A students’ survey of cultural competence as a basis for identifying gaps in the medical curriculum

BMC Medical Education

Marie-Louise Essink-Bot¹  Karien Stronks¹  Jeanine Suurmond¹  Majda Lamkaddem¹  Jessie Hermans²  Conny Seeleman¹ 

[1] Department of Public Health, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DE Amsterdam, The Netherlands;Netherlands School of Public and Occupational Health, Utrecht, The Netherlands

关键词: Medical education;    Consultation behaviour;    Reflection ability;    Diversity education;    Curriculum development;    Assessment;    Cultural competence;   

Others  :  1090675
DOI  :  10.1186/1472-6920-14-216

 received in 2014-05-02, accepted in 2014-10-03,  发布年份 2014

【 摘 要 】

Background

Assessing the cultural competence of medical students that have completed the curriculum provides indications on the effectiveness of cultural competence training in that curriculum. However, existing measures for cultural competence mostly rely on self-perceived cultural competence. This paper describes the outcomes of an assessment of knowledge, reflection ability and self-reported culturally competent consultation behaviour, the relation between these assessments and self-perceived cultural competence, and the applicability of the results in the light of developing a cultural competence educational programme.

Methods

392 medical students, Youth Health Care (YHC) Physician Residents and their Physician Supervisors were invited to complete a web-based questionnaire that assessed three domains of cultural competence: 1) general knowledge of ethnic minority care provision and interpretation services; 2) reflection ability; and 3) culturally competent consultation behaviour. Additionally, respondents graded their overall self-perceived cultural competence on a 1–10 scale.

Results

86 medical students, 56 YHC Residents and 35 YHC Supervisors completed the questionnaire (overall response rate 41%; n= 177). On average, respondents scored low on general knowledge (mean 46% of maximum score) and knowledge of interpretation services (mean 55%) and much higher on reflection ability (80%). The respondents’ reports of their consultation behaviour reflected moderately adequate behaviour in exploring patients’ perspectives (mean 64%) and in interaction with low health literate patients (mean 60%) while the score on exploring patients’ social contexts was on average low (46%). YHC respondents scored higher than medical students on knowledge of interpretation services, exploring patients’ perspectives and exploring social contexts. The associations between self-perceived cultural competence and assessed knowledge, reflection ability and consultation behaviour were weak.

Conclusion

Assessing the cultural competence of medical students and physicians identified gaps in knowledge and culturally competent behaviour. Such data can be used to guide improvement efforts to the diversity content of educational curricula. Based on this study, improvements should focus on increasing knowledge and improving diversity-sensitive consultation behaviour and less on reflection skills. The weak association between overall self-perceived cultural competence and assessed knowledge, reflection ability and consultation behaviour supports the hypothesis that measures of sell-perceived competence are insufficient to assess actual cultural competence.

【 授权许可】

   
2014 Seeleman et al.; licensee BioMed Central Ltd.

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