Results of Teacher assessment in
the project Culturally Competent in
Medical Education (C2ME)
(2013-2015)
6th EUPHA MEMH Conference
Oslo 23-25 June 2016
Janne Sorensen
Background
Cultural diversity included in curricula of
many medical schools, but …..
1. Lack of training of faculty members
2. Lack of organisational policy for
structural implementation
Objectives C2ME
1. To develop, test and implement
Teach-the-Teacher modules on cultural
diversity in the participating European
countries.
2. To develop test and implement a
policy for structural embedding of
cultural competence training in medical
schools.
Methods C2ME
1. Develop TtT modules:
- Framework teaching skills: Delphi study
- Teacher assessment
- Online modules & 5 Pilot TtT courses
2. Develop policy for structural embedding CC in
medical school:
- Assessment of policies in medical schools
- Policy guidelines to implement CC
Teachers assessment
- Survey among medical teachers at 12
participating universities about preparedness to
teach and interests in training (Likert scale 0-5)
- 43 items
- “How prepared do you feel to….”
- “How interested are you to receive training on…”
- N = 1103 (response rate: 20 %)
- Characteristics of sample: large differences
between participating universities (size; type of
teachers)
Sociale Geneeskunde
Overall results Teacher
assessment
•
•
•
•
56 % culturally competent
60 % feels culturally competent
78 % interested in receiving CC training
86 % feels that integrating CC in the medical
curriculum is important
Results (1)
Cultural competencies
Q1
Patients look at health problems through their own
cultural lens
Q2
Care providers look at health problems through their own
cultural lens
Q3
I look at health problems through my own cultural lens
Frequency of scores 4 and 5 on Q 1 = 90.9%
Frequency of scores 4 and 5 on Q 2 = 72.6%.
Frequency of scores 4 and 5 on Q3 = 66.8 %.
Sociale Geneeskunde
Results (2)
Interest in receiving training
Table 1 Relative frequencies of values 4 and 5 on Questions 25-35 Interest in receiving training on
teaching cultural competence topics
Relati Q.
Q.
Q.
Q.
Q.
Q.
Q.
Q.
Q.
Q.
Q. 35
ve in
25
26
27
28
29
30
31
32
33
34
%
4
5
4+5
46.
5
29.
2
75.
7
48.
7
28.
4
77.
1
44.
5
23.
3
67.
8
44.
7
33.
0
77.
7
42.
2
22.
0
64.
2
43.
1
25.
9
69.
0
43.1
46.6
29.5
27.5
72.6
74.1
44.
0
35.
4
79.
4
45.
1
35.
8
80.
9
42.8
38.7
81.5
- Q29: How to work effectively with interpreters
+ Q34: How to address conflict when there are different cultural views
between care provider & patient
+ Q35: How to prepare students to adapt their communication style to
respond to patient’s needs/capabilities
+ Q33: How to explore students’ own perspectives and values
Sociale Geneeskunde
Results (3)
Interest in receiving training
Table 2:
Relative in % Q. 37
Q. 38
Q. 39
Q. 40
4
44.9
42.6
38.3
35.3
5
31.4
35.1
42.7
44.6
4+5
76.3
77.7
81.0
79.9
Relative frequencies of values 4 and 5 on Questions 37-40 Interest in receiving training on teaching a diverse classroom
+ Q39: Engage, motivate and encourage participation among all
students when teaching
+ Q40: Create a safe and open atmosphere for all students when
teaching
Sociale Geneeskunde
Results (4)
Importance of integration cc
- Q 36: To what extent are you interested in receiving
training on how to integrate CC topics in the medical
curriculum:
73 % (4 and 5 scores on Likert scale) (5 = very important)
- Q 41 In your opinion, how important do you think it is to
incorporate cultural competence topics into the medical
school curriculum?:
86% (5 score on Likert scale)
Sociale Geneeskunde
Results (5)
Competence vs training
interest
Theme
Item / Question (answer options on 5-points Likert scale)
Preparedness > 4, in
%
Training needs > 4,
in %
Difference (Training needs
minus Preparedness)
CC topics
10 / 25 How to explore the patient’s cultural and religious beliefs that could have an impact
on their care
50.9
75.5
24.8
L (large)
11 / 26 How to explore aspects of the patient’s social context that could have an impact on
care
65.0
77.1
12.1
S (small)
59.6
67.7
8.1
S
13 / 28 How to explore the patient’s views regarding the cause, severity, impact and
treatment of their illness
63.3
77.7
14.4
S
14 / 29 How to work effectively with interpreters
50.8
64.2
13.4
S
15 / 30 About disparities in health and health care
50.1
69.0
18.9
16 / 31 About prejudice and discrimination in health care
54.2
72.6
18.4
17 / 32 About migrant health (epidemiology, social determinants, access and barriers to
care, etc.)
50.2
74.1
23.9
18 / 33 How to explore students' own perspectives and values and reflect on how these may
influence their future practice
47.5
79.4
31.9
L
19 / 34 How to address conflict when there are different cultural views between the care
provider and the patient
46.2
80.9
34.7
L
20 / 35 How to prepare students to adapt their communication style to respond to the
patient’s needs and capabilities
55.6
81.5
25.9
L
21 / 37 Teach students from a range of diverse cultural and religious backgrounds
63.4
76.3
12.9
S
22 / 38 Examine your own cultural biases that may influence your behaviour as a teacher
64.0
77.7
13.7
S
23 / 39 Engage, motivate and encourage participation among all students when teaching
84.2
81.0
-3.2
NEG
24 / 40 Create a safe and open atmosphere for all students when teaching
89.7
79.9
-9.8
NEG
12 / 27 How to identify the patient’s language and literacy levels
Diverse Classroom
Sociale Geneeskunde
Discussion
• High training needs, eg on how to address conflict when there
are different cultural views between the care provider and the
patient
• Confirmed by literature, eg teachers want training on how to
break bad news to patients when relatives do not want the
patient to hear a bad diagnosis
• Relatively low training needs on interpretation services 
unconscious incompetent? / tiredness around this topic?
Sociale Geneeskunde
Partnershhip
Sociale Geneeskunde