Using the Tool for Assessing Cultural Competence Training (TACCT) to measure faculty and medical student perceptions of cultural competence instruction in the first three years of the curriculum

Purpose To compare faculty and student perceptions of cultural competence instruction as measured by the AAMC's Tool for Assessing Cultural Competence Training (TACCT) as part of a comprehensive curricular needs assessment. Method In 2005, 25 basic science and clinical course directors and 92 third-year medical students at the University of California, Irvine, School of Medicine were asked to indicate which of 67 separate items listed on the TACCT describing knowledge, skill, and attitude about cultural competence were covered during the first three years of the curriculum. The mean percentage of "yes" responses to each item was computed and compared for both faculty and students. Results Response rates were 100% (25/25) for course directors and 75% (69/92) for students. Students systematically perceived that cultural competence instruction occurred more often in the curriculum (range of 28% to 93% "yes" responses) compared to the faculty (range of 8% to 64%). However, faculty and students demonstrated a high level of concordance (intraclass correlation coefficient = 0.89 across all items) in their perceptions about instruction, as measured by their relative rank orderings of the 67 TACCT items. Students and faculty identified clusters of TACCT items pertaining to health disparities, community partnerships, and bias/stereotyping as least likely to be presented. Conclusions Faculty and third-year students at one medical school responded congruently about the relative degree to which cultural competence instruction occurred. The TACCT can be used to identify significant gaps in cultural competence training and inform curricular revision. Further studies involving other schools are warranted.