Addressing Cultural Competency in Medical School

1. Addressing Cultural Competency in Medical School American Medical Student Association Race, Ethnicity and Culture in Health (REACH) Committee 2010-2011

2. Intended Learner Outcomes • Define cultural competency • Understand why cultural competency is important • Know how to implement cultural competency into one’s medical curriculum AMSA REACH: Cultural Competency

3. Cultural Competency • “‘Cultural competence’ in health care entails: understanding the importance of social and cultural influences on patients’ health beliefs and behaviors; considering how these factors interact at multiple levels of the health care delivery system (e.g., at the level of structural processes of care or clinical decision-making); and, finally, devising interventions that take these issues into account to assure quality health care delivery to diverse patient populations.” - Dr. Betancourt AMSA REACH: Cultural Competency

4. Why is it important? AMSA REACH: Cultural Competency

5. Future of the United States… • Increasingly diverse population • “Current health care system is not sustainable if it is unable to address the diverse health care beliefs, values and practices of a multicultural society” - Martin, et al., 2004 AMSA REACH: Cultural Competency

6. AMSA REACH: Cultural Competency

7. Goal • To integrate cultural competency into the curriculum as “Providing good patient care is not separate from basic or clinical sciences courses. It is not an elective” - Furman G and Dent MM AMSA REACH: Cultural Competency

8. Step 1: Identify a need • Talk to your friends • Survey- identify what your student body needs • You can even use AAMC’s Tool for Assessing Cultural Competence Training (TACCT) to formally evaluate your medical school’s curriculum. https://www.aamc.org/initiatives/54262/tacct/ AMSA REACH: Cultural Competency

9. Step 2: Find partners • Classmates who are also interested • Faculty and professors • Guidance • Expertise AMSA REACH: Cultural Competency

10. Step 3: Develop a good plan • “The greatest problem faced by schools is not resistance to innovations but the fragmentation, overload and incoherence resulting from the uncritical acceptance of too many different innovations.” - Fullan M and Stiegelbauer S. There are many ways to implement curriculum: • Language training • Lectures and interactive sessions • Workshops • Student clerkships • Elective courses • Immersion programs • Month-long rotations for residents • OSCEs with cultural teaching • Short immersion CME programs AMSA REACH: Cultural Competency

11. Step 4: Approach your Deans • Work with your Deans and revise or incorporate your plans into previous reform attempts. • “My Deans would probably be against this.” • Keep in mind that it’s an LCME accreditation standard. The Role of Students in the Accreditation of Medical Education Programs in the U.S. and Canada http://www.lcme.org/roleofstudents1112.pdf • AAMC pre and post medical school interview. • Finances or faculty time: • Internet free resources • Informal peer education AMSA REACH: Cultural Competency

12. Step 5: Tell AMSA about your Journey • Trials • Success • Failures • Any feedback on this tool… AMSA REACH: Cultural Competency

13. Tools • Midwest Academy Strategy Worksheet • AMSA Basic Project Planning Tool • ADDIE model (Assessment, Design, Development, Implementation, Evaluation) • Curricular Reform: The Complete How-To Guide http://amsa.org/AMSA/Files/Committee%20Docs/Curricular%20Reform%20AMSA.zip

14. Remember… • Work with your classmates and delegate the work • Addition/revision rather than overhaul AMSA REACH: Cultural Competency

15. Bibliography • Association of American Medical Colleges. Tool for Assessing Cultural Competence Training. Available at: https://www.aamc.org/initiatives/54262/tacct/ • Betancourt JR, Green AR, Carrillo JE, Ananeh-Firempong O. Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 2003; 118: 287-292. • Commission on Osteopathic College Accreditation. Accreditation of Colleges of Osteopathic Medicine: COM Accreditation Standards and Procedures. May 2010. Available at: http://www.osteopathic.org/pdf/SB03-Standards_of_Accreditation_July%201,%202010.pdf • Fullan M and Stiegelbauer S. “The new meaning of educational change.” 1991. NY, NY Teachers College Press. In Health Resources and Services Administration. Cultural Competency in Medical Education- A Guidebook for Schools. 2004, pg 13. • Health Resources and Services Administration. Cultural Competency in Medical Education- A Guidebook for Schools. Furman G and Dent MM. “Chapter 4: Seamless Learning: Incorporating Cultural Competency Into the Curriculum.” 2004, pg. 23. • Liaison Committee on Medical Education, Committee on the Accreditation of Canadian Medical Schools. The Role of Students in the Accreditation of Medical Education Programs in the U.S. and Canada. July 2010. Available at: http://www.lcme.org/roleofstudents1112.pdf • Martin JC, Avant RF, Bowman MA, et al. The Future of Family Medicine: a collaborative project of the family medicine community. Annals of Family Medicine. 2004; 2 Suppl 1, S3-S32. Drew Lee Loyola University Chicago Reach.education@amsa.org 2010-2011 AMSA REACH Med Ed Coordinator AMSA REACH: Cultural Competency