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• Subproject C: Staff training towards cultural competence: Enable hospital staff to better handle cross-cultural encounters •

Within the framework of the MFH project, a lack of cultural competence among hospital staff – identifiable as cultural unawareness, misunderstandings, and prejudices that are inhibiting factors in communication – was identified as a significant problem by the needs assessments in the participating European hospitals. On the basis of a systematic review of international literature, the solution chosen to help solve this problem focussed on an intervention in which a staff training course was held to improve cultural competence. This intervention is widely acknowledged by experts as a quality improvement measure for health care services. Training courses are widely practised, especially in classical immigration countries like the USA, Canada and Australia. As direct aims of this intervention, improving hospital staff’s awareness, knowledge, skills and comfort level relating to the care of a diverse patient community have been targeted.

Nine pilot hospitals participated in the staff training project (AT, DE, ES, FR, IR, IT, NL, SV, UK). Several tools – a factsheet, a pathway and modules for implementation and instruments for evaluation – were developed by LBISHM in collaboration with experts to support the hospitals (all tools are available in this report).

Results and experiences are summarised according to 5 criteria (for details see the evaluation report and the presentations of focal persons at the final conference):

  • F· Feasibility: could be demonstrated; acceptability among staff varied in the hospitals but altogether a total of 143 staff members participated.
  • Quality: was operationalised in terms of the following dimensions: content, structure, amount of training units, qualification of trainers, composition of participating staff, management support, systematic needs assessment on the department level, integration in ongoing quality assurance etc. Quality was measured as “conformity with the recommendations of the pathway” and, so defined, varied extensively, mainly due to a very narrow project timeframe that forced hospitals to rely on resources easily available.
  • Effectiveness: could be confirmed by improvement of staff’s self-rated awareness, knowledge, skills and comfort level concerning cultural diversity issues, as well as by increases in interest levels regarding cultural competence and in staff's self-rated ability to cope with work demands.
  • Cost-effectiveness: external training costs were low, but developmental costs rather high, despite personal costs being mainly covered through voluntary work.
  • Sustainability: training was recognised as an effective way to equip staff with important competencies and will be continued but modified in all participating hospitals.

The experiences of the European hospitals strengthen the case for investing in training towards cultural competency as a solution for tackling tensions and difficulties experienced in encounters between staff and a diverse patient population. Experiences indicate that it is advisable to distinguish two aspects of this issue: on the one hand cultural competence training as a short, generic, basic workshop, and on the other hand the systematic inclusion of cultural competence aspects into the regular quality management routines on the level of hospital departments (see the conclusions of the Evaluation Report).

International literature on cultural competence training