inclusion and diversity education at the Medical University of South Carolina, I am responsible for the development and inclusion of cultural competency education throughout the continuum of medical education. I also serve as the medical director for our PA program. With the growing diversity in our country, improving cultural competency in medical education is imperative for reducing health disparities associated with poor health outcomes and lower quality of care.

According to the 2010 AAPA census, minorities make up approximately 15% of the PA population, but the most recent US census figures indicate that more than 25% of the current population is minority. Studies have shown that patients respond best when cared for by people who look like them. Caring for a diverse population requires that you become aware of the “social and cultural circumstances” that affect a patients' health. It also requires that you examine your own biases in order to appreciate the differences in others.

So what is cultural competency? It describes a set of knowledge, skills, and attitudes that enhance a clinician's ability to understand and respect the patient's values, beliefs, and expectations; awareness of one's own assumptions; and the ability to adapt care congruent with the patient's expectations. The Liaison Committee on Medical Education standards ED 21 and ED 22 ensure that medical students are getting the necessary training to care for diverse cultures. Reviewing the Accreditation Standards for Physician Assistant Education, I found the following under professionalism and curriculum: “B 2.16. The program curriculum must include instruction in the principles and practice of medical ethics.” As explained in Comparison of ARC-PA Accreditation Standards for Physician Assistant Education, 4th Edition (2010), To the Competencies for the Physician Assistant Profession (2005), “An environment that fosters and promotes diversity is considered essential to preparing PAs to provide service to others that is not exclusionary of any group, race, or culture. The various insights and resources offered by a diverse faculty, staff and student body increase the overall impact the PA profession can have on the future of the global community.” In addition, section B1.06 of the Comparison states: “The curriculum must include instruction to prepare students to provide medical care to patients from diverse populations.”

Are those of us in PA education really including cultural competency education in our curriculum and assessments? It is our job to ensure that PA students not only get the necessary training to take care of that next MI, for example, but also know how culture may influence overall health and health care. Toward Culturally Competent Care: A Toolbox for Teaching Communication Strategies, published by Center for Health Professions, and A Curriculum for Culturally Responsive Health Care are resources I have found helpful for instruction. Incorporating culturally responsive care within each patient encounter leads to better patient satisfaction and clinical outcomes. Let's do our jobs as educators to make sure that we are compliant with standards and that our graduates are ready to provide health care in an increasingly diverse world.

Wanda Gonsalves is associate dean for resident inclusion and diversity education, associate professor in the Department of Family Medicine, and medical director of the PA program at the Medical University of South Carolina, Charleston. This blog post expresses her personal views and does not express or represent the views or policies of AAPA.