Perceptions of and preparedness for cross-cultural care: a survey of final-year medical students in Ireland

BACKGROUND

Migration is increasing globally, and societies are becoming more diverse and multi-ethnic. Medical school curricula should prepare students to provide high-quality care to all individuals in the communities they serve. Previous research from North America and Asia has assessed the effectiveness of medical cultural competency training, and student preparedness for delivery of cross-cultural care. However, student preparedness has not been explored in the European context. The aim of this study was to investigate how prepared final-year medical students in the Republic of Ireland (ROI) feel to provide care to patients from other countries, cultures, and ethnicities. In addition, this study aims to explore students' experiences and perceptions of cross-cultural care.

METHODS

Final-year medical students attending all six medical schools within the ROI were invited to participate in this study. A modified version of the Harvard Cross-Cultural Care Survey (CCCS) was used to assess their preparedness, skill, training/education, and attitudes. The data were analysed using IBM SPSS Statistics 28.0, and Fisher's Exact Test was employed to compare differences within self-identified ethnicity groups and gender.

RESULTS

Whilst most respondents felt prepared to care for patients in general (80.5%), many felt unprepared to care for specific ethnic patient cohorts, including patients from a minority ethnic background (50.7%) and the Irish Traveller Community (46.8%). Only 20.8% of final-year students felt they had received training in cross-cultural care during their time in medical school. Most respondents agreed that they should be assessed specifically on skills in cultural competence whilst in medical school (83.2%).

CONCLUSIONS

A large proportion of final-year medical students surveyed in Ireland feel inadequately prepared to care for ethnically diverse patients. Similarly, they report feeling unskilled in core areas of cross-cultural care, and a majority agree that they should be assessed on aspects of cultural competency. This study explores shortcomings in cultural competency training and confidence amongst Irish medical students. These findings have implications for future research and curricular change, with opportunities for the development of relevant educational initiatives in Irish medical schools.