Description

Instructors of courses in medicine and healthcare may incorporate essential concepts of intercultural communication into their courses. The goal is that students learn to recognize and take into account patients’ cultural practices and/or perspectives in medical conversations.

Why include this topic in a medical course?

One barrier to equitable medical care in our country is the lack of trust between healthcare providers, who work from the scientific perspective of western medicine, and their patients, who may bring alternative perspectives into healthcare routines. As a medical professional learns more about cultural practices in a specific population, he or she can develop skills designed to bridge cultural gaps and establish a more trusting, productive relationship with patients. As the adage goes, “A person will not care what you think until he/she thinks that you care.”

Where can I find basic concepts that can be built into lessons?

There are many aspects of intercultural communication that an instructor might include in a course in medical studies. Many of these concepts are addressed in the study of pragmatics: e.g. speech acts like requests or introductions and the dynamics of conversations. A medical conversation that occurs (with or without an interpreter) is an opportunity for the healthcare worker to use intercultural knowledge and skills. There are specific moments in which a doctor, nurse, therapist, etc., can phrase questions that respond to expressed or perceived cultural concepts; thus adapting the direction of their discussion with the patient. The goal is a more interactive conversation that achieves greater trust and understanding.

What are variables to be considered in creating an intercultural communication activity?

An obvious consideration in building this activity or unit is the course itself. Many students in medical careers choose to pursue courses in world languages and cultures, which have robust components of intercultural communication practice. Instructors of the required courses for healthcare careers can also successfully include activities that focus on intercultural communication awareness and skills. It is important that students develop the ability to adapt while conversing, whether the healthcare encounters are in the lingua franca, English, or conducted in a bilingual setting, with an interpreter.

Another focus of the activity might be the specific cultural background of a local patient population, which may or may not have recently become integrated into the community as refugees or immigrants. The intercultural communication skills learned in our classroom lessons can lead to real world applications, both in university clinicals and later in the workplace.

Specifics of this module

We will focus on:

awareness of culturally variable information, tone and body language in initial conversation encounters between healthcare personnel and patients,
giving directions and orders about a plan of treatment during a dialogue,
listening for clues that the patients may be incorporating other beliefs and practices into the prescribed plan of treatment. The medical worker can then ask informed questions that go beyond conversing with a “nodding patient” to increasing mutual understanding and ensuring better patient compliance with the plan of treatment.
For these three areas of conversations – introductions, giving directions and listening for clues of unspoken context, the learning sequence includes:
- self-awareness reflections on culture,
- reading or viewing videos of intercultural conversations
- responding to questions about the intercultural elements of the conversations
- student simulations of medical conversations that include cultural dynamics. These can be as simple as role plays in the classroom or on Zoom, or they may be more extensive, entailing the creation of culturally appropriate medical conversations that students present live or on video. This is what we are doing in the Virtual Global Exchange between my Spanish for Healthcare Personnel students and medical students at the University of Guadalajara.