Refugee & Immigrant Patients

 

Curriculum

 

PGY-1          PGY-2          PGY-3

 

Recent data suggest that individuals from non-Anglo racial and ethnic backgrounds have worse health outcomes than White Americans. These disparities result from a number of factors, including financial barriers to appropriate care, language barriers, cultural barriers and conscious and unconscious stereotyping of patients by providers.

The three workshops address the following:

PGY1 –Residents will develop an understanding of the meaning of culture, the components and skills that define cultural competency, and be able to communicate effectively with patients from different cultural and linguistic backgrounds, including the use of interpreters. This will include discussions of culture and cultural competence, collaborative care, laws and standards related to limited English speaking patients, different methods of effective communication including the use of interpreters, and the impact of being a refugee on physical and emotional health. Additional interpersonal/ communication skills will address utilization of the Kleinman Model when interviewing patients of a different culture, as well as specific skills in working with an interpreter and developing an awareness of the resident’s own personal attitudes, beliefs, biases, and behaviors and how they may impact clinical care.

PGY2 – Residents will learn to diagnose and manage a refugee patient with post-traumatic stress disorder (PTSD) and the emotional challenges and possible personal reactions of caring for refugee patients who have been significantly traumatized.  This will include the following related to PTSD: criteria for diagnosis, scales to measure symptoms, prevalence, challenges in assessment and treatment, local resources, and recognizing and addressing the emotional toll in caring for patients who have been traumatized.

PGY3 – Residents will be able to identify and address common ethical challenges in caring for refugees and immigrants. This will include discussion of Western ethical principles in healthcare, the role of family members in medical decision making, communicating bad news, and identifying patient preferences regarding disclosure information. This workshop will also address issues related to terminal illnesses in culturally diverse patient populations, including effective communication, culture specific discussions regarding advanced directives and living wills, consulting with other members of the healthcare team including an Ethics Committee, and other critical issues associated with the decision making process.