Medical students interact with multicultural patients to learn cultural diversity

Retrospective study of cultural biases and their reflections among Korean medical students: a cultural hybridity perspective

PURPOSE

Most of studies about racial or ethnic biases among medical students have been conducted in English-speaking developed countries. This study explores the hybridity and transformation of Korean medical students' biases, arguing that a nation's identity and culture are constantly in a state of ever-changing hybridity.

METHODS

This research used a qualitative document analysis. The study participants were 600 pre-clinical medical students at two medical colleges in Korea, who enrolled in anti-bias programs and subsequently submitted self-reflection essays. Data collection focused on biases related to race, ethnicity, nationality, and medical practices as doctors. Bhabha's cultural hybridity concepts guided the coding of the data in order to explore the hybridity and transformation of the students' biases.

RESULTS

The students presented cultural biases toward patients and doctors with ambivalence related to a person's high socioeconomic status and open-mindedness, as well as doctors' excellence and superiority as Korean authoritative figures. Since the students had ambivalent and complex biases toward patients and doctors, they felt unhomeliness as Korean doctors encountering international patients in Korean clinics. However, after discovering their contradictory assumptions, they transformed their unhomeliness into new hybrid identities. The students' biases were rarely based on race but instead were based on nationality, specifically national class by national income.

CONCLUSION

Understanding the changing hybrid nature of identities and culture from a cultural hybridity perspective could help clarify medical students' complex and changing biases and improve anti-bias education. Korean medical students' hybridized positions suggest that anti-bias education goes beyond focusing on prestige or racism.

Development and delivery of justice, equity, diversity, inclusion, and anti-oppression concepts in entry-level health professional education: A scoping review: BEME Guide No. 88

PURPOSE

Justice, equity, diversity, inclusion (JEDI), and anti-oppression (AO) concepts are necessary in healthcare settings to promote culturally safe and high-quality care; however, entry-level healthcare program curricula (EHPPC) may lack adequate integration and/or delivery of these concepts. The primary aim of this scoping review is to identify what guidelines, frameworks, and models (GFMs) are used, and how they are used, to develop and deliver JEDI, and AO concepts in mandatory EHPPC.

METHODS

A search of Ovid MEDLINE, Ovid EMBASE, and CINAHL was conducted for studies published in English from 2015 onwards that discuss what GFMs are included in mandatory EHPPC and how they guide the development and/or delivery of JEDI and/or AO concepts. Data from the included studies was collated into themes which were presented in tables and figures and described in narrative summaries.

RESULTS

Sixty-one studies from various healthcare programs including medicine, nursing, pharmacy, dentistry, and dietetics were included in this review. Data from the studies were organized into eight categories: GFMs, concepts, methods of evaluation, length and frequency of sessions, modes of delivery, learning activities, and training of curricular developers and facilitators.

CONCLUSIONS

GFMs are used in a variety of ways to integrate JEDI and/or AO concepts into health professional curriculum. Variability in the training of developers and facilitators of curricular concepts also exists. Future research is needed to determine if consistent or variable GFMs, as well as JEDI and/or AO developer and facilitator training, would be more effective for students' learning of these concepts.

Medical students' experience of culturally diverse family presence during resuscitation simulation

PURPOSE

This report describes the development of a simulation scenario for medical student that incorporates cultural diversity within the context of family presence during resuscitation (FPDR).

METHODS

Using a hybrid simulation approach, we designed a scenario focusing on communication with a family that immigrated from Korea to the United States during cardiopulmonary resuscitation (CPR). The scenario objectives were for learners to perform CPR with family presence, communicate with the family, and understand and negotiate cultural needs. Following a pilot scenario with two inexperienced volunteer medical students as learners, the program was evaluated through anonymous surveys and informal focus group feedback.

RESULTS

Students noted that this simulation differed from previous experiences as compared with emphasizing family communication rather than patient diagnosis or treatment. Students valued experiencing the practical application of cultural competence concepts. The suggestions for scenario improvement included balancing two student participation roles, adjusting the timeline, and utilizing a standardized family member.

CONCLUSION

This pilot study suggests that an FPDR simulation program can be effectively repeated with multiple medical students and applied to CPR simulations involving diverse cultural backgrounds.

Factors influencing multicultural acceptance of Korean nursing students

BACKGROUND

South Korea has already become a multicultural society due to immigration, marriage, and employment of foreigners, and the use of medical institutions by foreigners is increasing. In order to establish a therapeutic rapport relationship with foreigners, it is necessary to study multicultural acceptance. This study aimed to examine and identify the factors influencing the degree of multicultural acceptance of Korean nursing students.

METHODS

This study used a cross-sectional descriptive design. Study participants included 147 nursing students at University in Seoul or Gyeonggi-do, South Korea. Data included demographics, multicultural acceptance, cultural empathy, and multicultural attitude. Data were collected from March to June 2021. Data was analyzed using linear regression model in SPSS PC + version 23.0 statistical software program.

RESULTS

The adjusted R-squared representing the explanatory power of the model was 72.5%. The strongest predictor was cultural empathy (β = 0.55, P < 0.001), followed by multicultural attitude (β = 0.26, P = 0.001), residential area where they lived for the past 5 years (β = 0.19, P = 0.001), accessibility to multicultural internet and media (β = 0.17, P = 0.003), whether they have foreign friends (β = 0.16, P = 0.003), and multicultural education experience (β = 0.02, P = 0.002).

CONCLUSION

This study suggests that to improve the degree of multicultural acceptance of Korean nursing students, their cultural empathy and multicultural attitude should be strengthened. Nurses need to pay attention the influencing factors to improve the multicultural acceptance of Korean nursing students.

Barriers and facilitators in providing care for patients with a migration background

AIMS AND OBJECTIVES

The aim of this study was to identify the barriers and facilitators experienced by healthcare professionals while caring for patients with a migration background.

BACKGROUND

People with a migration background often face several structural inequalities and barriers in terms of accessibility to, and affordability of, healthcare. In order to provide quality care for patients with a migration background, it is important to understand which barriers healthcare professionals experience that prevent them from providing care and which factors can facilitate this.

DESIGN AND METHODS

Qualitative research following the COREQ criteria. A total of six focus groups (n = 37) and 12 individual interviews were conducted with a multidisciplinary sample: doctors, nurses, social workers, and occupational therapists. Nursing and medical students were also included. Thematic content analysis was used.

RESULTS

Key findings suggest that the main barrier is that healthcare professionals regard people with a migration background as "the other". Healthcare professionals do not feel secure or competent to provide care for these "others." According to the healthcare professionals, the hospital structures-and, particularly, the managerial instances-appear to be only slightly supportive. Structural barriers at the level of the healthcare system, such as limited implementation of care coordination and austerity measures (time pressure or economic restrictions), were also perceived as barriers. Facilitators can be the healthcare professionals' attitude or the flexibility of the management.

CONCLUSIONS

Healthcare professionals experience barriers in caring for people with a migration background. Othering plays a key role in building or maintaining several barriers. A multilevel approach is necessary to tackle these barriers and enable facilitators.

RELEVANCE TO CLINICAL PRACTICE

Raising awareness about "othering" in the educational programs of students and healthcare professionals is essential. Also, deploying support mechanisms and valuing the competences of multicultural and multi-lingual healthcare professionals can help facilitate quality care for patients with a migrant background.

PATIENT OR PUBLIC CONTRIBUTION

Patients, informal and formal caregivers participated in the study at several stages (e.g.: by involving them during the research design phase or providing feedback and input at specific moments across the study). In addition, community participants played a key role also during the research design and data analysis phases as well as by facilitating patients' recruitment.

The Relationship Between Cultural Intelligence and Cultural Competence of Students of Nursing and Midwifery During COVID-19: A Cross-Sectional Study

Objectives

This study aimed to determine the relationship between cultural intelligence and cultural competence (CC) of the school of nursing and midwifery students from the Zanjan University of Medical Sciences in 2020-2021.

Methods

This cross-sectional study was conducted on 245 from 600 nursing and midwifery students of the Zanjan University of Medical Sciences from November 24, 2020, to March 18, 2021. Data were collected using three questionnaires of demographic information, Cultural Intelligence Scale, and The Nurse Cultural Competence Scale. Data analysis was done through Pearson's test and the logistic regression model using SPSS Version 22.

Results

The response rate was 40.83%. The results showed that the total score of cultural intelligence had a strong positive relationship with CC (r = 0.88). Also, the logistic regression model showed that the cultural intelligence variable could predict nursing and midwifery students' CC (B = 0.1, P = .013).

Conclusion

It is recommended to pay more attention to increasing the cultural intelligence and CC of nursing and midwifery students.

Alternatives to Student Outbound Mobility-Improving Students' Cultural Competency Skills Online to Improve Global Health Without Travel

Introduction

Student outbound mobility is a major element in internationalization of medical education and global health education. However, this approach is often criticized, as it is inherently inequitable. Internationalization at home is a newer concept that aims to provide students with international skills and experiences without exchange travel. We report detailed outcomes of an international online program during the COVID-19 pandemic, which aimed to include acquisition of cultural awareness and competency-similar to what the students would have obtained if they had travelled abroad.

Method

Sixty-eight students from 12 international universities participated in international small peer group collaborative work, and online networking. Perceived improvement of cultural competency using Likert scale and open-ended questions was used as a measure of success. Furthermore, students' definition of cultural competency in the different countries was obtained.

Results

Students improved their cultural competency skills. Data analysis supported statistically significant improvement of the above skills after the program, in comparison to the start of the program.

Discussion

Internationalization of medical education can be achieved at home-via structured online peer exchanges-and can provide students with intercultural skills and networking opportunities that are typically achieved via international in-person travel. The above represents a socially just and equitable way to reach all students and can result in improvement of their cultural competency, preparing them for their work in global health, and thereby resulting in improvement of global health.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-021-01332-9.

Early Years Research Elective: Changing Perspectives and Dealing with Uncertainty

Uncertainty is ever-present within the medical profession. To effectively manage uncertainty, future doctors must develop key competencies including resilience, creativity and adaptability along with the capacity for collaboration and embracing multiculturalism. The authors believe that attending an overseas clinical research placement as a junior medical student can benefit medical education by offering an early opportunity to develop these qualities. These views are supported by reflections on a clinical research module and placement in Guangzhou, China completed by the authors during the second year of medical school and aims to highlight key learning opportunities.