8. The Preceptor and Cultural Competence

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affective preceptor series the preceptor
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and cultural competence
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what is cultural competence according to
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the Association of American Medical
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Colleges cultural and linguistic
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competence is a set of congruent
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behaviors knowledge attitudes and
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policies that come together in
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cross-cultural situations
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culture refers to integrated patterns of
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human behavior that include language
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thoughts actions customs beliefs and
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institutions of racial ethnic social or
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religious groups
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competence implies having the capacity
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to function effectively as an individual
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or an organization within the context of
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cultural beliefs
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purpose of these educational standards
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is to ensure that the medical world is
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keeping up with the rapidly evolving
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demographics of the US population
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cultural competence is not an option but
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a necessity to maximize the
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patient-physician interaction and
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physician effectiveness as a member of
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the healthcare delivery team what is the
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relevance to preceptors preceptors are
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positioned at the intersection of
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culture and clinical skills therefore
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they must use cross-cultural skills that
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are vital to the practice of medicine
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and share them with medical students
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what should the preceptor assess to
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assess some medical students knowledge
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skills and attitudes in cross-cultural
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education the following examples have
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been recommended by the AAMC
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knowledge assessment has the student
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learn the key core cross-cultural issues
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such as communication styles mistrust
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prejudice autonomy and family
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decision-making
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skills assessment as the student learn
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how to explore core cross-cultural
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issues and the patient’s explanatory
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model of health as the student learned
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how to effectively collaborate with a
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patient
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attitude assessment has the student
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learned the importance of intellectual
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curiosity empathy and respect in
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cross-cultural encounters
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what cross-cultural communication models
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are available
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one of the most comprehensive approaches
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to facilitate cross-cultural
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communication uses climene’s questions
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for example what do you think has caused
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your problem how severe is your sickness
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what kind of treatment do you think you
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should receive what are the most
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important results you hope to receive
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from this treatment
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what do you fear most about your
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sickness
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other approaches use the belief or
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ethnic mnemonic let’s go through both of
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these belief beliefs about health
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explanation
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learn
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impact
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Kathy
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and feelings
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ethnic
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nation treatment
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Keeler’s
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negotiate
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intervention
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collaboration
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teaching students to work with
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interpreters is also very important here
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are a few guidelines outlined by the
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providers guide to quality and culture
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do not depend on children or other
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relatives and friends hold a brief
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pre-interview meeting with the
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interpreter avoid jargon and technical
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terms
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keep your utter insisting to permit
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interpretation ask only one question at
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a time and be prepared to repeat
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yourself in different words if your
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message is not understood if you
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absolutely must communicate through
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someone who is not a professional make
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sure the family member or friend
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understands his or her own role before
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you begin use simple vocabulary speak in
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short sentences and check to see that
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the message is understood for a
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comprehensive list please visit the
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online website for the providers guide
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to quality and culture
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medical students need to know and
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remember that medicine itself is a
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culture that means that we bring at
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least two cultures to a patient
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encounter as preceptors it is critical
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that we role model our cultural
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competence and deliver quality health
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services
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