Cultural Competency Interventions During Medical School: a Scoping Review and Narrative Synthesis

Abstract

Many medical accreditation bodies agree that medical students should be trained to care for diverse patient populations. However, the teaching methods that medical schools employ to accomplish this goal vary widely. The purpose of this work is to summarize current cultural competency teaching for medical students and their evaluation methods. A scoping review was completed by searching the databases PubMed, Scopus, MedEdPOR-TAL, and MEDLINE for the search terms "medical education" and "cultural competency" or "cultural competence." Results were summarized using a narrative synthesis technique. One hundred fifty-four articles on cultural competency interventions for medical students were systematically identified from the literature and categorized by teaching methods, length of intervention, and content. Fifty-six articles had a general focus, and ninety-eight articles were focused on specific populations including race/ethnicity, global health, socioeconomic status, language, immigration status, disability, spirituality at the end of life, rurality, and lesbian, gay, bisexual, transgender, and queer. About 54% of interventions used lectures as a teaching modality, 45% of the interventions described were mandatory, and 9.7% of interventions were not formally evaluated. The authors advocate for expansion and more rigorous analysis of teaching methods, teaching philosophies, and outcome evaluations with randomized controlled trials that compare the relative effectiveness of general and population-specific cultural competency interventions.

Knowledge and attitudes of U.S. medical students regarding the care of Asian American patients: a cross-sectional survey study

“…Schools with relatively smaller AsAm patient populations can increase simulations and vignettes with AsAm patients. Simulations, such as virtual or standardized patient encounters, are effective in providing CC training [ 36 – 38 ]. Schools can also support away rotations in AsAm-dense regions or international experiences.…”

“…While CC education is part of the core medical school curriculum, its implementation—including structure/format, content, and requirements—varies widely across programs. Furthermore, standardized implementation guidelines and educator resources are lacking [ 36 , 38 ]. Currently, the Association of American Medical Colleges provides a 67-item checklist for medical schools to assess the topics covered in their CC curriculum, without further guidance regarding implementation [ 39 ].…”

Virtual patients reflecting the clinical reality of primary care – a useful tool to improve cultural competence

“…One main goal is to improve equity and thereby reduce disparities in health care [ 16 , 17 ]. Cultural competence is a complex concept and despite the ongoing debate on its appropriateness in medical education and health care, it is to date probably the most established concept, and will therefore be used in this article [ 9 , 14 , 18 ]. Cultural competence is often a part of the informal curriculum in post-graduate education in primary care; with learning taking place experientially in the workplace and formal learning activities being scarce [ 9 , 19 – 21 ].…”

Medical Student Involvement in a Human Rights Program: Impact on Student Development and Career Vision

“…Although such programs and human rights education are thought to enable students to drive meaningful change in their communities, research exploring their direct impact on students is limited [15,16]. One prior study explored medical students' work with asylum seekers and refugees, as a way to increase cultural competency and as a teaching modality designed to reach beyond the traditional classroom format of lectures and discussions [17]. Other studies have investigated the influence that clinical experiences with asylum seekers and refugees have had on medical learners, but have not directly interviewed these students [18][19][20].…”