Kai J, Bridgewater R, Spencer J
Department of Primary Health Care, University of Newcastle-upon-Tyne, Newcastle, UK.
Med Educ. 2001 Mar;35(3):250-6. doi: 10.1046/j.1365-2923.2001.00871.x.
The case for being able to respond effectively to cultural and ethnic diversity in health care is attracting increasing debate in medical education. However research exploring the perspectives of learners is lacking.
We sought medical learners' perceptions and their perceived training needs in relation to cultural and ethnic diversity in health care.
A series of nine focus group interviews was conducted with 55 medical learners, including undergraduate students in a UK medical school and a group of postgraduate general practitioners in training. Interview data were analysed using qualitative methods.
Participants had a broad but superficial awareness of multicultural issues. This focused upon "difference" with students emphasizing their need to acquire knowledge of different beliefs and practices. Current teaching was perceived as inadequate and limited largely to ethnic patterns of disease. Most felt a need for greater training. They regarded development of particular communication skills, such as working with interpreters as helpful. Beyond avoiding stereotyping, learners rarely identified reflecting upon their attitudes or the issue of racism as important. Students anticipated a range of potential problems for further training, but sought learning that was relevant, practically oriented and stimulating.
The study points to learners' experience of inadequate training but suggests a willingness to learn more. The possible predominance of a "difference" perspective might drive a narrow focus upon learning cultural knowledge at the expense of promoting a balance with self-reflection upon attitudes and developing generic skills. Educators might heed learners' views about how they should be taught successfully.
在医疗保健中有效应对文化和种族多样性的问题在医学教育中引发了越来越多的讨论。然而,缺乏探索学习者观点的研究。
我们旨在了解医学学习者对医疗保健中文化和种族多样性的看法以及他们认为的培训需求。
对55名医学学习者进行了一系列9次焦点小组访谈,其中包括一所英国医学院的本科生和一组接受培训的研究生全科医生。访谈数据采用定性方法进行分析。
参与者对多元文化问题有广泛但肤浅的认识。这集中在“差异”上,学生们强调他们需要了解不同的信仰和做法。他们认为当前的教学不足,并且很大程度上局限于疾病的种族模式。大多数人觉得需要更多培训。他们认为培养特定的沟通技巧,比如与口译员合作很有帮助。除了避免刻板印象,学习者很少认为反思自己的态度或种族主义问题很重要。学生们预计进一步培训会遇到一系列潜在问题,但他们寻求的是相关的、注重实践且有启发性的学习。
该研究指出了学习者培训不足的经历,但表明他们愿意学习更多。“差异”视角可能占主导地位,这可能导致过于狭隘地专注于学习文化知识,而牺牲了在态度自我反思和培养通用技能方面取得平衡。教育工作者可能需要关注学习者对如何成功教学的看法。