A New Approach to Developing Cross-Cultural Communication Skills

Published in: Medical Teacher, v. 26, no. 2, Mar. 2004, p. 126-132

Posted on RAND.org on December 31, 2003

by Joel Rosen, Erica S. Spatz, Annelise M. J. Gaaserud, Henry Abramovitch, Baruch Weinreb, Neil S. Wenger, Carmi Z. Margolis

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The need for cross-cultural training (CCT) increases as physicians encounter more culturally diverse patients. However, most medical schools relegate this topic to non-clinical years, hindering skills development. Some residency programs have successfully addressed this deficit by teaching cross-cultural communication skills in a teaching objective structured clinical examination (tOSCE) context. The authors developed and evaluated a CCT workshop designed to teach cross-cultural communication skills to third-year medical students using a tOSCE approach. A 1 and 1/2-day workshop incorporating didactic, group discussion and tOSCE components taught medical students cross-cultural awareness, interviewing skills, working with an interpreter, attention to complementary treatments, and consideration of culture in treatment and prevention. Six standardized patient cases introduced various clinical scenarios and the practical and ethical aspects of cross-cultural care. Student evaluation of the workshop was positive concerning educational value, skills advancement and pertinence to their clinical activities. Survey of students before and after the workshop demonstrated improvement in students' abilities to assess the culture and health beliefs of patients and negotiate issues regarding treatment. CCT in the context of medical student clinical training can be carried out effectively and efficiently using a dedicated multi-modal workshop including standardized patients.

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