Primary care residencies are expected to provide training in cultural competence. However, we have insufficient information about the perceptions of stakeholders actually involved in healthcare (i.e. residents, faculty and patients) regarding commonly encountered cross-cultural barriers and the skills required to overcome them.

This study used a total of 10 focus groups to explore resident, faculty and patient attitudes and beliefs about what culturally competent doctor-patient communication means, what obstacles impede or prevent culturally competent communication, and what kinds of skills are helpful in achieving cultural competence. A content analysis was performed to identify major themes.

Residents and faculty defined culturally competent communication in terms of both generic and culture-specific elements, however, patients tended to emphasize only generic attitudes and skills. Residents and patients were liable to blame each other in explaining barriers; faculty were more likely to consider systemic influences contributing to resident-patient difficulties. All groups emphasized appropriate skill and attitude development in learners as the key to successful communication. However, residents were sceptical of sensitivity and communication skills training, and worried that didactic presentations would result in cultural stereotyping.

All stakeholders recognized the importance of effective doctor-patient communication. Of concern was the tendency of various stakeholders to engage in person-blame models.

Family physicians lack data on how best to address the needs of adults with physical disabilities. We undertook this study to understand how consumers, educators, and other professionals perceive primary care for people with disabilities.

We conducted six focus groups, three with 27 health professionals in primary care practices affiliated with an urban university medical center and three with 19 local adults, ages 21-64 years, with physical disabilities. From transcribed recordings, three investigators conducted separate content analyses. Independent author reviews and participant review confirmed saturation and agreement for major themes.

All groups perceived that generalist physicians and other health professionals need more education about disability issues. Multiple barriers limit care, including physical access and transportation, funding, limitations in professionals' knowledge and attitudes, communication gaps, and health systems failures. Both consumers and professionals recommended reducing barriers by educating professionals and trainees about disabilities and resources, improving provider-patient communication, enhancing physical access (eg, high-low examination tables, wide automatic doors, high-contrast signs and lighting, wheelchair scales), and increasing appointment times.

Primary care must address the unmet needs of people with disabilities. Family medicine educators can begin by teaching learners how to coordinate care, access resources, and communicate about disability issues.

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Limited data illuminate how resident doctors view their important roles as teachers, supervisors and role models. Analysing qualitative data about resident teachers' self-perceptions can offer helpful insights.

One year after a randomised trial of a residents-as-teachers curriculum at a university medical centre, we invited its 23 resident participants to participate in semistructured interviews. We interviewed 21 third year residents from internal medicine, family medicine and paediatrics, including 12 intervention residents who had been randomly assigned to receive a 13-hour teacher training programme and 9 control residents who had received no training. We used grounded theory techniques. Two investigators independently content-analysed the transcribed interviews for emerging themes and we then developed a schema for a third investigator to code the transcripts.

Three key themes consistently emerged: enthusiasm for teaching (current and future), learner-centredness, and self-knowledge about teaching. Compared with control residents, the intervention residents expressed greater enthusiasm for teaching, more learner-centred and empathic approaches, and a richer understanding of teaching principles and skills. Most intervention residents wanted to continue teaching during and after training. Fewer control residents enjoyed their current teaching, and fewer still wanted to teach in the future. The control residents seemed easily frustrated by time constraints and they often expressed cynicism and blame toward learners.

One year after participating in a randomised trial of a residents-as-teachers curriculum, generalist residents revealed fairly consistent perceptions of their teaching roles. Teacher training may offer residents lasting benefits, including improved teaching skills and satisfaction.

Family practice residents and students receive substantial teaching from senior residents. Yet, we lack data about residents' needs for teaching skills development, particularly in generalist training. This multicenter, interdisciplinary study describes the learning needs of generalist residents for becoming more effective teachers.

One hundred medical students, residents, and faculty infamily medicine, internal medicine, and pediatrics participated in 11 focus groups and 4 semi-structured key informant interviews at the University of California, Irvine and the University of California, Los Angeles in 2000-2001.

Participants agreed that resident teachers fulfill critical roles in medical education, providing powerful, skills-based teaching that can tangibly benefit both residents themselves and their junior learners. House staff often facilitate students' best learning experiences despite inherent risks in serving as teachers and professional role models. Residents need teaching skills training that prepares them to lead clinical teams and teach students essential skills that include history taking and physical examination, critical reasoning, charting, and procedures.

Generalist residents fulfill important roles as practical clinical teachers and role models for junior learners. Future research should address how resident teachers affect learners' clinical skills, academic performance, and professionalism.

Medical educators need practical and accurate instruments for evaluating clinical teaching. Our purpose was to develop norms for the Clinical Teaching Perception Inventory (CTPI) on a multidisciplinary group of North American faculty and resident teachers.

A no-cost, on-line inventory (www.residentteachers.com) measured participants' comfort with teaching. Respondents recruited through surveys and professional organizations completed two identical Q-sorts, ranking 28 descriptors first for "my ideal teacher" and then for "myself as a teacher."

An international sample of 255 residents and 256 faculty members--including 143 respondents from family medicine--completed the on-line CTPI from April 2001 to March 2003. Resident and faculty teachers agreed on top descriptors for ideal clinical teachers: stimulating, encouraging, competent, communicates, and well-read. Resident teachers revealed larger discrepancies between "self" and "ideal" scores than faculty participants did. Many respondents wished to be more stimulating and well-read, highlighting perceived needs for teaching skills development. Between the subsamples of 143 family medicine teachers and 368 non-family medicine teachers, scores were virtually indistinguishable.

A multidisciplinary sample of 511 faculty and resident teachers agreed on key characteristics of ideal clinical teachers. Generalist educators and others can use the on-line CTPI at no cost to assess their self-perceptions as clinical teachers.

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