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Developed by:

Sunita Mutha, MD, FACP
Division of General Internal Medicine
Center for the Health Professions

Carol Allen, MA
Center for the Health Professions

Melissa Welch, MD, MPH
UCSF/ San Francisco General Hospital
Principal/ Founder, PODSDT

University of California, San Francisco

Format:

The 170-page curriculum is organized into eleven sections that focus on teaching clinicians to recognize cultural differences in patient interactions and use specific communication skills to improve patient care. The materials organized can be adapted for sequential one-hour sessions or for daylong seminars.

How Will Clinicians Benefit?

This curriculum teaches the skills and knowledge to help health professionals provide culturally competent care. At the end of training, participants will be more effective in eliciting accurate clinical information and providing appropriate care to their patients, regardless of their cultural background. Clinicians also learn how to work with medical interpreters and acquire new approaches to addressing cultural differences.

Curriculum Description

As the U.S. has evolved into a more diverse society, opportunities for misunderstandings in the clinical setting between physician and patient become more likely. In the past decade evidence has linked cultural diversity to disparities among populations in the delivery of medical care and in health outcomes.

This curriculum is a toolbox of materials for teaching culturally competent skills needed for practical day-to-day encounters between clinicians and patients. The goals of the curriculum are to teach participants to recognize when cultural differences exist in patient encounters and to utilize specific communication skills to elicit their patients' cultural perspectives about health and illness. Finally, the curriculum assists clinicians in negotiating with patients to provide appropriate care that is congruent with patients' expectations and preferences.

Each section of the curriculum includes exercises with descriptions of purpose, learning objectives and teaching instructions, time requirements, overheads and handouts. The teaching approach emphasizes experiential learning as a means of expanding awareness and developing new knowledge and skills. The curriculum includes information on specific cultural groups only when such information will help the learner understand and gain insight into patients' experiences of being "different."

The curriculum reflects the authors' decade of cumulative experience in designing, facilitating and evaluating interdisciplinary workshops for health professionals on various aspects of providing care and communicating with patients of diverse cultures.

Learning Objectives

Participants who successfully complete the curriculum will be able to:

1. describe how cultural influences shape individual health behavior;
2. describe cultural differences that can influence patient-physician relationships;
3. discuss how explanations of disease etiology can differ among diverse patients ;
4. identify and address cultural barriers that may affect communication in patient-physician relationships;
5. employ culturally appropriate questions that effectively elicit patient information in the clinical encounter;
6. work effectively with a medical interpreter;
7. apply communication techniques to resolve conflicts in culturally sensitive ways.

Intended Audience

The audience for the workshops can include a wide variety of clinicians including physicians, nurses, pharmacists, dentists, residents and students. The curriculum is designed for use by facilitators who are experienced in teaching clinicians, but who may be new to some areas of cross-cultural care.

Pilot Testing

Components of the curriculum have been used to plan trainings ranging from one hour to 4 days in duration. Over 100 individuals have been included in pilot testing of these materials. Evaluations of the trainings have been overwhelmingly favorable. Baseline and post workshop assessments of participants' attitudes, knowledge, and perceptions of their abilities and skill in providing culturally appropriate care and are being analyzed.

Resources Needed to Use This Curriculum

• Facilitation: Trainings using these curricular materials should be led by a facilitator who has experience in designing curricula and in teaching health professionals. The facilitator should be familiar with concepts related to cultural competence and have extensive experience in facilitation.
• Support staff: Assist with workshop logistics, publicity, registration; duplicate workshop materials, evaluation forms; summarize evaluations.
• Equipment: Access to VCR, overhead projector.
• Materials: Flip charts, pens/pencils, curriculum
  

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