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 Impacts of Acceptance and Commitment Training on Clinical Engagement and Cultural Humility in Standardized Patient Interactions: Adding Behavioral Observation to Assessments in Medical Education |
| Saturday, May 25, 2024 |
| 3:00 PM–3:50 PM |
| Marriott Downtown, Level 3, Independence Ballroom |
| Area: CSS/OBM; Domain: Applied Research |
| Chair: Ramona Houmanfar (University of Nevada, Reno) |
| Discussant: Anthony Biglan (Oregon Research Institute; Values to Action) |
| CE Instructor: Alison Szarko, Ph.D. |
| Abstract: Like behavior analysts, medical professionals have an ethical obligation to provide their patients with patient-centered and culturally humble care. Therefore, medical schools are required to teach Patient Centered Care (PCC) and Cultural Humility (CH) skills along with how to manage burnout and implicit bias given the deleterious effects of leaving these neglected. Acceptance and Commitment Training (ACT) is an empirical approach to increase psychological flexibility (PF). ACTraining studies have demonstrated positive outcomes in a variety of settings and with a wide variety of populations including: mental health and innovation, stigma, stress, burnout, sick leave, physical and psychological well-being, absenteeism, college performance, and worksite distress. A majority of this literature has utilized self-report metrics (Newsome et al., 2019), however. Studies presented in this symposium examined the effects of ACT on medical students’ repertoires in a standardized patient encounter, wherein target behaviors related to implicit bias, PCC, and CH were operationally defined and objectively measured. Results and implications for future research will be discussed. |
| Instruction Level: Intermediate |
| Keyword(s): ACT, Cultural Humility, Patient-Centered Care, Psychological Flexibility |
| Target Audience: Graduate Students, Faculty, BCaBAs, BCBAs, Professionals Audience members may benefit from having some familiarity with Acceptance and Commitment Therapy/Training |
| Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) Desribe how Acceptance and Committment Training (ACT) can Facilitate Patient-Centered Care and Cultural Humility in their Practice; (2) Describe historical measurement with respect to these Patient Centered Care and Cultural Humility; (3) Create behavioral measurement systems related to ACT goals of interest. |
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| Effects of Psychological Flexibility and Implicit Bias on Medical Student Clinical Engagement and Academic Performance |
| ALISON SZARKO (University of Nevada, Reno), Ramona Houmanfar (University of Nevada, Reno), Neda Etezadi-Amoli (University of Nevada, Reno (School of Medicine)), Gregory S. Smith (University of Dayton; University of Nevada, Reno (School of Medicine)), Melissa Patricia Piasecki (University of Nevada, Reno (School of Medicine)), Timothy Baker (University of Nevada, Reno (School of Medicine)) |
| Abstract: Medical schools are required to teach burnout management, implicit bias management, and patient-centered care (PCC). Acceptance and Commitment Training (ACT) is an empirical approach to increase psychological flexibility (PF). Increases in PF have been correlated with reductions in burnout, improvements in managing implicit biases, and improvements in academic performance. However, less is known about relationships between ACT, PF, implicit bias, PCC, and academic performance. The purpose of this study was to examine relationships between ACT, PF, clinically relevant implicit bias, academic performance, rates of clinical verbal responding, and PCC skills with two cohorts of medical students. Cohort One (n = 43) were exposed to ACT one time and Cohort Two (n = 48) were exposed to ACT twice. All participated in an Objective Structured Clinical Exam with a Standardized Patient during their third-year OB/GYN clerkship rotation and completed standardized medical knowledge competency exams. Independent samples t-tests between cohorts were conducted as well as multiple linear regressions. Results found exposure to ACT, experience with clinical encounters, and weight bias all had an impact on clinical engagement and rate of clinical verbal responding. Levels of PF were also correlated with academic performance. Limitations and implications will be discussed. |
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| Exploring the Behavioral Measurement and Impact of Acceptance and Commitment Based Cultural Humility Training on Standardized Patient Interactions |
| Kian Assemi (University of Nevada, Reno), DONNA WEST (University of Nevada, Reno), Ramona Houmanfar (University of Nevada, Reno), Anayansi Lombardero (University of Nevada, Reno (School of Medicine)), Gregory S. Smith (University of Dayton; University of Nevada, Reno (School of Medicine)), Irene Le (University of Nevada, Reno (School of Medicine)), Nicole Jacobs (University of Nevada, Reno (School of Medicine)) |
| Abstract: Several researchers have highlighted the importance of training healthcare professionals to interact in a culturally humble manner with their patients (Nadal et al., 2014; Pascoe & Smart Richman, 2009; Sirois & Burg, 2003; Williams & Mohammed, 2009). A critical component of the development of an effective training process is the systematic assessment of cultural humility. As an extension of previous research (Kanter et al., 2020; Lombardero et al., 2023), this study implemented an evidence-based cultural humility intervention (Acceptance and Commitment Training-based) to improve medical students’ interactions with Standardized Patients (SPs) which was assessed via direct behavioral observation. Specifically, the observational measurement system was created which focused on culturally humble responses to patients reporting microaggressions to the medical professional. A pre-post comparison of the results demonstrated statistically significant improvements pertaining to participants’ culturally humble responses to SPs’ reports of microaggressions. These results and implications for future research across behavior analysis and medicine will be discussed. |
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