Cross-cultural medical education: Can patient-centered cultural competency training be effective in non-Western countries?

Ho, Ming‐Jung; Yao, Grace; Lee, Keng-Lin; Beach, Mary Catherine; Green, Alexander R.

doi:10.1080/01421590802232842

Cited by 23 publications

(10 citation statements)

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“…Several models for cultural competence training have been developed in Western countries, 3,4 and the current pedagogy embraces a patient-centered approach that focuses on evaluating individual patients and considers the unique cultural and social factors that affect their care. 5–7 Although several studies have demonstrated the immediate effectiveness of this patient-centered cultural competence training approach in controlled trials in many Western and a few Eastern countries, 4,8–10 we could find no evidence in the medical literature evaluating the long-term effectiveness of this strategy. 11 …”

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confidence: 78%

Long-Term Effectiveness of Patient-Centered Training in Cultural Competence: What is Retained? What is Lost?

Yao

Lee

et al. 2010

Academic Medicine

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Purpose To determine whether the effects of a patient-centered cultural competence curriculum could be sustained for one year. Method In 2006, 57 fifth-year medical students at National Taiwan University were randomly assigned either to a group that received training in patient-centered cross-cultural communication skills or one that received no training. Students’ scores on objective structured clinical exams (OSCEs) were compared in the realms of exploring (1) patient perspectives and (2) social factors related to illness, immediately after training (OSCE1) and one year after training (OSCE2). Results Regarding students’ exploration of patient perspectives, the intervention group scored significantly higher than the control group at OSCE1, but there was a significant decrease from OSCE1 to OSCE2 in the intervention group and no significant difference between the intervention and control group at OSCE2. Regarding students’ exploration of social factors related to illness, the intervention group scored significantly higher than the control group at OSCE1, with a nonsignificant decrease from OSCE1 to OSCE2 in the two groups, such that the intervention group again scored higher than the control group in OSCE2. Conclusions The effect of a patient-centered cultural competence training curriculum on students’ exploration of social factors related to illness was sustained to a significant degree after one year, whereas the effects on students’ exploration of patient perspectives were not. Further research is needed to determine the extent to which additional training can prevent the loss of student skills.

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confidence: 78%

Long-Term Effectiveness of Patient-Centered Training in Cultural Competence: What is Retained? What is Lost?

Yao

Lee

et al. 2010

Academic Medicine

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“…Indeed, researchers have observed that patient welfare and patient autonomy are among the most common aspects of medical humanities practised by Taiwanese interns . In recent years, patient‐centred cultural competence training has been introduced, and might have impacted on students’ conceptions of professionalism …”

Section: Discussionmentioning

confidence: 99%

“…46 In recent years, patient-centred cultural competence training has been introduced, and might have impacted on students' conceptions of professionalism. 12,47 In Sri Lanka, the dominant dimension of professionalism as rules, could be partly explained by British colonial and Commonwealth history, as this dimension was also dominant in Welsh, English and Australian data. In Sri Lanka, for example, medical education is considerably influenced by structures and identities imparted during the colonial period.…”

Section: Discussion Of Key Findings In Light Of Existing Theory and Lmentioning

confidence: 99%

Taiwanese and Sri Lankan students’ dimensions and discourses of professionalism

et al. 2017

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ContextThe definition of medical professionalism poses a challenge to global medical educators. This is especially pronounced in settings where professionalism frameworks developed in the west are transferred into different cultures. Building upon our previous study across Western contexts, we examine Taiwanese and Sri Lankan medical students’ conceptualisations of professionalism in terms of what professionalism comprises (i.e. dimensions) and how it is linguistically framed (i.e. discourses).MethodsA qualitative group interview study was undertaken comprising 26 group interviews with 135 participants from one Taiwanese (n = 64; Years 4–7) and one Sri Lankan medical school (n = 71; Years 2–5). Through thematic framework analysis we examined the data for explicit dimensions of professionalism. Through discourse analysis we identified how participants constructed professionalism linguistically (discourses).ResultsThirteen common dimensions across Taiwanese and Sri Lankan talk were identified, with the dimensions (contextual, integration and internalised self) being identified only in Sri Lankan data. Professionalism as knowledge and patient‐centredness were dominant dimensions in Taiwan; in Sri Lanka, attributes of the individual and rules were dominant dimensions. Participants in both countries used four types of discourses previously identified in the literature. Individual and interpersonal discourses were dominant in Taiwanese talk; the collective discourse was dominant in Sri Lankan talk. Findings were compared with our previous data collected in Western contexts.ConclusionsDespite some overlap in the dimensions and discourses identified across both this and Western studies, Taiwanese and Sri Lankan students’ dominant dimensions and discourses were distinct. We therefore encourage global medical educators to look beyond a one‐size‐fits‐all approach to professionalism, and to recognise the significance of context and culture in conceptualisations of professionalism.

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“…It is important to take national and regional cultural differences sufficiently into account when disseminating educational theories [14, 15]. The style of communication in East Asia is sometimes described as “cultural reticence,” which consists of a reluctance to speak and a tendency not to express as much as is known or felt [16].…”

Section: Discussionmentioning

confidence: 99%

How do case presentation teaching methods affect learning outcomes?-SNAPPS and the One-Minute preceptor

et al. 2016

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BackgroundVarious techniques have been developed to enable preceptors to teach residents effectively in outpatient settings to promote active learning, including SNAPPS and the One-Minute Preceptor (OMP). This study aimed to ascertain the differences between SNAPPS and the OMP in case presentation content and learner evaluation when used to teach residents about case presentation.MethodsFrom 2011 to 2013, participants were 71 junior clinical residents employed in two hospitals for clinical training. They were randomly allocated to two groups, one using SNAPPS and the other the OMP. From recorded discussions, the “differential diagnoses”, “questions and uncertainties”, “treatment plans”, and “learning issues” were counted. Also, a self-evaluation form was distributed at the end of the study to evaluate the residents’ satisfaction with the case presentation.ResultsMembers of the SNAPPS group used significantly more meaning units related to questions and uncertainties compared with those of the OMP group (P < 0.001). Self-evaluation sheets revealed that members of the SNAPPS group had significantly higher positive responses than those of the OMP group in terms of the following evaluations: “It was easy to bring up questions and uncertainties” (P = 0.046), “It was easy to present the case efficiently” (P = 0.002), “It was easy to present the case in the sequence given” (P = 0.029), and “I was able to give an in-depth case presentation” (P = 0.005).ConclusionsSNAPPS may induce more meaning units related to questions and uncertainties and give more satisfaction to residents than the OMP.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0531-6) contains supplementary material, which is available to authorized users.

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Cross-cultural medical education: Can patient-centered cultural competency training be effective in non-Western countries?

Abstract: Background-No evidence addresses the effectiveness of patient-centered cultural competence training in non-Western settings.

Cited by 23 publications

References 1 publication

Long-Term Effectiveness of Patient-Centered Training in Cultural Competence: What is Retained? What is Lost?

Long-Term Effectiveness of Patient-Centered Training in Cultural Competence: What is Retained? What is Lost?

Taiwanese and Sri Lankan students’ dimensions and discourses of professionalism

How do case presentation teaching methods affect learning outcomes?-SNAPPS and the One-Minute preceptor

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