Teaching transcultural skills to medical students in France. A qualitative study of a focus group

Abstract Background: Academic instruction about the impact of culture on health care (through cultural representations of diseases, the body, and various treatments) is sparse in France, although this topic is widely taught in other countries with substantial immigration, especially Canada and United States. Medical students' reception of this instruction must be assessed in the French context, where the consideration of cultural diversity is controversial, even taboo. Objectives: We seek to describe the effect of a course on transcultural issues in medicine among second- and third-year medical students, especially on their behavior, on the patient-student relationship, and on their perceptions of migrant patients; we also aim to identify the aspects of the course that have the greatest effect on these young students. Methods: Two focus groups (at the first and last course sessions) were conducted with 38 medical students who had participated in the optional course "Transcultural approach to the physician-patient relationship" at the Université Paris Cité medical school in 2023. Results: Our qualitative analysis of the focus group transcripts showed four themes: the place of the mother tongue at the hospital; equity and humanity in caring for the vulnerable; the balance between professional neutrality and the use of cultural identity as a resource to improve the care relationship; and the effects of the course on the students' position toward the health-care team and the patient. Discussion: The two focus groups showed the course had a transformative effect on the students in their awareness of cultural prejudices, but also in enabling them to dare to consider cultural dimensions and to recognize the importance of interpreters. Conclusion: A discussion group is an appropriate format for a course on transcultural approaches for this public of young learners and makes it possible to focus on its global themes and foundations.