Surveys 2016 April C Cultural Competence Questionnaire for Internationa

Cultural Competence Questionnaire for Internationa

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Exit Survey

Cultural Competence Hello: You are invited to participate in our survey of cultural competence for dental students in the international dentists program. In this survey, approximately 100 people will be asked to complete a survey that asks questions about cultural competence. It will take approximately 20 minutes to complete the questionnaire. Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions. Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Irene Lubker at 555-5555 or by email at the email address specified at the end of the survey. Thank you very much for your time and support. Please consent to the survey below and start with the survey now by clicking on the "Next" button below.  I Agree     How knowledgeable are you about each of the following subject areas? (select one response line) Very Quite a bit Somewhat A little Not at all Historical and contemporary impact of racism in health care experienced by various population groups in the United States   Office for Civil Rights August 30, 2000 Policy Guidance on the Title VI Prohibition Against National Origin Discrimination as it Affects Person with Limited English Proficiency Office of Minority Health’s National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care     How SKILLED are you in dealing with sociocultural issues in the following areas of patient care in the USA? (select one response per line) Very Quite a bit Somewhat A little Not at all Prescribing/negotiating a culturally sensitive dental treatment plan? Dealing with cross-cultural compliance problems Eliciting the patient’s perspective about health and illness (e.g., its etiology, name, treatment, course, prognosis)     How IMPORTANT are each of the following factors in contributing to health disparities (select one response per line) Very Quite a bit Somewhat A little Not at all Genetics Lifestyle Poverty Education     How AWARE are you of your own: (select one response per line) Very Quite a bit Somewhat A little Not at all Racial, ethnic, or cultural stereotypes? Biases and prejudices?     How IMPORTANT do you believe sociocultural issues are in your interactions with: (select one response per line) Very Quite a bit Somewhat A little Not at all Patients Colleagues Other students Staff Faculty       * How long have you lived in the United States?   0 - 5 years   6 -10 years   11 to 15 years   More than 15 years       * What year did you graduate from your previous dental school?   1990 - 1995   1996 - 2000   2001 - 2005   2006 - 2010   2011 and later       * Country of origin       * What gender do you identify with?   Male   female   Other

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