Impact of game jam learning about cultural safety in Colombian medical education: a randomised controlled trial

Juan Pimentel,Neil Andersson,Anne Cockcroft

doi:10.1186/s12909-021-02545-7

Juan Pimentel, Neil Andersson + Show 1 more

Open Access

https://doi.org/10.1186/s12909-021-02545-7

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Abstract

BackgroundCultural safety, whereby health professionals respect and promote the cultural identity of patients, could reduce intercultural tensions that hinder patient access to effective health services in Colombia. Game jams are participatory events to create educational games, a potentially engaging learning environment for Millennial medical students. We set out to determine whether medical student participation in a game jam on cultural safety is more effective than more conventional education in changing self-reported intended patient-oriented behavior and confidence in transcultural skills.MethodsWe conducted a parallel-group, two-arm randomized controlled trial with 1:1 allocation. Colombian medical students and medical interns at University of La Sabana participated in the trial. The intervention was a game jam to create an educational game on cultural safety, and the reference was a standard lesson plus an interactive workshop on cultural safety. Both sessions lasted eight hours. Stratified randomization allocated the participants to the intervention and control groups, with masked allocation until commencement.Results531 students completed the baseline survey, 347 completed the survey immediately after the intervention, and 336 completed the survey after 6 months. After the intervention, game jam participants did not have better intentions of culturally safe behaviour than did participants in the reference group (difference in means: 0.08 95% CI − 0.05 to 0.23); both groups had an improvement in this outcome. Multivariate analysis adjusted by clusters confirmed that game jam learning was associated with higher transcultural self-efficacy immediately after the intervention (wt OR 2.03 cl adj 95% CI 1.25–3.30).ConclusionsGame jam learning improved cultural safety intentions of Colombian medical students to a similar degree as did a carefully designed lecture and interactive workshop. The game jam was also associated with positive change in participant transcultural self-efficacy. We encourage further research to explore the impact of cultural safety training on patient-related outcomes. Our experience could inform initiatives to introduce cultural safety training in other multicultural settings.Trial registrationRegistered on ISRCTN registry on July 18th 2019. Registration number: ISRCTN14261595.

Highlights

Cultural safety, whereby health professionals respect and promote the cultural identity of patients, could reduce intercultural tensions that hinder patient access to effective health services in Colombia
In Colombia, more than 40% of the population turn to traditional and cultural health practices, [1] but public and private institutions promote health services grounded in the Western biomedical model
The randomised controlled trials (RCT) addressed the question: Among medical students and interns from University of La Sabana, compared with a standard lesson plus a workshop on cultural safety, does game jam participation result in improved student and intern self-reported intended behavior, and confidence in transcultural skills?

Summary

Introduction

Whereby health professionals respect and promote the cultural identity of patients, could reduce intercultural tensions that hinder patient access to effective health services in Colombia. We set out to determine whether medical student participation in a game jam on cultural safety is more effective than more conventional education in changing self-reported intended patient-oriented behavior and confidence in transcultural skills. Medical students are not trained to acknowledge and address intercultural tensions that arise in clinical practice. These tensions hinder patient access to effective health services, [2, 3] especially for those who use traditional health practices [4]. Cultural safety training of Colombian health professionals could address intercultural tensions, improving the access of patients from nondominant cultures to health services. A concept analysis of cultural safety [7] identified three foundations: equal partnership, active participation of patients from nondominant cultures, and protection of cultural identity and well-being

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