Intrdouction
According to the Association of American Medical Colleges, approximately 30% of US medical students participate in international medical experiences (IMEs) (i.e., electives, rotations, research, etc.) during training. IMEs present unique challenges for institutions equipping students to serve in culturally appropriate ways across highly diverse settings. While the Liaison Committee on Medical Education requires institutions to teach cultural competency, to date, no widespread guidance exists for a standard curriculum for cross-cultural training which has resulted in a lack of consensus among schools’ pre-departure training and cultural competency training programs. The objective of this research was to evaluate trends in educational models for medical students participating in IMEs and provide recommendations for best practices for developing an equitable global health program.
Methods
A thematic review of literature was conducted using PubMed and Google Scholar to identify articles published between 1960 and 2022 that discuss cultural training programs for medical students participating in IMEs. Programs were assessed on educational content and learning objectives.
Results
Cultural competency programs in medical schools emerged in the early 2000s, focusing on categorical knowledge of host cultures and skill building. While programs often emphasized a curiosity mindset, much of the literature included self-critiques regarding potential stereotyping and stigmatization. Beginning in the mid-2010s, programs shifted to focus on cultural humility. These programs emphasized self-reflection and sensitivity, instructing emotional intelligence over knowledge mastery. These trends are reflected in the publication results over time of PubMed queries (Figure 1).
Tables & Figures
Figure 1. Publication frequency over time for “cultural competence” and “cultural humility” queries on PubMed.
References
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Betancourt, J. R., & Green, A. R. (2010). Commentary: linking cultural competence training to improved health outcomes: perspectives from the field. Academic Medicine, 85(4), 583- 585.
Kalbarczyk, A., Nagourney, E., Martin, N. A., Chen, V., & Hansoti, B. (2019). Are you ready? A systematic review of pre-departure resources for global health electives. BMC medical education, 19(1), 1-10.
Koplan, J. P., Bond, T. C., Merson, M. H., Reddy, K. S., Rodriguez, M. H., Sewankambo, N. K., & Wasserheit, J. N. (2009). Towards a common definition of global health. The Lancet, 373(9679), 1993-1995.
Kripalani, S., Bussey-Jones, J., Katz, M. G., & Genao, I. (2006). A prescription for cultural competence in medical education. Journal of general internal medicine, 21(10), 1116- 1120.
Liason Committee on Medical Education. Full text of LCME Accreditation Standards. Available at: http://www.lcme.org/stnd- text.htm#educationalprogram.