According to the last U.S. Census, Minnesota has the largest number of refugees per capita in the country. Prioritizing refugee health is important in bridging local and global health. Through a recently funded five-year grant from the Center for Disease Control and Prevention (CDC), M Simulation will support the Minnesota Department of Health Refugee Health Program (MDHRHP) as it transitions to become a Center of Excellence in Newcomer Health, partnering with PI Hope Pogemiller, MD, MPH, assistant professor of medicine and pediatrics, and Karin Quick, DDS, PhD, associate professor of dentistry.
In addition to the University of Minnesota, MDHRHP is partnering with HealthPartners, Denver Health and Hospitals, Thomas Jefferson University, Children’s Hospital of Philadelphia, the International Organization for Migration, and the Cultural Orientation Resource Exchange to identify and monitor health needs for newly arriving refugees; contribute to evidence-based policies and guidelines; educate health care and service providers; and facilitate communication with newcomers about health care issues and services.
“This work aligns with our value of advancing diversity, equity, and inclusion by supporting learners with safe training spaces in which to recognize and explore social determinants of health in accordance with cultural differences. We will achieve this by partnering with our simulated patients (SPs) in a series of human simulation online training sessions purposefully designed to foster cultural sensitivity in participating providers that will ultimately benefit the patients they serve,” said Clark.
As part of its activities, the new center will develop online, simulation-based communication training activities designed to teach advanced skills for discussing health screening recommendations, results, and management with newcomers with limited English proficiency. Clark and education director Anne Woll, MS, are working with Pogemiller and Quick to create these human simulation scenarios and implement them online. The team will build upon their previous work developing and implementing SP scenarios with interpreters for dental students. SPs are community members who are trained to portray patients’ medical histories, physical findings, and emotional or behavioral characteristics; they are instrumental in teaching and assessment activities.
“For the last five years, we've collaborated with the School of Dentistry and interpreting partners to develop training that helps address disparities for limited English proficient patients," said Woll.
“It’s not enough to have an interpreter on hand, but rather, there is a need to approach this work as an interprofessional partnership so that interpreters are seen as members of the health care team. We developed a curriculum that provides just-in-time training and practice opportunities for dental providers, learners, and interpreters to work together,” said Woll.
COMMUNICATING ACROSS LANGUAGE BARRIERS
In order to build trust and design appropriate health screenings for newly arrived refugees, effective communication techniques are needed to develop follow through for managing health conditions and disseminating results. For refugees with complex medical issues, this is of particular importance to ensure continuity of care. The Center of Excellence in Newcomer Health will develop educational and quality improvement activities that promote effective communication while increasing clinician understanding and implementation of CDC guidelines, including population-specific guidance.
During the next year, the M Simulation team, Pogemiller, and Quick will create an online orientation that includes the role of an interpreter, basic techniques for working with an interpreter, and common pitfalls in this communication. Clinical scenarios will be recorded with good and bad techniques to serve as teaching examples. Virtual simulations will include clinical scenarios relevant to guideline implementation and a facilitated discussion about legal and ethical issues related to caring for patients with limited English proficiency. An assessment tool will be created, and a pilot of these sessions will be run with a small group of learners.
In the next several years, they will increase the number of human simulations online with SPs to train 120 health care providers in Minnesota and around the United States annually. Instructional materials will be made available for free online for other health centers and training programs. The Center of Excellence in Newcomer Health will deliver training sessions through M Simulation’s established human simulation online program and leverage existing University expertise in global health education.