GLH5 Preparation, Implementation, Assessment, & Additional Considerations

Preparation

In preparation for building a lesson about intercultural communication, you might review some general ideas from intercultural pragmatics. The Center for Advanced Research on Language Acquisition, or CARLA (University of Minnesota) website has sample activities for speech acts such as apologies, complaints, greetings, invitations and requests: view Initiatives, Pragmatics.

Relationships with coworkers and patients in the workplace are based not only on what is spoken and written literally, but also on intangibles that we have not traditionally taught on purpose. Hence, in a cross-cultural situation, the medical provider could benefit from knowing how to ask about practices, and perspectives, and adjust the rest of his or her conversation accordingly. When the plan of treatment is simply presented to the patient without dialogue, one runs the risk of have a “nodding patient” who later follows his own preferences and does not faithfully comply with the medically based instructions.

To present these ideas to the students, see examples of how the concepts have been implemented in micro-lessons in the service encounters listed in the website of the Center for Advanced Research on Language Acquisition, or in Activities A and B, showcased in this module.

Implementation

The following two activities may be used in asynchronous or in-person classes.

Activity A: Giving culturally sensitive directions in conversations about the plan of treatment.
A pharmacist discusses possible interactions between medication prescribed for Diabetes 2 and the client’s herbal remedies.

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Use the Cultural Iceberg illustration to spark thoughts about what constitutes cultural practices and perspectives.
Have students complete questions from the personal culture Inventory.
Preview the cultural concepts that will be in the video: ways of showing courtesy, cultural variations in names and surnames, listening skills such as following up on the other person’s comment with an acknowledgement of a cultural perspective. Do warn against stereotyping, but explain that some cultures speak directly, others indirectly, show different levels of courtesy. This is a good place to refer to the AACU rubric for Intercultural Knowledge and Communication.
In class or asynchronously, direct students to view a case study video of a conversation between medical professional and patient/ client.
Provide questions to elicit student’s analysis of the intercultural communication skills evident in the video. This can be graded with a simple reflection rubric.
Provide the students instructions for a role play, in which students apply the skills to original simulations of conversations between healthcare personnel and patients. This may vary in complexity from a simple, spontaneous classtime role play activity to a group creation of a video of an original dialogue.

Activity B: First encounter medical conversations & video project.

This is being implemented in a Virtual Exchange between students in an IU Online Medical Spanish course and a group of Mexican medical students who are graduate assistants, teaching in medical course simulation labs at the University of Guadalajara. This project is asynchronous, except for the initial orientation meeting on Zoom with students from both universities.

Objective: In simulated first encounter medical conversations, students will apply best practices of intercultural communication, such as taking care with names, using the appropriate linguistic register and asking questions that respect the patients’ perspective. Students can identify their own cultural patterns and adapt with flexibility to those who have different practices and beliefs. Refer to the AACU rubric, specifically to the intercultural communication items.

The overview to this activity provides basic concepts of transcultural differences in healthcare conversations. Students will view a video with strong cultural elements between a doctor, an interpreter and a patient with diabetes.

The pre-activity survey about personal cultural beliefs provides students with awareness of how culture comes into play in a conversation between healthcare provider and patient.

Design the first week as preparation, during which students should
complete the pre-activity personal culture survey and view the sample video. This is the longer video between doctor, patient and interpreter.
Hold the orientation synchronous Zoom meeting.
Create the meeting agenda with an introduction, an ice breaker (breakout rs), a discussion of cultural elements in medical conversations, and finally, time for the small groups to pre-plan the meeting schedule and topic for their projects.
Allow several weeks for the students to meet in their small groups and create the script for their First Medical Encounter videos.
They will determine when and how to meet, what the topic and script of the video will be, and finally, create the video.
Direct the groups as to where they should submit the final project. Students will all view videos of two other groups, and observe the intercultural elements there.
The cultural differences may be linguistic in nature, as well as entailing different beliefs and practices.

Assessment

Reflection prompts by means of which the participants can evaluate the skills that they have learned in the module and consider additional skills they would like to acquire in the future.
Reflections on the lessons learned about communicating with global partners and cross-cultural dimensions
Rubric for the Reflection
Post Toolkit survey on the effectiveness of the components of this Global Learning Strategy