Abstract
BackgroundThe growing demand for a competent health workforce to meet the needs of increasingly diverse societies has been widely acknowledged. One medical school in New Zealand explored the integration of the commonly used patient-centred model approach, with an intersectional framework in the development of a cultural competency training programme. In the Pacific Immersion Programme, medical students in their fourth year of training are given the opportunity to learn about different factors that influence the health and health care of a minority community through immersion in that community. The programme objectives include enabling students to learn through experience living within the local community context, and supporting them to re-evaluate their own personal beliefs, assumptions and/or prior prejudices. This study evaluates the usefulness of this programme in the training of medical students to work in diverse communities.MethodsTwo analytical approaches were used for evaluation. Deductive and inductive analyses were conducted on 235 reflective essays completed by three cohorts of students from 2011 to 2013 to ascertain the value of the programme for student learning. In addition, one cohort was invited to complete a pre and post-programme questionnaire.ResultsOverall, the students found the programme to be a valued learning environment. They found living within a Pacific family environment to be an eye opening experience. It increased students comfort level in cross cultural engagement and emphasised the importance of patient’s perspectives in health care provision. Students’ self-reported knowledge about Pacific cultural values, protocols, traditional beliefs and the main health challenges increased significantly after the programme. They appreciated learning directly from community members, and through observations about how culture, beliefs and the socio-economic environment influence peoples’ health and wellbeing.ConclusionsMedical schools are required to train a competent health workforce to meet the needs of diverse communities. The Pacific Immersion Programme provides a unique learning environment which can improve the training of doctors to work in diverse communities. The key to its success is enabling students to be engaged learners from “the inside” rather than an “outsider looking in”. The Programme enables experiential learning in a sensitive and meaningful way and can be useful for training in other institutions.
Highlights
The growing demand for a competent health workforce to meet the needs of increasingly diverse societies has been widely acknowledged
Some studies have shown that the teaching of culture and diversity can positively influence change [8,9,10], while others have not [11,12,13]
Whilst the patient-centred model is often used as a framework for cultural competency training [14], recent research suggests that the inclusion of the social context and social determinants of health of patients through an intersectional framework would be valuable [15]
Summary
The growing demand for a competent health workforce to meet the needs of increasingly diverse societies has been widely acknowledged. Training a medical workforce to meet the needs of diverse societies requires the active recruitment of under-represented minorities, but ensuring that all graduates have competencies to work effectively in different communities. The Pacific Immersion Programme is an innovative approach to cultural competency training in a New Zealand medical school which enables the students to learn about the health of people within their own social and community setting. There are socio-economic differences where 27% Pacific peoples live in severe hardship compared to 8% of the total population. They are more likely to be unemployed, have lower educational achievements, lower income, less likely to own their own homes and more likely to under-utilise health care services. One percent of all medical doctors in New Zealand identify themselves as having a Pacific ethnicity [24], most Pacific patients are likely to treated by a non-Pacific doctor
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