Evidence map›Paper›PMID 36594616›Full record

ArticleMedical education online2023

Underprepared: influences of U.S. medical students' self-assessed confidence in immigrant and refugee health care.

Shanna D Stryker, Katharine Conway, Caitlin Kaeppler, Kelsey Porada, Reena P Tam, Peter J Holmberg, Charles Schubert, and Medical Student Global Health study group

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Medical education online, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
3.6field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 1 country.

Shanna D StrykerDepartment of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.ORCID 0000-0001-9983-1346
Katharine ConwayDepartment of Family Medicine, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, USA.
Caitlin KaepplerDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin,USA.
Kelsey PoradaDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin,USA.
Reena P TamDepartment of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Peter J HolmbergDepartment of Pediatrics, Mayo Clinic, Rochester, MN, USA.
Charles SchubertDepartment of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
and Medical Student Global Health study group
Medical College of Wisconsin · USCincinnati Children's Hospital Medical Center · USMayo Clinic in Arizona · USUniversity of Cincinnati Medical Center · USUniversity of Utah · USWright State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnited States (U.S.) census data from 2017 indicates that the percentage of persons born outside of the U.S. is increasing. However, no studies describe the amount of class time focused on immigrant and refugee health during medical school in the U.S. nor on incoming residents' confidence in providing culturally sensitive care. The objective of this study is to characterize final-year medical students' exposure to immigrant and refugee health and their confidence in caring for these populations.

methodsA voluntary, cross-sectional survey was sent electronically to fourth-year medical students at twelve U.S. medical schools in 2020, with 707 respondents (46% response rate). Questions addressed respondents' curricular exposure to immigrant and refugee health care during medical school and their confidence in providing culturally sensitive care. Chi-square tests were used to assess relationships between categorical variables, and odds ratios were calculated for dichotomized variables.

resultsMost students (70.6%) described insufficient class time dedicated to culturally sensitive care, and many (64.5%) reported insufficient clinical exposure in caring for immigrants/refugees. The odds that incoming residents felt 'usually' or 'always' confident in their ability to provide culturally sensitive care to immigrants and refugees were higher in those with more class time on culturally sensitive care (OR 5.2 [3.6-7.4]), those with more clinical opportunities to care for immigrants and refugees (OR 7.2 [5.1-10.2]), and those who participated in a domestic low-resource or international elective (OR 1.4 [1.02-1.9]). More than half (55.3%) of respondents reported feeling 'not at all' or only 'sometimes' confident in their ability to provide culturally sensitive care to immigrants/refugees.

conclusionsMost fourth-year U.S. medical students entering residency feel unprepared to deliver culturally sensitive care to immigrants and refugees. This may be mediated by increased exposure to didactic curricula class time and/or experiential clinical activities, as those factors are associated with improved student confidence.

Indexed as

Emigrants and ImmigrantsRefugeesStudents, MedicalCross-Sectional StudiesDelivery of Health CareHumansUnited Statescultural competenceelectiveimmigrantmedical studentRefugeeundergraduate medical education

Identifiers

PMID36594616
PMCPMC9815430
OpenAlexW4313488567

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.