Evidence map›Paper›PMID 38921829›Full record

Trial reportAnnals of surgery2024

A Randomized Crossover Trial Evaluating the Impact of Cultural Dexterity Training on Surgical Residents' Knowledge, Cross-Cultural Care, Skills, and Beliefs: The Provider Awareness and Cultural Dexterity Training for Surgeons (PACTS) Trial.

Douglas S Smink, Gezzer Ortega, Brittany M Dacier, Emil R Petrusa, Yu-Jen Chen, Namra Q Shaikh, Benjamin G Allar, Maria B J Chun, Alexander R Green, Katharine E Caldwell and 16 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Annals of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

26 authors.

Douglas S SminkDepartment of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Gezzer OrtegaDepartment of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Brittany M DacierCenter for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Emil R PetrusaDepartment of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Yu-Jen ChenCenter for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Namra Q ShaikhCenter for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Benjamin G AllarCenter for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Maria B J ChunDepartment of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI.
Alexander R GreenMassachusetts General Hospital, Boston, MA.
Katharine E CaldwellDepartment of Surgery, Washington University School of Medicine, St. Louis, MO.
Rachel B AtkinsonDepartment of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Emma ReidyCenter for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Olubode A OlufajoDepartment of Surgery, Howard University College of Medicine, Washington, DC.
L D BrittDepartment of Surgery, Eastern Virginia University, Norfolk, VA.
Molly A BrittainDepartment of Surgery, Eastern Virginia University, Norfolk, VA.
Jorge Zárate RodriguezDepartment of Surgery, Washington University School of Medicine, St. Louis, MO.
Sandra M SwobodaJohns Hopkins University School of Medicine, Baltimore, MD.
Edward E CornwellDepartment of Surgery, Howard University College of Medicine, Washington, DC.
Kenneth A LynchDepartment of Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI.
Paul E WiseDepartment of Surgery, Washington University School of Medicine, St. Louis, MO.
David T HarringtonDepartment of Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI.
Tara S KentDepartment of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
John T MullenDepartment of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Pamela A LipsettDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Adil H HaiderCenter for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
and the PACTS Trial Group

Funding

Evaluation of a Cultural Dexterity Training Program for Surgeons: The PACTS TrialR01MD011685 · NIMHD · BRIGHAM AND WOMEN'S HOSPITAL · PI HAIDER, ADIL H, SMINK, DOUGLAS · 2018 to 2021
$3.4M
Improving Outcomes for Spanish-Speaking Surgical Patients with Limited English ProficiencyK23MD016129 · NIMHD · BRIGHAM AND WOMEN'S HOSPITAL · PI Gezzer Ortega · 2022 to 2026
$864k
NIMHD NIH HHS K23 MD016129NIMHD NIH HHS R01 MD011685
6 · The paper itself

Abstract

objectivesThis trial examines the impact of the Provider Awareness and Cultural dexterity Toolkit for Surgeons (PACTS) curriculum on surgical residents' knowledge, cross-cultural care, skills, and beliefs.

backgroundCross-cultural training of providers may reduce health care outcome disparities, but its effectiveness in surgical trainees is unknown.

methodsPACTS focuses on developing skills needed for building trust, working with patients with limited English proficiency, optimizing informed consent, and managing pain. The PACTS trial was a randomized crossover trial of 8 academic general surgery programs in the United States: The Early group ("Early") received PACTS between periods 1 and 2, while the Delayed group ("Delayed") received PACTS between periods 2 and 3. Residents were assessed preintervention and postintervention on Knowledge, Cross-Cultural Care, Self-Assessed Skills, and Beliefs. χ 2 and Fisher exact tests were conducted to evaluate within-intervention and between-intervention group differences.

resultsOf 406 residents enrolled, 315 were exposed to the complete PACTS curriculum. Early residents' Cross-Cultural Care (79.6%-88.2%, P <0.0001), Self-Assessed Skills (74.5%--85.0%, P <0.0001), and Beliefs (89.6%-92.4%, P =0.0028) improved after PACTS; knowledge scores (71.3%-74.3%, P =0.0661) were unchanged. Delayed resident scores pre-PACTS to post-PACTS showed minimal improvements in all domains. When comparing the 2 groups in period 2, Early residents had modest improvement in all 4 assessment areas, with a statistically significant increase in Beliefs (92.4% vs 89.9%, P =0.0199).

conclusionsThe PACTS curriculum is a comprehensive tool that improved surgical residents' knowledge, preparedness, skills, and beliefs, which will help with caring for diverse patient populations.

Indexed as

Clinical CompetenceCross-Over StudiesCurriculumGeneral SurgeryInternship and ResidencyAdultCultural CompetencyCulturally Competent CareEducation, Medical, GraduateFemaleHealth Knowledge, Attitudes, PracticeHumansMaleUnited States

Identifiers

PMID38921829
PMCPMC12881993

What OpenQuestion holds

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Registered trials

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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.