A Cross-Cultural Curriculum for Medical Students

Abstract

Increasingly in our multi-cultural society, patients and physicians are of different cultures. Physicians must acquire skills to deal with cross-cultural issues as part of the context of health care. Undergraduate education must play a major role in the teaching of such skills. At the University of Toronto, all 2nd year medical students receive such training as part of their preclerkship clinical methods course. This cross-cultural curriculum has didactic, clinical and evaluation components. The didactic component introduces students to cross-cultural interpretation of health beliefs, and the impact of cultural beliefs and health practices upon the clinical encounter. Selected readings are utilized to initiate discussion of cultural issues that patients and physicians bring to the clinical encounter. The clinical component gives students an opportunity to practice cross-cultural interviewing, and specific skills in triadic interviewing and working with interpreters. A pool of standardized patients (SPs) has been developed, who are trained to enact and demonstrate important elements of the cross-cultural encounter, using scenarios developed specifically for this purpose. The evaluation component consists of OSCE stations designed to assess student performance in cross-cultural clinical encounters. Stations from the past two academic years are described. This required curricular module provides students with the basic generic tools with which to deal with cross-cultural issues in the clinical encounter, and provides standardized educational materials for didactic, clinical and evaluation components.