Primary care physicians' attitudes regarding race-based therapies.

Background: There is little to no information on whether race should be considered in the exam room by those who care for and treat patients. How primary care physicians understand the relationship between genes, race and drugs has the potential to influence both individual care and racial and ethnic health disparities.

Objective: To describe physicians' use of race-based therapies, with specific attention to the case of BiDil (isosorbide dinitrate/hydralazine), the first drug approved by the FDA for a race-specific indication, and angiotensin-converting enzyme (ace) inhibitors in their black and white patients.

Physicians' attitudes toward race, genetics, and clinical medicine.

Purpose: This qualitative study explored black and white general internists' attitudes about the relevance of race in clinical care; views of the relationships among race, genetics, and disease; and expectations about the future of genetics and health.

Methods: We conducted 10 racially concordant focus groups of primary care physicians in five metropolitan areas in the United States. Ninety board certified or eligible general internists (50 self-identified whites and 40 self-identified blacks) participated in the study.

Improving the diversity climate in academic medicine: faculty perceptions as a catalyst for institutional change.

Purpose: To assess perceptions of underrepresented minority (URM) and majority faculty physicians regarding an institution's diversity climate, and to identify potential improvement strategies.

Method: The authors conducted a cross-sectional survey of tenure-track physicians at the Johns Hopkins University School of Medicine from June 1, 2004 to September 30, 2005; they measured faculty perceptions of bias in department/division operational activities, professional satisfaction, career networking, mentorship, and intentions to stay in academia, and they examined associations between race/ethnicity and faculty perceptions using multivariate logistic regression.

Results: Among 703 eligible faculty, 352 (50.

Chief complaints, diagnoses, and medications prescribed seven weeks post-Katrina in New Orleans.

Background: In the aftermath of Hurricane Katrina, widespread flooding devastated the New Orleans healthcare system. Prior studies of post-hurricane healthcare do not consistently offer evidence-based recommendations for re-establishing patient care post-disaster. The primary objective of this study is to examine associations between patient characteristics, chief complaints, final diagnoses, and medications prescribed at a post-Katrina clinic to better inform strategic planning for post-disaster healthcare delivery (e.

Assessing validity of standardized patient ratings of medical students' communication behavior using the Roter interaction analysis system.

Objective: The primary objective of this study is to examine concurrent validity of standardized patient (SP) ratings of second year medical students' communication skills with the Roter interaction analysis system (RIAS).

Methods: We designed An Integrated Medical Encounter (AIME), to teach second year medical students the link between communication and clinical reasoning with emphasis placed on understanding the connection between biomedical and psychosocial aspects of patient care. We randomized 120 students to intervention (AIME) and control groups (non-AIME).

Self-administered instruments to measure cultural competence of health professionals: a systematic review.

Background: Tools that measure knowledge, attitudes, and skills reflecting cultural competence of health professionals have not been comprehensively identified, described, or critiqued.

Summary: We systematically reviewed English-language articles published from 1980 through June 2003 that evaluated the effectiveness of cultural competence curricula targeted at health professionals by using at least one self-administered tool. We abstracted information about targeted providers, evaluation methods, curricular content, and the psychometric properties of each tool.

Improving health care quality for racial/ethnic minorities: a systematic review of the best evidence regarding provider and organization interventions.

Background: Despite awareness of inequities in health care quality, little is known about strategies that could improve the quality of healthcare for ethnic minority populations. We conducted a systematic literature review and analysis to synthesize the findings of controlled studies evaluating interventions targeted at health care providers to improve health care quality or reduce disparities in care for racial/ethnic minorities.

Methods: We performed electronic and hand searches from 1980 through June 2003 to identify randomized controlled trials or concurrent controlled trials.

Teaching medical students the important connection between communication and clinical reasoning.

Background: Medical students are rarely taught how to integrate communication and clinical reasoning. Not understanding the relation between these skills may lead students to undervalue the connection between psychosocial and biomedical aspects of patient care.

Objective: To improve medical students' communication and clinical reasoning and their appreciation of how these skills interrelate in medical practice.

The role of cultural diversity climate in recruitment, promotion, and retention of faculty in academic medicine.

Background: Ethnic diversity among physicians may be linked to improved access and quality of care for minorities. Academic medical institutions are challenged to increase representation of ethnic minorities among health professionals.

Objectives: To explore the perceptions of physician faculty regarding the following: (1) the institution's cultural diversity climate and (2) facilitators and barriers to success and professional satisfaction in academic medicine within this context.

Challenges in systematic reviews of educational intervention studies.

Educators have recognized the need to apply evidence-based approaches to medical training. To do so, medical educators must have access to reliable evidence on the impact of educational interventions. This paper describes 5 methodologic challenges to performing systematic reviews of educational interventions for health care professionals: finding reports of medical education interventions, assessing quality of study designs, assessing the scope of interventions, assessing the evaluation of interventions, and synthesizing the results of educational interventions.

A systematic review of the methodological rigor of studies evaluating cultural competence training of health professionals.

Purpose: To systematically examine the methodological rigor of studies using cultural competence training as a strategy to improve minority health care quality. To the authors' knowledge, no prior studies of this type have been conducted.

Method: As part of a systematic review, the authors appraised the methodological rigor of studies published in English from 1980 to 2003 that evaluate cultural competence training, and determined whether selected study characteristics were associated with better study quality as defined by five domains (representativeness, intervention description, bias and confounding, outcome assessment, and analytic approach).

Cultural competence: a systematic review of health care provider educational interventions.

Objective: We sought to synthesize the findings of studies evaluating interventions to improve the cultural competence of health professionals.

Design: This was a systematic literature review and analysis.

Methods: We performed electronic and hand searches from 1980 through June 2003 to identify studies that evaluated interventions designed to improve the cultural competence of health professionals.