Learning by Teaching an Unsuccessful “Cultural Sensitivity” Course

Joining Ethnography and History in Cultural Competence Training

“…Sometimes, these moments are emotionally disturbing and tense. Such strong reactions as those reported for example in Willen's, Bullon's and Carpenter-Song and Whitley's papers (Willen 2013;Bullon 2013;Carpenter-Song and Whitley 2013), however, I have never experienced as yet.…”

“…The most obvious point is perhaps the observation that in the German context, ''cultural diversity'' is usually identified as a rather exclusive issue of ''migrants'', very similar to Llerena-Quinn's (2013) observation that ''culture'' is still perceived as ''something 'others' have' ' and Bullon's (2013) report on finding himself considered ''expert'' on cultural diversity only because of his minority background. In Germany, almost any statement, conference, article or book on cultural diversity in medicine and health currently starts with the magic numbers ''16 million'' and ''nearly 20 %'', which indicate the total number and the percentage of ''migrants'', respectively.…”

“…The highly emotional reactions documented by several papers in this special issue give a vivid account of the importance of taking counter-transfer into account (especially: Willen 2013;Bullon 2013;Carpenter-Song and Whitley 2013). However, it is important to note that counter-transference is not always that explosive and not specific to situations in which ethnic minority patients, migrants or indigenous people are involved, but relevant in any physician-patient-interaction.…”

“…A particular aim is to overcome what often is termed the ''reductionist'' and ''fragmented'' view of physicians prompted by a largely biologically defined understanding of disease and disciplinary boundaries, and to reinsert individual physicians and patients into a social relationship. Within this special issue, these points are especially present in the contributions of the three clinical educators, Bullon (2013), Malik (2013) and Llerena-Quinn (2013). From a historical perspective, this sort of critique and demands are anything but new.…”

‘Fostering transformative learning, self-reflexivity and medical citizenship through guided tours of disadvantaged neighborhoods’

“…Although laudably seeking to increase students’ awareness of healthcare challenges in low income communities [7,8], health disparities education based on decontextualized statistical data and clinical rotations that expose students to safety-net healthcare settings often fail to promote ‘transformative learning experiences’—that is, deep seated, lasting changes to students’ personal perspectives and professional sensibilities[9]. What is more, such educational programs risk reifying negative stereotypes of low-income communities when the underlying socio-structural factors contributing to health disparities, and learners’ personal preconceptions of impoverished populations, are left uninterrogated [10–13]. Instead, transformative learning theory suggests that learners’ firmly ingrained cultural biases must first be disrupted before meaningful change can take hold.…”