Exploring The Impact of Genogram-Based Family Practice on Physicians’ Cultural Competence in Primary Care

Abstract

Cultural competence is essential in primary care, especially in settings serving diverse populations. Although training programs often address theoretical aspects, practical tools to enhance cultural understanding are underused. The genogram is a visual representation of family and social structures and may offer a useful approach to improve cultural insight in clinical practice. This study explored the relationship between family physicians’ genogram knowledge and their levels of cultural competence. A cross-sectional survey was conducted among 84 family physicians in Erzurum, Türkiye. Data included demographics, clinical experience, cross-cultural exposure, genogram knowledge, and weekly patient volume. Cultural competence was measured using a validated 20-item scale comprising knowledge, skills, and sensitivity domains. Physicians who could draw a genogram scored significantly higher in overall cultural competence (p = 0.025) and cultural sensitivity (p = 0.028). Cross-cultural patient care experience was associated with higher scores across all subdomains (p < 0.01). Weekly patient volume was the only independent predictor of overall competence (β = 0.037, p = 0.015). Female physicians demonstrated lower cultural sensitivity than males (p = 0.01). Although 90.5% of participants were familiar with genograms, only 36.9% could construct one accurately. Practical exposure, through genogram use and cross-cultural interaction appears more effective than theoretical knowledge alone in developing cultural competence. Integrating genogram-based training and immersive experiences into medical education may enhance cultural responsiveness in primary care.

Keywords

• Cross-cultural healthcare
• cultural competence
• family medicine
• genogram

Birinci Basamakta Genograma Dayalı Aile Hekimliği Uygulamasının Hekimlerin Kültürel Yeterliliği Üzerindeki Etkisinin İncelenmesi

Abstract

Kültürel yeterlilik, özellikle farklı hasta gruplarına hizmet veren birincil sağlık bakımında çok önemlidir. Eğitim programları genellikle teorik konulara odaklansa da, kültürel anlayışı artırmaya yönelik pratik araçlar yeterince kullanılmamaktadır. Genogram ailenin ve sosyal yapıların görsel bir temsilidir ve klinik uygulamalarda kültürel farkındalığı geliştirmek için faydalı bir yaklaşım sunabilir. Bu çalışma, aile hekimlerinin genogram bilgisi ile kültürel yeterlilik düzeyleri arasındaki ilişkiyi incelemiştir. Erzurum, Türkiye’de 84 aile hekimi ile kesitsel bir anket çalışması yapılmıştır. Toplanan veriler arasında demografik bilgiler, klinik deneyim, kültürlerarası etkileşim deneyimi, genogram bilgisi ve haftalık hasta sayısı yer almıştır. Kültürel yeterlilik, bilgi, beceri ve duyarlılık olmak üzere üç alt boyutu kapsayan doğrulanmış 20 maddelik bir ölçek ile ölçülmüştür. Genogram çizebilen hekimler, toplam kültürel yeterlilik (p = 0,025) ve kültürel duyarlılık (p = 0,028) puanlarında anlamlı olarak daha yüksek skor elde etmiştir. Kültürlerarası hasta bakım deneyimi, tüm alt boyutlarda daha yüksek puanlarla ilişkili bulunmuştur (p < 0,01). Haftalık hasta sayısı, toplam yeterliliğin tek bağımsız yordayıcısı olarak belirlenmiştir (β = 0,037, p = 0,015). Kadın hekimler, erkeklere kıyasla daha düşük kültürel duyarlılık puanına sahip olmuştur (p = 0,01). Katılımcıların %90,5’i genogramdan haberdar olmasına rağmen, yalnızca %36,9’u doğru şekilde genogram çizebilmiştir. Genogram kullanımı ve kültürlerarası etkileşim gibi pratik deneyimler, teorik bilgiye göre kültürel yeterliliği geliştirmede daha etkili görünmektedir. Genogram tabanlı eğitim ve gerçek yaşam kültürlerarası deneyimlerin tıp eğitimine entegrasyonu, birinci basamak sağlık hizmetlerinde kültürel duyarlılığı artırabilir.

Keywords

• Aile hekimliği
• genogram
• kültürel yeterlilik
• kültürlerarası sağlık hizmeti

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