A Longitudinal Underserved Community Curriculum for Family Medicine Residents

Postgraduate education in cultural competence and community health is a key strategy for eliminating health disparities in underserved populations. Evidence suggests that an experiential, rather than knowledge-based approach equips physicians with practical and effective communication tools that generalize to a greater diversity of patients and cultures. However, there is limited data about the efficacy of a longitudinal, experiential residency curriculum. This study details the results of a longitudinal underserved community curriculum for family medicine residents training in a federally qualified health center. All residents in the first 5 years of a new residency participated in a longitudinal curriculum of workshops and seminars focused on social determinants of health and cultural competency for underserved patients. Pre- and postcurriculum surveys assessed knowledge gain. Self-reported Likert scale ratings assessed attitudes and confidence related to underserved care. Pre/post learning evaluations after each seminar documented average knowledge increase of 31.0% and 28.8%, respectively. At the end of the 3-year curriculum, 81.8% of residents reported confidence in their ability to incorporate culturally relevant information into a treatment plan and 57.1% of residents reported feeling very aware of obstacles faced by underserved populations seeking health care and of the relationship between sociocultural background, health, and medicine. A longitudinal, experiential curriculum in underserved community health and cultural competence can improve resident knowledge and attitudes with respect to health disparities and delivering health care to diverse patient populations.