Morell Venita W, Sharp Penny C, Crandall Sonia J
Wake Forest University School of Medicine, Department of Family and Community Medicine, Winston-Salem, NC 27157, USA.
Med Teach. 2002 Sep;24(5):532-4. doi: 10.1080/0142159021000012577.
Teaching medical students to recognize the need for cultural competence and accept their shortcomings in this area is a challenge. A simulated patient scenario was developed to address this challenge. The objective of the simulation is to enhance students' readiness to learn by moving them from 'unconscious incompetence' to 'conscious incompetence'. The patient scenario presents a Cherokee Indian woman with a complaint of abnormal menstrual bleeding who is resistant to gynaecologic care from male providers. A faculty member facilitates a small-group videotape review of student interviews. As students discuss their encounters, they realize they 'misdiagnose' and mishandle the interview. They are confronted by their inability to recognize cultural cues and the impact they may have on health outcomes and begin to question whether cultural beliefs are affecting the care of other patients. This simulation creates an eye-opening situation that must be handled carefully. This activity is an effective method to create awareness in students who feel they 'know all this stuff.'
教导医学生认识到文化能力的必要性并承认自己在这方面的不足是一项挑战。为此开发了一个模拟患者场景来应对这一挑战。该模拟的目的是通过将学生从“无意识的无能力”转变为“有意识的无能力”来提高他们的学习准备程度。患者场景呈现的是一位切罗基印第安女性，她主诉月经异常出血，拒绝男性医疗服务提供者提供的妇科护理。一名教员协助对学生访谈的录像进行小组回顾。当学生们讨论他们的问诊过程时，他们意识到自己“误诊”并处理不当。他们面临着无法识别文化线索以及这些线索可能对健康结果产生的影响，开始质疑文化信仰是否正在影响对其他患者的护理。这个模拟创造了一个必须谨慎处理的令人大开眼界的局面。对于那些觉得自己“已经了解所有这些内容”的学生来说，这项活动是一种提高他们认识的有效方法。
