Abstract
Purpose: Cross-cultural education is an integral and required part of undergraduate medical curricula. However, the teaching of cross-cultural care varies widely and methods of evaluation are lacking. We sought to better understand medical students' perspectives on their own cultural competency across the 4-year curriculum using a validated survey instrument.Methods:We conducted an annual Internet-based survey at Harvard Medical School with students in all 4 years of training, for four consecutive years. We used a tool previously validated with residents and slightly modified it for medical students, assessing their (1) preparedness, (2) skillfulness, and (3) perspectives on the educational curriculum and learning climate.Results: Of 2592 possible survey responses, we received 1561 (60% response rate). Fourth-year students had significantly higher scores than first-year students (p<0.001) for all but one preparedness item (caring for transgender patients) and all but one skillfulness item (identifying ability to read/write English). Less than 50% of students felt adequately prepared/skilled by their fourth year on 8 of 11 preparedness items and 5 of 10 skillfulness items. Lack of practical experience caring for diverse patients was the most frequently cited challenge.Conclusions: While students reported that preparedness and skillfulness to care for culturally diverse patients seem to increase with training, fourth-year students still felt inadequately prepared and skilled in many important aspects of cross-cultural care. Medical schools can use this tool with students to self-assess cultural competency and to help guide enhancements to their curricula focusing on cross-cultural care.
Highlights
Over the past few decades, medicine has undergone a transition from a paternalistic, ‘‘one-size-fits-all’’ approach, to a more patient-centered perspective.[1,2] Research has shown that patient-centered care improves quality of care, patient satisfaction, health outcomes, and quality of life, and decreases healthcare utilization.[3]
In 2005, we developed the Cross-Cultural Care Survey (CCCS) to assess self-perceived skills and preparedness to deliver cross-cultural care among resident physicians, and to assess the cultural climate and learning environment at their institutions.[6]
Lack of practical experience caring for diverse patient populations
Summary
Over the past few decades, medicine has undergone a transition from a paternalistic, ‘‘one-size-fits-all’’ approach, to a more patient-centered perspective.[1,2] Research has shown that patient-centered care improves quality of care, patient satisfaction, health outcomes, and quality of life, and decreases healthcare utilization.[3].
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