Teaching Cultural Competency to Future Physicians

1. Teaching Cultural Competency to Future Physicians Maria B.J. Chun, Ph.D., CHC, CPC-A University of Hawaii at Manoa Department of Surgery, Honors Program DiversityRx Conference Oakland, CA March 12, 2013

2. Objectives • Discuss the impetus for the initial course • Present how the course has evolved over time (including strengths and difficulties) • Share information on the new course that has been developed • Welcome feedback from other panelists, audience

3. Background • Instructor • Trained in community and cultural psychology • Conducts research on cultural competency in medicine (e.g., measuring efficacy of cultural training, cultural standardized patient exams) • Based in the UHM Department of Surgery, which is a part of the John A. Burns School of Medicine • Responded to course development call by UHM Honors Program

4. Honors 491 (2) – Cultural Competency for the Health Professions • First taught in Fall 2009 • Intended for all students (i.e., multidisciplinary) • Taught from the perspective of psychology, medicine, and anthropology • Focus was on premedical students • Plan by prior Honors Director was to make the course mandatory for all premedical Honors’ students • Average class size 8 to 11 students

5. Course Topics/Main Points • Culture is defined very broadly; there is no standardized definition of culture • When discussing culture, it needs to be viewed from multiple perspectives and placed within context • Cultural competency is not a bad term • Inclusion of cultural humility, social justice perspectives

6. Sample Syllabus http://www.honors.hawaii.edu/courses/course_description.php?course_id=210

8. Course Highlights • Students taught research process and work on either a literature review or a research proposal (in preparation for Honors’ thesis) on a topic of their choice • Topic must have a “cultural” and “health” focus • Guest speakers – Health sciences librarians, cultural experts, M.D.s, Ph.D.s • Field visits – Community health clinic (Kokua Kalihi Valley); UH Medical School • Blogging on course readings

9. Inaugural Class • All but one student was premed • Very bright students – most were double majors pursuing degrees in both basic sciences and social sciences/arts

10. Strengths • Highly verbal class, enjoyed discussing topics • Most had strong writing skills • Most had an easy time selecting a topic • Diverse cultural/ethnic backgrounds, ages, life experiences • Responded to constructive criticism positively; revisions always showed improvement

11. Difficulties • Some students were offended/alienated by other class members during discussions on social justice • Despite this being a junior-level Honors course, some students had no clue on how to conduct a basic literature search, how to obtain a copy of a journal article • To make up for this “deficiency,” class can get bogged down in process and lose sight of content • Those not premed can sometimes feel left out • Diverse ethnicity, ages

12. Addressing Difficulties • Better gauged students’ experience and maturity levels • Assess students’ skills up front; adjust class accordingly • After a certain point, need to let go of having students become expert researchers • Focus the course on medicine, but include perspectives from other disciplines – interdisciplinary • Embrace the diversity, utilize it to help teach the course

13. Summary/Conclusion • Teaching the potential impact of “culture” in health care can be challenging, but is mostly rewarding • Discussions and interactions reflect the “real world” • Premedical training can serve as a good basis for future lessons at the UME and GME levels

14. My New Class http://www.honors.hawaii.edu/courses/course_description.php?course_id=287 • Developing Resources for Cross Cultural Health Care (aka Cultural Competency for the Health Professions 2.0) • Students spend the entire class developing a resource that will assist patients, providers, organizations, etc.

15. Thank You! Email: mariachu@hawaii.edu CCHC 2015: www.cchc-conference.com