Cross-cultural Education in U.S. Medical Schools

PURPOSE: Medical education is responding to an increasingly diverse population and to regulatory and quality-of-care requirements by developing cross-cultural curricula in health care. This undertaking has proved problematic because there is no consensus on what elements of cross-cultural medicine should be taught. Further, less is known about what is being taught. This study hypothesized that a tool could be developed to assess common themes, concepts, learning objectives, and methods in cross-cultural education. METHOD: In 2001, 31 U.S. medical schools were invited to provide the researchers all written and/or Web-based materials related to implementing cross-cultural competency in their curricula. A tool was developed to measure teaching methods, skill sets, and eight content areas in cross-cultural education. RESULTS: A total of 19 medical schools supplied their curricular materials. There was considerable variation in approaches to teaching and in the content of cross-cultural education across the schools. Most emphasized teaching general themes, such as the doctor-patient relationship, socioeconomic status, and racism. Most also focused on specific cultural information about the ethnic communities they served. Few schools extensively addressed health care access and language issues. CONCLUSIONS: This assessment tool is an important step toward developing a standard nomenclature for measuring the success of cross-cultural education curricula. On the national level, the tool can be used to compare program components and encourage the exchange of effective teaching tools by promoting a common language, which will be essential for developing and implementing curricula, for comparing programs, and evaluating their effects on quality of care.