The School of Medicine, under the direction of Dr. Morrison, working with the project director, Working group leaders, core faculty team, and the Advisory Board bring together a multidisciplinary team of educators to build a series of clinical cases aimed at medical students, residents, and practicing physicians. Four teams have been organized and are lead by experts in Cardiology, Pulmonary, Hematology, and Neurology. The goal of the cases are to understand and manage cultural barriers to health care among multi-ethnic populations with heart, lung, blood or sleep disorders (Table 1).
Teams For Case Development Across UME, GME and CME Training Programs
|Team||Working Group Chair|
|Cardiology||Susan Wiegers, MD|
|Pulmonary||Lisa Bellini, MD|
|Hematology||Eric Russell, MD|
|Neurology||Scott Kasner, MD|
We believe that the case-based approach is the right model to teach cultural competency because it helps learners to understand health implications of cultural diversity and how cultural perspectives shape a person’s approach to health and illness. This innovative, multidisciplinary cross cultural, case-based model has resulted in the development of 25 cases, each composed of core competencies that examine how these factors may influence access to healthcare, compliance, adherence and response to treatment. These cases not only build upon our current cross cultural education initiatives, but provide an opportunity to implement exportable materials on the UME, GME and CME levels and for other medical schools. These newly developed cases cover the ethnic, cultural, religious, socioeconomic, linguistic and other factors that contribute to health disparities and propose culturally competent approaches to mitigating these disparities. They address cultural attributes and attitudes that influence health behaviors, the explanatory model of disease (causation), preference and attitudes about treatment, values, patient-decision making, communication with physicians, language and literacy level, dietary preferences, advanced directives, death and dying. Discussions also include the prevalence of the specific disease, morbidity and mortality in minority populations; cultural beliefs and background of the patient, social support network, and help-seeking behaviors so that learners recognize the importance of improving health care providers’ ability to deliver culturally appropriate and tailored care to patients with diverse values, beliefs, and behaviors.
Faculty from the Schools of Medicine, Nursing, and Social Work can worked collaboratively on the development of these cases and the Advisory Board met annually to assist with this process and giving feedback.
This case-based training program should enhance the knowledge of the many factors that influence the health needs and attitudes of people from diverse backgrounds, and by applying this knowledge to patient care. We use the AAMC’s Tools for Assessing Cultural Competency Training (TACCT) as the basis for our program assessment and development phase as well as implementation and evaluation across the medical education continuum. The five content domains dealing with culturally competent care, and the knowledge, skills and attitude objectives for each domain will become the foundation of our curriculum development efforts across UME, GME and CME. These include: 1) rationale, context and definition of cultural competence; 2) key aspects of cultural competence; 3) understanding the impact of stereotyping on medical decision making; 4) health disparities and factors influencing health; 5) cross-cultural clinical skills.