DiscussionAcquire, apply, and activate knowledge: A pyramid model for teaching and integrating cultural competence in medical curricula
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
References (35)
- et al.
The effectiveness of problem-based learning on development of nursing students’ critical thinking: a systematic review and meta-analysis
Int. J. Nurs. Stud.
(2014) - et al.
Sociology
(2013) The Sociology of Health and Illness
(2013)Health
(2010)- et al.
Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care
Public Health Rep.
(2003) - et al.
Racial/ethnic variation in health care satisfaction: the role of acculturation
Soc. Work Health Care
(2016) - et al.
Cross-cultural Caring: A Handbook for Health Professionals
(2005) - et al.
Cultural competence and health care disparities: key perspectives and trends
Health Aff. (Millwood)
(2005) - et al.
The biopsychosocial model 25 years later: principles, practice, and scientific inquiry
Ann. Family Med.
(2004) Which ethnic groups have the poorest health
Ethnic Identity and Inequalities in Britain: The Dynamics of Diversity
(2015)
Cultural respect encompassing simulation training: being heard about health through broadband
J. Public Health Res.
A systematic review of the methodological rigor of studies evaluating cultural competence training of health professionals
Acad. Med.
The effectiveness of cultural competence programs in ethnic minority patient-centered health care – a systematic review of the literature
Int. J. Qual. Health Care
Cultural Competence Education for Health Professionals. Cochrane Database of Systematic Reviews
Cultural competence dimensions and outcomes: a systematic review of the literature
Health Soc. Care Community
Preparing doctors for a multicultural world
Acad. Med.
Cultural Competence Education for Students in Medicine and Public Health: Report of an Expert Panel
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Examining the implementation of teaching and learning interactions of transition cultural competence through a qualitative study of Taiwan mentors untaking the postgraduate nursing program
2019, Nurse Education TodayCitation Excerpt :This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness (Young and Guo, 2016). Most studies do not outline the learning processes involved in cultural competence education, but Constantinou et al. (2017) proposed a pyramid model for building cultural competence into medical curricula, whereby medical students can enhance their skills through acquiring, applying, and activating knowledge. The preliminary stage involves assistance in knowledge acquisition; however, the accumulation of work experience is necessary for appropriate application of the acquired knowledge.
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