SOURCE: Medical Directions Inc.

Tucson, Arizona, March 5, 2009: A study performed by University of Arizona educators found that a brief 1-hour Internet-based training program can improve physician confidence and self-reported skills in managing cross-cultural communications issues. This work is important because health professional cross-cultural training has been cited by the Institute of Medicine as an intervention that holds significant promise for reducing health disparities.

The online training program was developed by Dr. Randa Kutob, Assistant Professor of Family Medicine at the University's College of Medicine, in collaboration with national experts in cultural competency training and diabetes management. To assure clinical relevance, the program emphasized the challenges of cross cultural care in the context of treating type 2 (adult onset) diabetes. This topic was chosen because of the high prevalence of diabetes in Arizona's American Indian and Hispanic populations.

The online program emphasized a skills-based approach, based on work by Harvard Professor Arthur Kleinman, that doctors can use in any culturally diverse setting. Dr. Kutob stated, "Our course defines 'culture' in the broadest sense. The underlying message is that you can't understand an individual's culture unless you ask them about it. We teach fundamental, non-judgemental communications strategies. If doctors use these strategies in all their encounters, they will do a better job of understanding their patients' needs and in communicating their advice."

The online training program was tested in a national group of 122 family medicine resident physicians. All physicians took a standardized pretest and then 58 randomly assigned physicians completed the program. After 4 weeks, all physicians completed the same test a second time. The online program was prepared and all online testing was managed by Medical Directions, Inc., a Tucson firm specializing in the development and evaluation of online health professional education. Study results showed that physicians who completed the online training significantly improved their test scores, while those who did not take the program showed no change in scores. Study results were reported in the March, 2009 issue of the journal Family Medicine.

An important implication of this work is its relevance for the enhanced use of information technology in medical education. Many practicing physicians obtain their continuing medical education via the Internet because of its increased convenience and low costs. Medical schools and graduate medical education programs, which are under financial stress, are also seeking ways to lower training costs. To date, most cultural competency training programs have been based on labor intensive approaches such as live workshops. This work demonstrates that an online training program, which can be distributed at virtually no cost, can be used to improve physician skills nationally.

Training program development and the research study were supported by a small business technology transfer grant from the National Institute of Diabetes and Digestive and Kidney Diseases, one of the U.S. National Institutes of Health. As part of this project, Dr. Kutob and her associates revised and expanded the online program to cover more complex topics and to provide up to nine CME credits. The enhanced cultural competency training program, "Managing Type 2 Diabetes in Diverse Populations" is for sale to individual health care practitioners and professional training programs via Medical Directions, Inc. and The Virtual Lecture Hall.

About MDI - MDI is a privately held company that works with academic medical centers, professional organizations, and government agencies to develop, evaluate, and distribute online education programs for health professionals. For more information, please visit www.md-inc.com.

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