1. + Increasing cultural competence and awareness in the pharmacy curriculum Samia B.

2. + Introduction Involvement with the Women’s Center/Multicultural Center on campus SNPHA

3. + Introduction Zweber A. Cultural competence in pharmacy practice. Am J of Pharm Ed 2002; 66:172-176. Shaya FT, Gbarayor CM. The case for cultural competence in health professions education. Am J of Pharm Ed 2006; 70: 124. O'Connell, MB, et al. Cultural Competency in Health Care and Its Implications for Pharmacy Part 3A: Emphasis on Pharmacy Education, Curriculums, and Future Directions. Pharmacotherapy. 2013. doi 10.1002/phar. 1353. O'Connell, MB, et al. Cultural Competency in Health Care and Its Implications for Pharmacy Part 3B: Emphasis on Pharmacy Education Policy, Procedures, and Climate. Pharmacotherapy. 2013. doi 10.1002/phar. 1352.

4. + Introduction Pharmacy courses already implementing cultural competence Fall P1 recitation lecture All classes have varying ways of including cultural competence into the curriculum

5. + Survey Objectives Primary objective: Examine pharmacy students’ attitudes and opinions are about cultural competence and their preferred method of learning more about the topic Secondary objective: Examine multicultural center students’ attitudes and opinions about cultural competence, how it compares to pharmacy students’ attitudes and opinions and how it can contribute to pharmacy students learning about the topic

6. + Assessment Pharmacy Students (n=73) Multicultural Center (n=16) Year in Pharmacy School P2 P3 P4 Faculty Year in University Y1 Y2 Y3 Y4 GS Fac Other

7. + Assessment Demographics Ethnicity Pharmacy Students (n=75)Multicultural Center (n=16) Race/Ethnic Profile of MCC StudentsRace/Ethnic Profile of Pharmacy Students AA AS CAHI NA N/A

8. + Assessment Demographics Gender Pharmacy Students (n=76)Multicultural Center (n=16) Gender Male Female No Answer

9. + What does it mean to be culturally competent or inclusive of diversity?” Pharmacy Students (n=60) 34% said be understanding 26% said be open- minded 24% said being respectful 22% said be aware Multicultural Center (n=15) 33% said be understanding 13% said be open- minded 13% said being respectful 6% said be aware

10. + Assessment Preferences for cultural competence and diversity in the curriculum Pharmacy Students 96% of students (n=76) believe having exposure to cultural competence in the curriculum is somewhat or very important. “What information should a potential healthcare worker be aware of in regards to a patient's cultural or social background to provide optimal care?” (n=58) 57% said beliefs (religious, cultural, etc.) 14% said gender identity and sexual orientation 11% said language barriers

11. + Assessment Preferences for cultural competence and diversity in the curriculum Pharmacy Students (n=75) Order of student preferences on ways they would like to learn about cultural competence and diversity IPPE or APPE rotations abroad or other Guest speakers share their personal experiences Cultural competence and diversity in patient cases Lecture or information session

12. + Assessment Preferences for cultural competence and diversity in the curriculum Pharmacy Students (n=72) Classes In Which Students Prefer To Learn About Cultural Competence P1 Recitation CORELabs Electives IPPE/APPE N= 40 30 20 10

13. + Assessment Preferences for cultural competence in the curriculum Multicultural Center Students 93.8% of students believe having exposure to cultural competence in the curriculum is somewhat or very important. (n=16) 6.3% were neutral “What information should a potential healthcare worker be aware of in regards to a patient's cultural or social background to provide optimal care?” (n=15) 33% said beliefs (religious, cultural, etc.) 6.7% said gender identity and sexual orientation 6.7% said language barriers

14. + Assessment Preferences for cultural competence and diversity in the curriculum Multicultural Center Students (n=16) Student preferences on ways they would like to learn about cultural competence and diversity 1. Practical experience (internships, volunteer opportunities/service learning, etc.) 2. Guest speakers share their personal experiences 3. Lecture or information session 4. Completing class exercises using cultural competence cases

15. + Assessment Personal Experiences Regarding Cultural Competence Pharmacy Students –”Have you had any experiences studying abroad, working/volunteering in a setting where you were able to learn about different cultural and social backgrounds and how it affects the choices made about health and care...” N= 40 30 20 10 Study Abroad Volunteering Work Yes No

16. + Assessment Personal Experiences Regarding Cultural Competence Pharmacy Students 10% of students who had experience for either volunteered RI Free Clinic or Clinic Esperanza Communities that students have mentioned they encounter Jewish Hispanic/Latino Italian Vietnamese

17. + Assessment Personal Experiences Regarding Cultural Competence Pharmacy Students “Do you, a family member, or someone from your community have personal experiences where cultural background and differences make a difference in care rec’d?” N= 60 40 20 Yes No You Family Member Community

18. + Assessment Personal Experiences Regarding Cultural Competence Multicultural Center Students Have you had any experiences studying abroad or working/volunteering in a setting where you were able to learn about different cultural and social backgrounds and how it affects the choices made in terms of health and care received? Study Abroad VolunteeringWork N= 8 6 4 2 Yes No

19. + Assessment Personal Experiences Regarding Cultural Competence Multicultural Center Students Would you, a family member or a community member be willing to speak about experiences with the cultural influence on choices made in health, the way care is received, etc. to student pharmacists? Your perspective can be personal, something learned while studying abroad or something learned during paid or volunteer work. You Family Member Community Member N= 8 6 4 2 Yes No

20. + Assessment Pharmacy Students Additional Comments “I think a good exercise would be to learn about resources to get accurate cultural information, or techniques on how to acquire it.” “I would like if this address whether or not students have faced negative experiences where people lacked cultural competency and how it effected them.” “Every student should have some sort of cultural competency training. It should not be for just those that are interested. It should be strongly encouraged for all”

21. + Assessment Pharmacy Students Additional Comments “Instead of solely adjusting ourselves for the patient's culture, I really wish there was a way to encourage more people to learn English and embrace the American culture. We should both be learning about each other (in other words, not one-sided as it often is where too many foreign patients do not even make an effort to speak the language or adapt)”

22. + Conclusions Pharmacy Students A majority of pharmacy students find learning about cultural competence for healthcare professionals somewhat or very important Pharmacy students prefer having practical experience to learn about cultural competence (APPE/IPPE) Pharmacy students prefer learning about cultural competence in P1 recitation > electives = lab 17% of pharmacy students will be willing to share or have somebody share a personal experience

23. + Conclusions Multicultural Center Students A majority of MCC students find learning about cultural competence for healthcare professionals somewhat or very important Multicultural students prefer healthcare professional students having practical experience to learn about cultural competence 56% of multicultural center students will be willing to share or have somebody share a personal experience

24. + Assessment Attitudes towards cultural competence and diversity “Comfort with the dynamic and complex nature of race in this country. The identification of ways in which we are privileged and an examination of the historical treatment of marginalized groups as a source of that privilege” -comment from Multicultural Center Survey

25. + Assessment Personal Experiences Regarding Cultural Competence Pharmacy Students’ Personal Experiences “My grandmother does not speak English well and after undergoing a hip replacement she was placed in a nursing home where her needs were basically ignored because she could not communicate effectively in English. It truly created a difficult environment for her recovery and she ultimately avoided attending another rehab facility when her other hip was replaced” “My family is from China and parents are skeptic of "putting chemicals in their body". Chinese medication is a lot more herbal and alternative focused so explaining the importance of adhering to medications can be difficult even when talking to my own parents.”

26. + Assessment Personal Experiences Regarding Cultural Competence Pharmacy Students’ Personal Experiences “I was born with a genetic disorder and come from a large family where finances were strict. Making choices on when and where to seek medical attention were very difficult.” “My grandmother, from Portugal and very religious, refused medication near the end of her life because she did not feel they were helping her. I’ve seen people at my pharmacy go without medications because they could not afford them.”

27. + Assessment Personal Experiences Regarding Cultural Competence Multicultural Center Students’ Study Abroad/Work/Volunteer experiences “While working for the Government of the Virgin Islands, I attended town hall meetings where people from culturally diverse backgrounds discussed their inability to access healthcare.” “When I lived on Guam in 1999 (for work) you were considered a dirty person if you were tested for HIV as a part of a routine checkup. The attendant shamed patients by announcing the test in the waiting room, even. For that reason, may people were not tested.” “Working at a school for children with special needs. Very diverse student body because of poverty area. Many parents were not able to give children appropriate care.”

28. + Assessment Personal Experiences Regarding Cultural Competence Multicultural Center Students’ Personal Experiences “My African-American, uncle, age 50+ was not urged by physicians to add his name to the kidney donor list. Seemingly, people in the African American community in Georgia go on dialysis and eventually die. I have no narratives of any of these cases (and they are numerous) resulting in a transplant.” “I only use services (pharmacy, doctors, etc.) that treat me respectfully. It might be difficult to explain how one knows when one is being treated negatively because of one's background, but one knows. I refuse to give my business to places that treat me like a second-class citizen.” “In terms of myself, a physicians attribution of my health problems as being racial delayed appropriate behavioral responses to improve my health. This has also happened to my brother. I have developed a psychological measure to capture racial microaggression in the physician's office, so I have confirmation that it happens to other community members.”