Friday, April 9, 2010


Welcome to our site! Having worked in the field of cross cultural medical education for over twenty years, I have seen the ever-changing terminology to our work. First there was diversity, and then came cultural competence, now health disparities. So what do I mean by cross cultural effectiveness in health care? I have defined this as the process between health care provider and patient that consists of awareness of difference (of self and others), knowledge of culturally relevant attitudes, experiences and worldviews and skills to deliver excellent and appropriate health care. Although the most MESH headed term is cultural competence and efforts to evaluate and assess impact are important, I think medicine needs to focus on advancing the process of care delivery, not just the product. Regrettably, cultural competence is sometimes viewed as the checklist of things I need to know about a group - not the nature of the interaction. It is far easier to memorize exotic sounding health beliefs. It is harder to reflect in the mirror, 'how to I come across?" "What assumptions am I holding?' It may be even harder still to create safe spaces within medical education and training to nurture this work.
    I also give the caveat that cross-cultural effectiveness within the patient-doctor relationship is a myopic snapshot of the entire picture and that an ecological model needs to be considered in designing educational venues and addressing the challenges.