PP904 - Cultural Literacy: Audiologists' Perspectives and Attitudes

Patient-centered care mandates a mutual understanding of beliefs and customs between the patient and the audiologist. Cultural literacy, that is practitioner knowledge, cultural awareness, and diverse cultural encounters, is an important component of patient-centered care.  There is limited research investigating how audiologists and their respective workplaces address cultural literacy as they pertain to providing best practices for culturally diverse patients. An ad-hoc survey was used to explore audiologists’ attitudes, perspectives, graduate level experiences specific to cultural diversity education, and the extent to which they believe their workplace accommodates patients from culturally diverse backgrounds.

Summary:

Rationale/

Purpose:
The purpose of this study is to investigate the degree to which audiologists are prepared and confident in delivering culturally sensitive care necessary for patient-centered care.  
Three research questions guided this study:
1. What are the general perspectives of audiologists on culturally competent care and their
self-perceived cultural literacy?
2. What is the extent to which audiologists believe their respective organizations address
cross-cultural challenges in the workplace?
3. What were the general experiences of audiologists in their graduate program related to cultural
diversity education?



Methods:
An ad-hoc, online questionnaire was made available to practicing audiologist across the U.S. The survey included 28 items defining demographic factors age, gender, race, language, education, state of residence, licensure, clinical setting, and years in practice. Questions addressed graduate and post-graduate education experiences that specifically examined culturally diverse learning opportunities such as course contents and clinical experiences.  Five-point Likert scales were used to determine participants’ attitudes about the importance of culturally sensitive considerations and self-perceived cultural literacy. A total of 57 respondents completed the online questionnaire.



Results:
Audiologists’ overall mean-rating for self-perceived cultural literacy was lower (2.8/5) than the self-reported mean-ratings for the importance of culturally competent care (4.2/5.) Whereas only 16% of respondents self-rated high cultural literacy, 84% indicated that providing culturally competent patient care was important. Most respondents reported their workplaces addressed cultural diversity via interpreter/translator services (88%), non-English assessment materials (90%) and mandatory diversity training (64%). Only 12% of respondents reported diversity in clinic media materials.
Regarding graduate education, 48 respondents (84%) provided data regarding diversity in educational experiences in their audiology program. Eighty-three percent (N= 40) reported a diverse caseload during graduate clinical training, 58% (N=28) reported outreach events targeting underserved populations. Diversity course content was also explored, and recent graduates (0-3 years of post-graduation) reported greater breadth of diverse content areas than those who had more than 3 years of experience (x^₂ =13, p >0.001). The majority of those graduating over three years ago reported that the curriculum addressed only, D/deaf culture (74%).

Conclusions:
Cultural literacy in audiology is loosely defined and audiologists’ experiences continue to be largely variable. Audiologists in this sample acknowledged that recognizing cultural differences in patients is important, however, their self-reported cultural literacy skill level did not meet the level of importance. Audiologists generally reported that their workplaces address cultural differences across patients via use of translators, non-English assessment material, and diversity training, but interestingly, clinic media lacks diverse representation. It appears that audiology curriculum in more recently years addresses cultural literacy to a greater degree than previously. However, in recent graduates, cultural literacy continues to lag importance. Study limitations include self-report data, relatively small sample size, and lack of representation from audiologists from various cultural groups. Assessing cultural literacy in real-world clinical settings is complicated; however, there is a need to develop means to close the gap between desire to provide culturally sensitive care and the ability to do so.