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Shrivastava SR, Borkar S, Petkar P, Shrivastava PS, Mendhe HG, Bandre G. Community Health Immersion Programs in Medical Institutions. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1857-S1859. [PMID: 38882748 PMCID: PMC11174250 DOI: 10.4103/jpbs.jpbs_1242_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 12/23/2023] [Accepted: 01/09/2024] [Indexed: 06/18/2024] Open
Abstract
Exposure to the local community is crucial and pivotal to deliver contextual learning to medical students and thereby aid in the process of attaining subject-specific competencies. In the field of medical education, community health immersion refers to a set of systematic and immersive educational experiences for medical students to expose them to sociocultural and health-related attributes of the general population. Community health immersion has been linked with multiple merits that are crucial in the making of a competent medical graduate, who is well equipped to deliver patient-centered care. Even though there are multiple benefits to community health immersion nevertheless, its implementation in the community might vary based on institutional support and local community-related factors. There is an immense need to overcome these challenges to ensure optimal benefit, and this will essentially require the adoption of a multipronged approach with the help of all the concerned stakeholders.
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Affiliation(s)
- Saurabh RamBihariLal Shrivastava
- Deputy Director (Research and Development), Off Campus, Datta Meghe Institute of Higher Education and Research, Wanadongri, Nagpur, Maharashtra, India
| | - Sonali Borkar
- Department of Community Medicine, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Wanadongri, Nagpur, Maharashtra, India
| | - Prithvi Petkar
- Department of Community Medicine, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Wanadongri, Nagpur, Maharashtra, India
| | | | - Harshal Gajanan Mendhe
- Department of Community Medicine, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Wanadongri, Nagpur, Maharashtra, India
| | - Gulshan Bandre
- Department of Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India
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Anstice NS, Alam K, Armitage JA, Biles B, Black JM, Boon MY, Carlson T, Chinnery HR, Collins AV, Cochrane A, Duthie D, Hopkins S, Fitzpatrick G, Keay L, Watene R, Yashadhana A, Bentley SA. Developing culturally safe education practices in optometry schools across Australia and Aotearoa New Zealand. Clin Exp Optom 2023; 106:110-118. [PMID: 36336833 DOI: 10.1080/08164622.2022.2136514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Access to culturally safe health services is a basic human right, however through the lasting effects of colonisation, oppression, and systemic racism, the individual and community health of Indigenous peoples in Australia and Aotearoa New Zealand have been severely impacted. The Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy of the Australian Health Practitioners Regulation Agency, and the Standards of Cultural Competence and Cultural Safety of the Optometrists and Dispensing Opticians Board of New Zealand, recognise the importance of access to safe health care for Aboriginal, Torres Strait Islander and Māori patients, which encompasses both clinical competency and cultural safety. Universities have an ongoing responsibility to ensure their learning and teaching activities result in graduates being able to provide culturally safe practice. This article highlights the emergence of culturally safe practices in the Australian and Aotearoa New Zealand optometry curricula over the last five years incorporating Indigenous ways of knowing, being and doing into the curricula, understanding the local Indigenous histories and contexts, the adoption of online cultural education modules, and clinical placement partnerships with local Indigenous communities. Whilst there is still much work to do to achieve the goal of graduating culturally safe optometrists, this paper focuses on features that enable or impede progress in the development of culturally safe practices within the optometry programmes to improve eye health equity for Indigenous recognise the diversity of Indigenous cultures across Australia and NZ.
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Affiliation(s)
- Nicola S Anstice
- Optometry and Vision Science, Flinders University, Adelaide, Australia
| | - Khyber Alam
- Division of Optometry, University of Western Australia, Perth, Australia
| | - James A Armitage
- School of Medicine (Optometry), Deakin University, Geelong, Australia
| | - Brett Biles
- Office of Medical Education, University of New South Wales, Sydney, Australia
| | - Joanna M Black
- School of Optometry and Vision Science, The University of Auckland, Aotearoa New Zealand
| | - Mei Ying Boon
- Optometry and Vision Science, University of Canberra, Bruce, Australia
| | - Teah Carlson
- College of Health, Massey University, Aotearoa, New Zealand
| | - Holly R Chinnery
- Department of Optometry and Vision Science, The University of Melbourne, Melbourne, Australia
| | - Andrew V Collins
- School of Optometry and Vision Science, The University of Auckland, Aotearoa New Zealand
| | - Anthea Cochrane
- Department of Optometry and Vision Science, The University of Melbourne, Melbourne, Australia
| | - Debbie Duthie
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Shelley Hopkins
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Australia
| | - Gary Fitzpatrick
- Division of Optometry, University of Western Australia, Perth, Australia
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Renata Watene
- School of Optometry and Vision Science, The University of Auckland, Aotearoa New Zealand
| | - Aryati Yashadhana
- Office of Medical Education, University of New South Wales, Sydney, Australia
| | - Sharon A Bentley
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Australia
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Reflexive Practice as an Approach to Improve Healthcare Delivery for Indigenous Peoples: A Systematic Critical Synthesis and Exploration of the Cultural Safety Education Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116691. [PMID: 35682275 PMCID: PMC9180854 DOI: 10.3390/ijerph19116691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 11/22/2022]
Abstract
Cultural safety is increasingly being taught in tertiary programmes of study for health professionals. Reflexivity is a key skill required to engage in culturally safe practice, however, there is currently limited literature examining how reflexivity is taught or assessed within cultural safety curricula. A systematic review of the literature up until November 2021 was conducted, examining educational interventions which aimed to produce culturally safe learners. Studies were limited to those with a focus on Indigenous health and delivered in Australia, Aotearoa New Zealand, Canada, and the United States. A total of 46 documents describing 43 different educational interventions were identified. We found that definitions and conceptualisations of reflexivity varied considerably, resulting in a lack of conceptual clarity. Reflexive catalysts were the primary pedagogical approaches used, where objects, people, or Indigenous pedagogies provided a counterpoint to learners’ knowledges and experiences. Information regarding assessment methods was limited but indicates that the focus of existing programmes has been on changes in learner knowledge and attitudes rather than the ability to engage in reflexivity. The results demonstrate a need for greater conceptual clarity regarding reflexivity as it relates to cultural safety, and to develop methods of assessment that focus on process rather than outcomes.
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Te M, Blackstock F, Chipchase L. Fostering cultural responsiveness in physiotherapy: curricula survey of Australian and Aotearoa New Zealand physiotherapy programs. BMC MEDICAL EDUCATION 2019; 19:326. [PMID: 31470833 PMCID: PMC6717323 DOI: 10.1186/s12909-019-1766-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 08/26/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Developing cultural responsiveness among physiotherapists is considered essential to promote quality and equity in healthcare provision for our culturally diverse populations. The aim of this study was to evaluate how entry-level physiotherapy programs in Australia and Aotearoa New Zealand (NZ) design curricula to foster the development of cultural responsiveness in physiotherapy students. Further, the challenges of integrating educational content and approaches, and the perceptions of the effectiveness of these curricula were also explored. METHODS A cross-sectional telephone survey with closed and open-ended questions, was conducted with 18 participants representing 24 entry-level physiotherapy programs (82% of all programs) in Australia and NZ between May and September 2017. Data were analysed descriptively in the form of frequencies, percentages or ratios as appropriate. Open-ended responses were thematically analysed. RESULTS Results suggest variability in the structure, and teaching and assessment methods used across all programs. The majority of programs appeared to rely on didactic teaching methods, along with knowledge based and implicit assessment methods. The main challenges reported were that cultural responsiveness was thought to be perceived by academic staff as unimportant and that the curriculum was perceived to be 'overcrowded'. Participants also felt there was room for improvement despite perceiving the curriculum to be effective at fostering cultural responsiveness. CONCLUSION Results provide insight into the educational content and approaches integrated in entry-level physiotherapy curricula in Australia and NZ, and suggest opportunities for further research and development to foster cultural responsiveness among physiotherapy students.
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Affiliation(s)
- Maxine Te
- School of Science and Health, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Felicity Blackstock
- School of Science and Health, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Lucy Chipchase
- School of Science and Health, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia
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Francis-Cracknell A, Murray M, Palermo C, Atkinson P, Gilby R, Adams K. Indigenous Health Curriculum and Health Professional Learners: A Systematic Review. MEDICAL TEACHER 2019; 41:525-531. [PMID: 30299183 DOI: 10.1080/0142159x.2018.1497785] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Background: Globally, an estimated 370 million Indigenous peoples reside in more than 70 countries with these people commonly experiencing health care access inequity. Purpose: This systematic review aimed to examine the impact of Indigenous health care curriculum on entry-level health professional learners in preparation to deliver equitable health care. Methods: Seventeen articles were identified and analyzed for: context; study design; study measures, teaching and learning delivery mode, content and duration; positive and negative learner reactions; learning gained and article quality was assessed using the Medical Education Research Study Quality Instrument. Results: Most included studies described face-to-face delivery along with blended learning combining a placement in an Indigenous setting, stand-alone placements and digital learning. Descriptions of learning gained covered five domains: remembering, understanding, self-knowledge, perspective and application relating mostly to cultural awareness. Factors contributing to positive learner reactions included attitude, environment, educator skill, pedagogy and opportunities. Factors contributing to negative learner reactions included attitude and environment. Conclusions: There is a need to further explore how health professional graduates are prepared to work in Indigenous health and the appropriate measures to do this. There is opportunity to learn more about Indigenous health teaching and learning across learning domains, in mainstream clinical placements and in digital learning.
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Affiliation(s)
| | - Margaret Murray
- b Faculty of Medicine Nursing and Health Sciences, Department of Nutrition and Dietetics , Monash University , Clayton , Australia
| | - Claire Palermo
- c Department of Nutrition and Dietetics , Monash University , Melbourne , Australia
| | - Petah Atkinson
- a Faculty of Medicine Nursing and Health Sciences , Monash University , Frankston , Australia
| | - Rose Gilby
- d Department of Rural and Indigenous Health , Monash University , Mildura , Australia
| | - Karen Adams
- a Faculty of Medicine Nursing and Health Sciences , Monash University , Frankston , Australia
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Kurtz DLM, Janke R, Vinek J, Wells T, Hutchinson P, Froste A. Health Sciences cultural safety education in Australia, Canada, New Zealand, and the United States: a literature review. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2018; 9:271-285. [PMID: 30368488 PMCID: PMC6387770 DOI: 10.5116/ijme.5bc7.21e2] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 10/17/2018] [Indexed: 05/23/2023]
Abstract
OBJECTIVES To review the research literature on cultural safety education within post-secondary health science programs. METHODS We conducted health and social science database searches from 1996-2016, using combined keywords: cultural competence or safety; teaching or curriculum; universities, polytechnics or professional programs; and Aboriginal or Indigenous. In dyads, authors selected, and reviewed studies independently followed by discussion and consensus to identify thematic linkages of major findings. RESULTS A total of 1583 abstracts and 122 full-text articles were reviewed with 40 selected for final inclusion. Publications from Australia, Canada, New Zealand and the United States described curriculum development and delivery. A variety of evaluation approaches were used including anecdotal reports, focus groups, interviews, course evaluations, reflective journals, pre-post surveys, critical reflective papers, and exam questions. Duration and depth of curricular exposure ranged from one day to integration across a six-year program. Changes in student knowledge, attitude, self-confidence, and behaviour when working with Indigenous populations were reported. Cultural safety education and application to practice were shown to be linked to improved relationships, healthier outcomes, and increased number of Indigenous people entering health education programs and graduates interested in working in diverse communities. CONCLUSIONS This review provides a summary of multidisciplinary didactic and experiential instructional approaches to cultural safety education and the impact on students, educators and Indigenous people. Institutional support, strategic planning and cultural safety curriculum policy within post-secondary settings and community engagement are imperative for positive student experiences, advocacy, and actions toward health equity and improved health for Indigenous people and communities.
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Affiliation(s)
- Donna Lee Marie Kurtz
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan Kelowna, Canada
| | - Robert Janke
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan Kelowna, Canada
| | - Jeanette Vinek
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan Kelowna, Canada
| | - Taylor Wells
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan Kelowna, Canada
| | - Pete Hutchinson
- First Nations, Inuit and Métis Cancer Control, Canadian Partnership Against Cancer
| | - Amber Froste
- Okanagan Indian Band, Community Services and Development, Vernon, Canada
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Pitama SG, Palmer SC, Huria T, Lacey C, Wilkinson T. Implementation and impact of indigenous health curricula: a systematic review. MEDICAL EDUCATION 2018; 52:898-909. [PMID: 29932221 DOI: 10.1111/medu.13613] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/13/2017] [Accepted: 03/19/2018] [Indexed: 06/08/2023]
Abstract
CONTEXT The effectiveness of cultural competency education in improving health practitioner proficiency and addressing health inequities for minoritised patient groups is uncertain. Identification of institutional factors that shape or constrain development of indigenous health curricula may provide insights into the impact of these factors on the broader cultural competency curricula. METHODS We undertook a systematic review using actor-network theory to inform our interpretive synthesis of studies that reported indigenous health curricula evaluated within medical, nursing and allied health education. We searched the MEDLINE, OVID Nursing, Educational Resources Information Center (ERIC), PsycINFO, EMBASE, Web of Science and PubMed databases to December 2017 using exploded MeSH terms 'indigenous' and 'medical education' and 'educational professional' and 'health professional education'. We included studies involving undergraduate or postgraduate medical, nursing or allied health students or practitioners. Studies were eligible if they documented indigenous health learning outcomes, pedagogical practices and student evaluations. RESULTS Twenty-three studies were eligible for the review. In an interpretive synthesis informed by actor-network theory, three themes emerged from the data: indigenous health as an emerging curriculum (drivers of institutional change, increasing indigenous capacity and leadership, and addressing deficit discourse); institutional resource allocation to indigenous health curricula (placement within the core curriculum, time allocation, and resources constraining pedagogy), and impact of the curriculum on learners (acceptability of the curriculum, learner knowledge, and learner behaviour). CONCLUSIONS Systemic barriers acting on and within educational networks have limited the developmental capacity of indigenous health curricula, supported and sustained hidden curricula, and led to insufficient institutional investment to support a comprehensive curriculum. Future research in health professional education should explore these political and network intermediaries acting on cultural competence curricula and how they can be overcome to achieve cultural competency learning outcomes.
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Affiliation(s)
- Suzanne G Pitama
- Māori/Indigenous Health Institute (MIHI), University of Otago, Christchurch, New Zealand
| | - Suetonia C Palmer
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Tania Huria
- Māori/Indigenous Health Institute (MIHI), University of Otago, Christchurch, New Zealand
| | - Cameron Lacey
- Māori/Indigenous Health Institute (MIHI), University of Otago, Christchurch, New Zealand
| | - Tim Wilkinson
- Department of Medicine, University of Otago, Christchurch, New Zealand
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Sopoaga F, Zaharic T, Kokaua J, Covello S. Training a medical workforce to meet the needs of diverse minority communities. BMC MEDICAL EDUCATION 2017; 17:19. [PMID: 28109292 PMCID: PMC5251211 DOI: 10.1186/s12909-017-0858-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/09/2017] [Indexed: 05/25/2023]
Abstract
BACKGROUND The growing demand for a competent health workforce to meet the needs of increasingly diverse societies has been widely acknowledged. One medical school in New Zealand explored the integration of the commonly used patient-centred model approach, with an intersectional framework in the development of a cultural competency training programme. In the Pacific Immersion Programme, medical students in their fourth year of training are given the opportunity to learn about different factors that influence the health and health care of a minority community through immersion in that community. The programme objectives include enabling students to learn through experience living within the local community context, and supporting them to re-evaluate their own personal beliefs, assumptions and/or prior prejudices. This study evaluates the usefulness of this programme in the training of medical students to work in diverse communities. METHODS Two analytical approaches were used for evaluation. Deductive and inductive analyses were conducted on 235 reflective essays completed by three cohorts of students from 2011 to 2013 to ascertain the value of the programme for student learning. In addition, one cohort was invited to complete a pre and post-programme questionnaire. RESULTS Overall, the students found the programme to be a valued learning environment. They found living within a Pacific family environment to be an eye opening experience. It increased students comfort level in cross cultural engagement and emphasised the importance of patient's perspectives in health care provision. Students' self-reported knowledge about Pacific cultural values, protocols, traditional beliefs and the main health challenges increased significantly after the programme. They appreciated learning directly from community members, and through observations about how culture, beliefs and the socio-economic environment influence peoples' health and wellbeing. CONCLUSIONS Medical schools are required to train a competent health workforce to meet the needs of diverse communities. The Pacific Immersion Programme provides a unique learning environment which can improve the training of doctors to work in diverse communities. The key to its success is enabling students to be engaged learners from "the inside" rather than an "outsider looking in". The Programme enables experiential learning in a sensitive and meaningful way and can be useful for training in other institutions.
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Affiliation(s)
- Faafetai Sopoaga
- Department Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 913, , Post Code 9054 Dunedin, New Zealand
| | - Tony Zaharic
- Department of Biochemistry, University of Otago, P.O. Box 56, , Post Code 9054, Dunedin, New Zealand
| | - Jesse Kokaua
- Pacific Islands Research & Student Support Unit, Division of Health Sciences, University of Otago, P.O. Box 56, , Post Code 9054 Dunedin, New Zealand
| | - Sahra Covello
- Pacific Islands Research & Student Support Unit, Division of Health Sciences, University of Otago, P.O. Box 56, , Post Code 9054 Dunedin, New Zealand
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Charles L, Maltby H, Abrams S, Shea J, Brand G, Nicol P. Expanding Worldview: Australian Nursing Students' Experience of Cultural Immersion in India. Contemp Nurse 2014:4288-4308. [PMID: 24972634 DOI: 10.5172/conu.2014.4288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Abstract Increasing cultural diversity and a sense of global community has necessitated the introduction of cultural competence in the education of health care providers. Some institutions have utilized cultural immersion programs to address this need of cultural competence. Studies have not yet described what this experience is for Australian nursing students. The purpose of this study is to describe the immersion experience of a group of senior Australian nursing students who participated in a five week cultural immersion program in India.
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Almutairi AF, McCarthy A, Gardner GE. Understanding Cultural Competence in a Multicultural Nursing Workforce. J Transcult Nurs 2014; 26:16-23. [DOI: 10.1177/1043659614523992] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: In Saudi Arabia, the health system is mainly staffed by expatriate nurses from different cultural and linguistic backgrounds. Given the potential risks this situation poses for patient care, it is important to understand how cultural diversity can be effectively managed in this multicultural environment. The purpose of this study was to explore notions of cultural competence with non-Saudi Arabian nurses working in a major hospital in Saudi Arabia. Design: Face-to-face, audio-recorded, semistructured interviews were conducted with 24 non-Saudi Arabian nurses. Deductive data collection and analysis were undertaken drawing on Campinha-Bacote’s cultural competence model. The data that could not be explained by this model were coded and analyzed inductively. Findings: Nurses within this culturally diverse environment struggled with the notion of cultural competence in terms of each other’s cultural expectations and those of the dominant Saudi culture. Discussion: The study also addressed the limitations of Campinha-Bacote’s model, which did not account for all of the nurses’ experiences. Subsequent inductive analysis yielded important themes that more fully explained the nurses’ experiences in this environment. Implications for Practice: The findings can inform policy, professional education, and practice in the multicultural Saudi setting.
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Affiliation(s)
- Adel F. Almutairi
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- King Abdullah International Medical Research Centre, and King Saud bin Abdulaziz University for health Sciences, Riyadh, Saudi Arabia
| | - Alexandra McCarthy
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Glenn E. Gardner
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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A Canadian survey of postgraduate education in Aboriginal women's health in obstetrics and gynaecology. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2013; 35:647-53. [PMID: 23876643 DOI: 10.1016/s1701-2163(15)30891-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess Canadian obstetrics and gynaecology residents' knowledge of and experience in Indigenous women's health (IWH), including a self-assessment of competency, and to assess the ability of residency program directors to provide a curriculum in IWH and to assess the resources available to support this initiative. METHODS Surveys for residents and for program directors were distributed to all accredited obstetrics and gynaecology residency programs in Canada. The resident survey consisted of 20 multiple choice questions in four key areas: general knowledge regarding Indigenous peoples in Canada; the impact of the residential school system; clinical experience in IWH; and a self-assessment of competency in IWH. The program director survey included an assessment of the content of the curriculum in IWH and of the resources available to support this curriculum. RESULTS Residents have little background knowledge of IWH and the determinants of health, and are aware of their knowledge gap. Residents are interested in IWH and recognize the importance of IWH training for their future practice. Program directors support the development of an IWH curriculum, but they lack the resources to provide a comprehensive IWH curriculum and would benefit from having a standardized curriculum available. CONCLUSION A nationwide curriculum initiative may be an effective way to facilitate the provision of education in IWH while decreasing the need for resources in individual programs.
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Bellamy G, Gott M. What are the priorities for developing culturally appropriate palliative and end-of-life care for older people? The views of healthcare staff working in New Zealand. HEALTH & SOCIAL CARE IN THE COMMUNITY 2013; 21:26-34. [PMID: 22812427 DOI: 10.1111/j.1365-2524.2012.01083.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This paper explores the views of healthcare staff regarding the provision of culturally appropriate palliative care for Māori, Pacific Island and Chinese elders living in Auckland, New Zealand. The ageing population is culturally and ethnically diverse and, along with other developed countries experiencing high levels of migration, the challenge is balancing the rise in numbers of older people from different ethnic and cultural groups with end-of-life care, which reflects personal values and beliefs. Two joint interviews and ten focus groups were conducted with eighty staff across a range of primary, secondary and speciality care settings in 2010. The findings demonstrated that participants viewed the involvement of family as fundamental to the provision of palliative care for Māori, Pacific Island and Chinese elders. For Māori and Pacific Islanders, healthcare staff indicated the importance of enabling family members to provide 'hands-on' care. The role of family in decision-making was fundamental to the delivery of and satisfaction with care for older Chinese family members. Care staff highlighted the need to be cognisant of individual preferences both within and across cultures as a fundamental aspect of palliative care provision. The role of family in 'hands-on' palliative care and decision-making requires care staff to relinquish their role as 'expert provider'. Counter to the prioritisation of autonomy in Western health-care, collective decision-making was favoured by Chinese elders. Providing families with the requisite knowledge and skills to give care to older family members was important. Whilst assumptions are sometimes made about preferences for end-of-life care based on cultural values alone, these data suggest that care preferences need to be ascertained by working with family members on an individual basis and in a manner that respects their involvement in palliative care provision.
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Affiliation(s)
- Gary Bellamy
- School of Nursing, The University of Auckland, New Zealand.
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Henning MA, Shulruf B, Hawken SJ, Pinnock R. Changing the learning environment: the medical student voice. CLINICAL TEACHER 2011; 8:83-7. [PMID: 21585665 DOI: 10.1111/j.1743-498x.2011.00439.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Students' perceptions of their learning environment influence both how they learn and the quality of their learning outcomes. The clinical component of undergraduate medical courses takes place in an environment designed for clinical service and not teaching. Tension results when these two activities compete for resources. An impending increase in medical student numbers led us to assess the learning environment with a view to planning for the future. METHODS An open ended question 'If you could change three things about medical school, what would they be?' was added to the Dundee Ready Educational Environment Measure (DREEM). This was used to assess the learning environment of students in years 4 and 5. Allowing students to actively voice their views about changes in the curriculum was considered a useful extension to the DREEM questionnaire. RESULTS The findings indicated commonalities over the two years of clinical teaching. The areas of commonality included the need for: more clinical exposure early in the curriculum; fewer lectures; greater consistency in terms of assessment; and more constructive relationships. Fourth-year students tended to voice more concerns around resourcing, and sought more clarification about roles and learning outcomes. DISCUSSION There is a need to address concerns raised by students in the areas of curricula, assessments and access to earlier clinical training. Concerns that can be addressed are increasing resource access, implementation of clearer objectives, consistency of teaching and assessments across sites, more formative assessments, and engaging feedback. Students would also benefit from substantive mentoring and role-modelling.
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Affiliation(s)
- Marcus A Henning
- Centre for Medical and Health Sciences Education, University of Auckland, New Zealand
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Phiri J, Dietsch E, Bonner A. Cultural safety and its importance for Australian midwifery practice. Collegian 2010; 17:105-11. [DOI: 10.1016/j.colegn.2009.11.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Maley M, Worley P, Dent J. Using rural and remote settings in the undergraduate medical curriculum: AMEE Guide No. 47. MEDICAL TEACHER 2009; 31:969-83. [PMID: 19909036 DOI: 10.3109/01421590903111234] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The goal of global equity in health care requires that the training of health-care professionals be better tuned to meet the needs of the communities they serve. In fact medical education is being driven into isolated communities by factors including workforce undersupply, education pedagogy, medical practice and research needs. Rural and remote medical education (RRME) happens in rural hospitals and rural general practices, singly or in combination, generally for periods of 4 to 40 weeks. An effective RRME programme matches the context of the local health service and community. Its implementation reflects the local capacity for providing learning opportunities, facilitates collaboration of all participants and capitalises on local creativity in teaching. Implementation barriers stem from change management, professional culture and resource allocation. Blending learning approaches as much as technology and local culture allow is central to achieving student learning outcomes and professional development of local medical teachers. RRME harnesses the rich learning environment of communities such that students rapidly achieve competence and confidence in a primary care/generalist setting. Longer programmes with an integrated (generalist) approach based in the immersion learning paradigm appear successful in returning graduates to rural practice and a career track with a quality lifestyle.
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Affiliation(s)
- Moira Maley
- The University of Western Australia, Western Australia.
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Abstract
In New Zealand there is emphasis on improving access to primary healthcare, particularly for high health need populations such as Maori, the indigenous people of New Zealand. Critical to the development of the primary healthcare environment is building healthcare teams and better utilising health practitioners. This article reports on an interprofessional educational initiative where medical, nursing and pharmacy undergraduates learnt together in order to understand Maori health issues, how these are addressed by health services and also appreciate the contribution of different health professionals within the healthcare team. The educational initiative is described and interprofessional learning issues are explored across the different curricula structures of medicine, nursing and pharmacy.
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Affiliation(s)
- Margaret Horsburgh
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
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Dussán KB, Galbraith EM, Grzybowski M, Vautaw BM, Murray L, Eagle KA. Effects of a refugee elective on medical student perceptions. BMC MEDICAL EDUCATION 2009; 9:15. [PMID: 19358713 PMCID: PMC2676284 DOI: 10.1186/1472-6920-9-15] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Accepted: 04/09/2009] [Indexed: 05/27/2023]
Abstract
BACKGROUND There are growing numbers of refugees throughout the world. Refugee health is a relatively unstudied and rarely taught component of medical education. In response to this need, a Refugee Health Elective was begun. Medical student perceptions toward cultural aspects of medicine and refugee health before and after participation in the elective were measured. METHODS Preliminary questionnaires were given to all preclinical students at the academic year commencement with follow-up questionnaires at the refugee elective's conclusion. Both questionnaires examined students' comfort in interacting with patients and familiarity with refugee medical issues, alternative medical practices, and social hindrances to medical care. The preliminary answers served as a control and follow-up questionnaire data were separated into participant/non-participant categories. All preclinical medical students at two Midwestern medical schools were provided the opportunity to participate in the Refugee Health Elective and surveys. The 3 data groups were compared using unadjusted and adjusted analysis techniques with the Kruskall-Wallis, Bonferroni and ANCOVA adjustment. P-values < 0.05 were considered significant. RESULTS 408 and 403 students filled out the preliminary and follow-up questionnaires, respectfully, 42 of whom participated in the elective. Students considering themselves minorities or multilingual were more likely to participate. Elective participants were more likely to be able to recognize the medical/mental health issues common to refugees, to feel comfortable interacting with foreign-born patients, and to identify cultural differences in understanding medical/mental health conditions, after adjusting for minority or multilingual status. CONCLUSION As medical schools integrate a more multicultural curriculum, a Refugee Health Elective for preclinical students can enhance awareness and promote change in attitude toward medical/mental health issues common to refugees. This elective format offers tangible and effective avenues for these topics to be addressed.
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Affiliation(s)
| | - Erin M Galbraith
- Emory University Hospitals, Department of Cardiology, Atlanta, GA, USA
| | - Mary Grzybowski
- Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, MI, USA
| | | | - Linda Murray
- Michigan State College of Human Medicine, East Lansing, MI, USA
| | - Kim A Eagle
- University of Michigan, Department of Cardiology, Ann Arbor, MI, USA
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Art B, De Roo L, Willems S, De Maeseneer J. An interdisciplinary community diagnosis experience in an undergraduate medical curriculum: development at Ghent University. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2008; 83:675-83. [PMID: 18580088 DOI: 10.1097/acm.0b013e31817829a6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Since 2002, the medical curriculum at Ghent University has incorporated a community diagnosis exercise, teaming medical students with master of social work and social welfare studies students. The course focuses on the interaction between the individual and the community in matters of health and health care. During one week, small groups of students visit patients and their caregivers in six underserved urban neighborhoods, and they combine these experiences with public health data, to develop a community diagnosis. Local family physicians and social workers monitor sessions. The course requires students to design an intervention tackling one community health issue. At the end of the course, the students present their diagnoses and interventions to community workers and policy makers who provide feedback on the results. In the authors' experience, medical and social work students all value the joint learning experience. The occasional culture clash is an added value. The one-week course is very intensive for students, mentors, and cooperating organizations. Although students criticize time restraints, they feel that they reach the outlined objectives, and they rate the overall experience as very positive. The authors find that this interdisciplinary, community-oriented exercise allows students to appreciate health problems as they occur in society, giving them insight into the interaction of the local community with health and health care agencies. Combining public health data with experiences originating from a patient encounter mimics real-life primary care situations. This campus-community collaboration contributes to the social accountability of the university.
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Affiliation(s)
- Bruno Art
- Department of Family Medicine and Primary Healthcare, Ghent University, Ghent, Belgium.
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Gürsoy ST, Ocek ZA, Ciçeklioğlu M, Aksu F, Soyer MT. Evaluation of an educational programme in Ege University, Turkey: Medical student's home visits with midwife preceptors. Midwifery 2008; 24:226-37. [PMID: 17320252 DOI: 10.1016/j.midw.2006.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Revised: 10/03/2006] [Accepted: 12/10/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE to evaluate the efficiency of the midwife preceptors in teaching comprehensive health care for women and their families through exploring how they perceive their roles as educators and from the perspectives of medical students; to assess the number of educational goals achieved. DESIGN for midwives, a quantitative method was used for pre- and post-evaluation of a 'Medical Students' Home Visits with Midwife Preceptors' course. Focus-group interviews were used to gather qualitative data. Students were evaluated after undertaking home visits with the midwives. SETTING urban health centres in Western Turkey and Ege University Faculty of Medicine. PARTICIPANTS a sample of four clusters of second year medical students (130 out of 284) and all midwives (n=32) linked with the health centres participated in the programme. FINDINGS in general, both the midwives and the medical students found the programme useful. Students declared that they achieved their learning objectives and midwives stated that they had contributed to this achievement. Scores of eight of the 20 learning objectives significantly increased in the midwives' post-test evaluation. Midwives and students valued the effective communication they had with each other. All midwives participated in focus-group interviews, and reported that the course before the home visits was useful to them. Nearly all of the midwives suggested that the home visits course should be longer, repeated, or both. It was difficult to organise home visits for all of the medical students, and access to some households to enable students to gain training experience was refused. CONCLUSIONS this programme encouraged the medical students to adopt broad public health approaches in assessing the health needs of defined communities. It also increased their awareness of the importance of multi-professional teamwork and comprehensive health care for women and their families. At the same time, the programme improved the professional knowledge of midwives, and they were able to appreciate their roles and functions in primary health care, and enhance their self-esteem. The findings also indicated that this programme is an effective way of promoting multi-professional education in medical schools.
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Affiliation(s)
- Safak T Gürsoy
- Ege University, Faculty of Medicine, Department of Public Health, Turkey.
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Mak DB, Plant AJ, Toussaint S. "I have learnt ... a different way of looking at people's health": an evaluation of a prevocational medical training program in public health medicine and primary health care in remote Australia. MEDICAL TEACHER 2006; 28:e149-55. [PMID: 17074694 DOI: 10.1080/01421590600776404] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The purpose of this study was to gain insight into what prevocational medical practitioners (PMPs) learnt during a six-month public health medicine and primary health care training program (the Program) in remote Aboriginal Australia in 2001-2002. The Program's curriculum objectives included clinical and public health management of sexually transmitted infections, immunization, clinical audit and quality improvement, primary health care in remote Aboriginal communities, and working as part of an interdisciplinary team with health and non-health professionals, and lay people. The mode and location of delivery of these objectives was determined by the healthcare needs of the Kimberley population, and availability of safe, supported workplaces. Qualitative data from a variety of sources, including PMPs' reflective journals, were examined in the context of the Program's curriculum objectives and by conducting a content analysis of journal notes. Findings are presented using the curriculum objectives and other comments that emerged while examining the data. Preliminary data indicated that PMPs gained knowledge and practical experience in clinical and public health management of sexually transmitted infections, immunization and primary health care in poorly resourced remote Aboriginal settings. Deeper understandings of health and illness in a cross-cultural setting also developed, along with professional and personal growth, as illustrated by the following quotations from PMPs: "I have learnt ... a different way of looking at people's health ... I was encouraged to think more deeply than before about the whys and wherefores of medical practice, and thus consider the most effective ways of influencing patients' behaviours for the better." "I was encouraged to examine the thought processes behind the ways ... healthcare was provided ... [after leaving the Kimberley] I am constantly questioning the reason why we are practising medicine in a certain way in the big city hospitals-much to the consternation of my colleagues ... ." The Program was successful in teaching its first four PMPs the basic tools of public health medicine and remote area primary health care.
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Affiliation(s)
- Donna B Mak
- Curtin University of Technology, Western Australia.
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Price EG, Beach MC, Gary TL, Robinson KA, Gozu A, Palacio A, Smarth C, Jenckes M, Feuerstein C, Bass EB, Powe NR, Cooper LA. A systematic review of the methodological rigor of studies evaluating cultural competence training of health professionals. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2005; 80:578-86. [PMID: 15917363 DOI: 10.1097/00001888-200506000-00013] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
PURPOSE To systematically examine the methodological rigor of studies using cultural competence training as a strategy to improve minority health care quality. To the authors' knowledge, no prior studies of this type have been conducted. METHOD As part of a systematic review, the authors appraised the methodological rigor of studies published in English from 1980 to 2003 that evaluate cultural competence training, and determined whether selected study characteristics were associated with better study quality as defined by five domains (representativeness, intervention description, bias and confounding, outcome assessment, and analytic approach). RESULTS Among 64 eligible articles, most studies (no. = 59) were published recently (1990-2003) in education (no. = 26) and nursing (no. = 14) journals. Targeted learners were mostly nurses (no. = 32) and physicians (no. = 19). Study designs included randomized or concurrent controlled trials (no. = 10), pretest/posttest (no. = 22), posttest only (no. = 27), and qualitative evaluation (no. = 5). Curricular content, teaching strategies, and evaluation methods varied. Most studies reported provider outcomes. Twenty-one articles adequately described provider representativeness, 21 completely described curricular interventions, eight had adequate comparison groups, 27 used objective evaluations, three blinded outcome assessors, 14 reported the number or reason for noninclusion of data, and 15 reported magnitude differences and variability indexes. Studies targeted at physicians more often described providers and interventions. Most trials completely described targeted providers, had adequate comparison groups, and reported objective evaluations. Study quality did not differ over time, by journal type, or by the presence or absence of reported funding. CONCLUSIONS Lack of methodological rigor limits the evidence for the impact of cultural competence training on minority health care quality. More attention should be paid to the proper design, evaluation, and reporting of these training programs.
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Affiliation(s)
- Eboni G Price
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Mak DB, Plant AJ. Reducing unmet needs: A prevocational medical training program in public health medicine and primary health care in remote Australia. Aust J Rural Health 2005; 13:183-90. [PMID: 15932489 DOI: 10.1111/j.1440-1854.2005.00698.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To describe the development and implementation of a prevocational medical training program in public health medicine and primary health care in remote Australia and to evaluate the program's adherence to adult learning principles. METHODS Reports, funding applications and other relevant material relating to the program were reviewed to document learning objectives, and teaching and program implementation strategies. RESULTS The 24-week program employs two prevocational medical practitioners each year and comprises four weeks at Fremantle Hospital's sexual health clinic followed by 20 weeks in the Kimberley. Curriculum objectives include clinical and public health aspects of sexually transmitted infection management, immunisation, clinical audit and quality improvement, primary health care in remote Aboriginal communities, oral and written presentation skills and working as part of an interdisciplinary team. Teaching strategies used were in accordance with adult learning principles. CONCLUSIONS Prevocational medical training in public health medicine and primary health care in remote Australia is achievable and reduces current gaps in prevocational medical education.
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Affiliation(s)
- Donna B Mak
- Department of Health Western Australia, The University of Western Australia, Medlands, Western Australia, Australia.
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Sidelinger DE, Meyer D, Blaschke GS, Hametz P, Batista M, Salguero R, Reznik V. Communities as teachers: learning to deliver culturally effective care in pediatrics. Pediatrics 2005; 115:1160-4. [PMID: 15821302 DOI: 10.1542/peds.2004-2825l] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A patient's culture has an effect on her or his view of illness, decision to seek care, and adherence to treatment plans and follow-up visits. In this article, we describe community-academic partnerships designed to teach improved delivery of culturally effective care conducted in pediatric residency training programs in New York, New York, and San Diego, California. Columbia University-Children's Hospital of New York-Presbyterian focuses most of residents' cultural-training experiences within 1 community program, a home-visitation program (Best Beginnings) with which residents work in various capacities throughout residency. The University of California, San Diego and Naval Medical Center San Diego use a series of cultural "immersion experiences" as a primary method. The creation of community-academic partnerships for the purpose of service and training can be a critical asset in the development of culturally effective care training: community partners become teachers and local communities serve as classrooms.
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Affiliation(s)
- Dean E Sidelinger
- Department of Pediatrics, University of California, San Diego, School of Medicine, La Jolla, California 92093-0927, USA.
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Affiliation(s)
- Nisha Dogra
- University of Leicester, Greenwood Institute of Child Health, Leicester, UK.
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Kristina TN, Majoor GD, van der Vleuten CPM. Defining generic objectives for community-based education in undergraduate medical programmes. MEDICAL EDUCATION 2004; 38:510-521. [PMID: 15107085 DOI: 10.1046/j.1365-2929.2004.01819.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
RATIONALE The availability of a framework for the definition of generic objectives for community-based education (CBE) programmes may assist in the rational design of objectives for specific CBE programmes. STRATEGY Factors impacting on community health from the perspective of a developing country were collected. Potential assistance from medical students to communities to improve their health status was determined. Competencies required in students to execute tasks in the community were defined and eventually educational objectives to develop these competencies in the students were established. METHODS Factors impacting on community health and activities of medical students in CBE programmes were identified by review of literature and Internet resources. Competencies desired for execution of tasks by students and educational objectives to develop these competencies were defined by us and checked against pertinent literature. A draft table representing the 4 elements of the framework was discussed by an international group of experts for external validation. MAIN OUTCOMES A total of 26 factors impacting on community health were identified and clustered in 5 domains. Twenty-one generic objectives for CBE programmes were defined to develop the required competencies in students. Analogues of each of these 21 objectives were found in at least 1 publication specifying objectives for specific CBE programmes but none of these publications stated any objective not covered by our list of generic objectives. CONCLUSION It proved possible to develop a framework to define generic objectives for CBE programmes. An example was elaborated from the perspective of a medical school in a developing country.
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Affiliation(s)
- T N Kristina
- Faculty of Medicine, Diponegoro University, Semarang, Indonesia
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Mutchnick IS, Moyer CA, Stern DT. Expanding the boundaries of medical education: evidence for cross-cultural exchanges. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2003; 78:S1-5. [PMID: 14557080 DOI: 10.1097/00001888-200310001-00002] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PROBLEM STATEMENT AND BACKGROUND Cross-cultural experiences are in increasing demand by both graduate and undergraduate medical students, yet the benefits of these experiences are not clearly established. METHOD A review of the literature was conducted to identify articles on the outcomes of cross-cultural experiences. Themes were identified and categorized into domains. RESULTS Forty-two studies were found; 27 articles used qualitative methods, nine used quantitative methods, and six used both. Most (24) were from the nursing literature, 18 were from the medical literature. All studies reported positive outcomes along four domains: students' professional development, students' personal development, medical school benefits, and host population benefits. CONCLUSIONS Studies reviewed were primarily case controlled or case series. Future research is needed that more clearly defines outcome measures and uses more rigorous methods. Although results suggest positive outcomes in all domains, additional research is needed before cross-cultural rotations can be supported based on evidence.
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Crampton P, Dowell A, Parkin C, Thompson C. Combating effects of racism through a cultural immersion medical education program. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2003; 78:595-598. [PMID: 12805038 DOI: 10.1097/00001888-200306000-00008] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The purpose of this paper is to provide a perspective from New Zealand on the role of medical education in addressing racism in medicine. There is increasing recognition of racism in health care and its adverse effects on the health status of minority populations in many Western countries. New Zealand nursing curricula have introduced the concept of cultural safety as a means of conveying the idea that cultural factors critically influence the relationship between carer and patient. Cultural safety aims to minimize any assault on the patient's cultural identity. However, despite the work of various researchers and educators, there is little to suggest that undergraduate medical curricula pay much attention yet to the impact of racism on medical education and medical practice. The authors describe a cultural immersion program for third-year medical students in New Zealand and discuss some of the strengths and weaknesses of such an approach. The program is believed to have great potential as a method of consciousness raising among medical students to counter the insidious effects of non-conscious inherited racism. Apart from the educational benefits, the program has fostered a strong working relationship between an indigenous health care organization and the medical school. In general, it is hoped that such programs will help medical educators to engage more actively with the issue of racism and be prepared to experiment with novel approaches to teaching and learning. More specifically, the principles of cultural immersion, informed by the concept of cultural safety, could be adapted to indigenous and minority groups in urban settings to provide medical students with the foundations for a lifelong commitment to practicing medicine in a culturally safe manner.
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Affiliation(s)
- Peter Crampton
- Department of Public Health, Wellington School of Medicine and Health Sciences, Wellington, New Zealand
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Prideaux D, Edmondson W. Cultural identity and representing culture in medical education. Who does it? MEDICAL EDUCATION 2001; 35:186-187. [PMID: 11260435 DOI: 10.1046/j.1365-2923.2001.00888.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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