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Decolonising medical curricula through diversity education: lessons from students

Decolonising medical curricula through diversity education: lessons from students
Decolonising medical curricula through diversity education: lessons from students
Introduction: The General Medical Council (GMC) expects that medical students graduate with an awareness of how the diversity of the patient population may affect health outcomes and behaviours. However, little guidance has been provided on how to incorporate diversity teaching into medical school curricula. Research highlights the existence of two different models within medical education: cultural competency and cultural humility. The Southampton medical curriculum includes both models in its diversity teaching, but little was known about which model was dominant or about the students’ experience.

Methods: Fifteen semi-structured, in-depth interviews were carried out with medical students at the University of Southampton. Data were analysed thematically using elements of grounded theory and constant comparison.

Results: Students identified early examples of diversity teaching consistent with a cultural humility approach. In later years, the limited diversity teaching recognised by students generally adopted a cultural competency approach. Students tended to perceive diversity as something that creates problems for healthcare professionals due to patients’ perceived differences. They also reported witnessing a number of questionable practices related to diversity issues that they felt unable to challenge. The dissonance created by differences in the largely lecture based and the clinical environments left students confused and doubting the value of cultural humility in a clinical context.

Conclusions: Staff training on diversity issues is required to encourage institutional buy-in and establish consistent educational and clinical environments. By tackling cultural diversity within the context of patient-centred care, cultural humility, the approach students valued most, would become the default model. Reflective practice and the development of a critical consciousness are crucial in the improvement of cultural diversity training and thus should be facilitated and encouraged. Educators can adopt a
bidirectional mode of teaching and work with students to decolonise medical curricula and improve medical practice.
0142-159X
385-393
Nazar, Mahdi
3805d613-4692-4705-bd2d-048f600085d3
Kendall, Kathleen
7c1c7abc-513b-4da5-b99d-268cd1d8bc58
Day, Lawrence
7cf4b103-8c53-4af0-b5d5-74a11e946f2c
Nazar, Hamde
f43edb87-9a8e-4019-9998-d13820eb281a
Nazar, Mahdi
3805d613-4692-4705-bd2d-048f600085d3
Kendall, Kathleen
7c1c7abc-513b-4da5-b99d-268cd1d8bc58
Day, Lawrence
7cf4b103-8c53-4af0-b5d5-74a11e946f2c
Nazar, Hamde
f43edb87-9a8e-4019-9998-d13820eb281a

Nazar, Mahdi, Kendall, Kathleen, Day, Lawrence and Nazar, Hamde (2015) Decolonising medical curricula through diversity education: lessons from students. Medical Teacher, 37 (4), 385-393. (doi:10.3109/0142159X.2014.947938).

Record type: Article

Abstract

Introduction: The General Medical Council (GMC) expects that medical students graduate with an awareness of how the diversity of the patient population may affect health outcomes and behaviours. However, little guidance has been provided on how to incorporate diversity teaching into medical school curricula. Research highlights the existence of two different models within medical education: cultural competency and cultural humility. The Southampton medical curriculum includes both models in its diversity teaching, but little was known about which model was dominant or about the students’ experience.

Methods: Fifteen semi-structured, in-depth interviews were carried out with medical students at the University of Southampton. Data were analysed thematically using elements of grounded theory and constant comparison.

Results: Students identified early examples of diversity teaching consistent with a cultural humility approach. In later years, the limited diversity teaching recognised by students generally adopted a cultural competency approach. Students tended to perceive diversity as something that creates problems for healthcare professionals due to patients’ perceived differences. They also reported witnessing a number of questionable practices related to diversity issues that they felt unable to challenge. The dissonance created by differences in the largely lecture based and the clinical environments left students confused and doubting the value of cultural humility in a clinical context.

Conclusions: Staff training on diversity issues is required to encourage institutional buy-in and establish consistent educational and clinical environments. By tackling cultural diversity within the context of patient-centred care, cultural humility, the approach students valued most, would become the default model. Reflective practice and the development of a critical consciousness are crucial in the improvement of cultural diversity training and thus should be facilitated and encouraged. Educators can adopt a
bidirectional mode of teaching and work with students to decolonise medical curricula and improve medical practice.

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Accepted/In Press date: 26 August 2014
e-pub ahead of print date: 26 August 2014
Published date: 3 April 2015
Organisations: Medical Education

Identifiers

Local EPrints ID: 368607
URI: http://eprints.soton.ac.uk/id/eprint/368607
ISSN: 0142-159X
PURE UUID: 836e417c-ed99-49cf-a117-03e6f8426429

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Date deposited: 06 Sep 2014 13:55
Last modified: 15 Jan 2020 17:32

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Contributors

Author: Mahdi Nazar
Author: Lawrence Day
Author: Hamde Nazar

University divisions

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