Cultural competency has been integrated into the Physician’s Core course wherein students learn important clinical skills, such as interviewing and examining patients. Students are introduced to the concept within the second week of their medical school career thus reinforcing that cultural competency training should be taken with the same seriousness as training in other essential clinical skills. Each lesson starts off with a formal lecture and introduction about a particular subtopic of cultural competency, followed by small group exercises where the students have the opportunity to apply what they just learned. Furthermore, students are encouraged to use what they have learned during clinical encounters while shadowing community physicians.
These sessions allow the students to immerse themselves into cultural competency and ensure that students develop and practice the knowledge, attitudes, and skills to begin their path towards the delivery of culturally and linguistically competent care. Halfway through and at the end of the year, students are formally tested on cultural competency as well as the other clinical skills that they have learned though a Teaching Objective Structured Clinical Exam (TOSCE) and an Objective Structured Clinical Exam (OSCE).
Cultural competency training continues into the second year of the Physician’s Core curriculum with the focus being on communication skills. Prior to each session, students are asked to review a case which will be the subject of discussion during small group sessions. Cross-cultural issues are embedded into case discussions in order to reinforce the concepts learned during their 1st year. In addition to the case review, students have the opportunity to practice cultural competency skills learned in real clinical settings. Throughout the year, students rotate through several preceptorship specialties where they are encouraged and evaluated on how well they incorporate their cultural competency skills into their clinical encounters with patients.
Furthermore, second year students have more opportunity for self-reflection as they participate in the “Poverty Simulation” in which students will be introduced to the social determinants of health and be asked to reflect on their own biases concerning poverty. The end goal is to assist students begin to understand the lives of those who are living in poverty. At the end of the year, students are required to take an OSCE exam that encompasses what they have learned throughout the first two years of their medical education.
During the third year of medical school, students rotating through six core clerkships (Psychiatry, Surgery, Pediatrics, Ob/Gyn, Medicine, and Family Medicine) have ample opportunity to apply the cross-cultural skills they learned throughout their first two years of medical school. Throughout the Clerkships during morning report or noon conference topics such as Hispanic Health, Health Disparities, LGBT Health are featured. The continued training and evaluation of how well students are using their skills is supervised and evaluated by each clerkship director.
During the fourth year, students continue to build on their cultural competency skills during their Emergency Medicine clerkship and elective clerkships dealing with a subspecialty of their own interest. Students learn to value diversity and inclusion. At the completion of the year, students are required to take a Graduation Objective Structured Clinical Examination (OSCE) that assesses whether they have attained the competencies related to cultural and linguistic competency. The exam builds upon what the students have been taught throughout the four years. At the core of this examination are the doctor-patient communication and students’ ability to work with diverse populations.
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