Integrating Theory, Content, and Method to Foster Critical Consciousness in Medical Students: A Comprehensive Model for Cultural Competence Training
- PMID: 27680318
- DOI: 10.1097/ACM.0000000000001390
Integrating Theory, Content, and Method to Foster Critical Consciousness in Medical Students: A Comprehensive Model for Cultural Competence Training
Abstract
Many efforts to design introductory "cultural competence" courses for medical students rely on an information delivery (competence) paradigm, which can exoticize patients while obscuring social context, medical culture, and power structures. Other approaches foster a general open-minded orientation, which can remain nebulous without clear grounding principles. Medical educators are increasingly recognizing the limitations of both approaches and calling for strategies that reenvision cultural competence training. Successfully realizing such alternative strategies requires the development of comprehensive models that specify and integrate theoretical frameworks, content, and teaching principles.In this article, the authors present one such model: Introduction to Medicine and Society (IMS), a required cultural competence course launched in 2013 for first-year medical students at the Perelman School of Medicine at the University of Pennsylvania. Building on critical pedagogy, IMS is centered on a novel specification of "critical consciousness" in clinical practice as an orientation to understanding and pragmatic action in three relational domains: internal, interpersonal, and structural. Instead of transmitting discrete "facts" about patient "types," IMS content provokes students to engage with complex questions bridging the three domains. Learning takes place in a small-group space specifically designed to spur transformation toward critical consciousness. After discussing the three key components of the course design and describing a representative session, the authors discuss the IMS model's implications, reception by students and faculty, and potential for expansion. Their early experience suggests the IMS model successfully engages students and prepares future physicians to critically examine experiences, manage interpersonal dynamics, and structurally contextualize patient encounters.
Comment in
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Reaching Out Beyond the Health Care System to Achieve a Healthier Nation.Acad Med. 2017 Mar;92(3):271-273. doi: 10.1097/ACM.0000000000001555. Acad Med. 2017. PMID: 28221221 No abstract available.
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When and How Do We Teach Cultural Awareness?Acad Med. 2017 Dec;92(12):1653. doi: 10.1097/ACM.0000000000001985. Acad Med. 2017. PMID: 29210736 No abstract available.
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In Reply to Weissman.Acad Med. 2017 Dec;92(12):1653. doi: 10.1097/ACM.0000000000001990. Acad Med. 2017. PMID: 29210737 No abstract available.
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