Discussion
Acquire, apply, and activate knowledge: A pyramid model for teaching and integrating cultural competence in medical curricula

https://doi.org/10.1016/j.pec.2017.12.016Get rights and content

Highlights

  • The importance of cultural competence has been acknowledged.

  • Integration of cultural competence in medical curricula has been poor.

  • The article presents a pyramid model for cultural competence in medical curricula.

Abstract

The importance of cultural competence in health care has been more acknowledged since modern societies are becoming increasingly multi-cultural. Research evidence shows that cultural competence is associated with improved skills and patient satisfaction, and it also seems to have a positive impact on adherence to therapy. Based on this evidence, the acknowledged importance of cultural competence and its poor integration into medical curricula, we present a pyramid model for building cultural competence into medical curricula whereby medical students can enhance their skills through acquiring, applying and activating knowledge.

Introduction

Contemporary societies are increasingly becoming multi-cultural [1], and medical practitioners encounter patients who bring to medical consultations their own views about health and illness, and are expected to understand the impact of various sociocultural factors on medical conditions [2]. As a result, medical practitioners are faced with the challenge of understanding their patients holistically [3] and communicating with them effectively in order to provide good quality care and improved health outcomes. To achieve a good relationship with their patients and positive health outcomes such as patient satisfaction, adherence to therapy and health improvement, medical practitioners need to be culturally competent [4]. We are presenting below the reasons why cultural competence has been acknowledged as an important skill in medical practice, and whether it is effective in terms of a number of outcomes, such as enhanced skills and attitudes, patient satisfaction, adherence to therapy and health improvement. We also discuss the existing frameworks and models of cultural competence and propose a pyramid model for teaching and integrating cultural competence skills in medical curricula in order to fill into an identified gap in medical education.

Section snippets

The need for, and effectiveness of, cultural competence

Betancourt et al. [4](p.297) explained that cultural competence refers to “understanding the importance of social and cultural influences on patients’ health beliefs and behaviours; considering how these factors interact at multiple levels of the health care delivery system and, finally, devising interventions that take these issues into account to assure quality health care delivery to diverse patient populations”. This definition reflects the fact that modern societies are increasingly

A pyramid model for teaching and integrating cultural competence in medical curricula

The proposed model is informed by constructivism and situated learning theories. Constructivism refers to contextualising learning by requiring learners to work together in groups to understand cases and solve problems [27]. Situated learning highlights the importance of learners’ participation in their learning by engaging in an active social environment and in a process of interpretation and reflection [28]. Constructivism and situated learning have been used in teaching methods in medical

Discussion

The pyramid model proposed in this paper is based on Miller’s prism of clinical competence, is informed by constructivism and situated learning theories, and aims to provide a simple framework of teaching cultural competence to medical students and integrating it in medical curricula. The model proposes acquiring, applying and activating knowledge through lectures/seminars, cases, and role-play and work-based experience in order for medical students to enhance their knowledge, skills and

Conclusion

The need for culturally competent care has increasingly been acknowledged as an important element in medical practice. Based on constructivism and situated learning, this paper presents how a basic pyramid model for integrating cultural competence in medical curricula could help medical students acquire, apply and activate their knowledge; and hence enhance their understanding of, communication with and treatment of their patients. The pyramid model could also be the basis of training medical

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