Student reflections on learning cross-cultural skills through a 'cultural competence' OSCE.

BACKGROUND

Medical schools use OSCEs (objective structured clinical examinations) to assess students' clinical knowledge and skills, but the use of OSCEs in the teaching and assessment of cross-cultural care has not been well described.

OBJECTIVES

To examine medical students' reflections on a cultural competence OSCE station as an educational experience.

DESIGN AND SETTING

Students at Harvard Medical School in Boston completed a 'cultural competence' OSCE station (about a patient with uncontrolled hypertension and medication non-adherence). Individual semi-structured interviews were conducted with a convenience sample of twenty-two second year medical students, which were recorded, transcribed, and analysed.

MEASUREMENTS AND RESULTS

Students' reflections on what they learned as the essence of the case encompassed three categories: (1) eliciting the patient's perspective on their illness; (2) examining how and why patients take their medications and inquiring about alternative therapies; and (3) exploring the range of social and cultural factors associated with medication non-adherence.

CONCLUSIONS

A cultural competence OSCE station that focuses on eliciting patients' perspectives and exploring medication non-adherence can serve as a unique and valuable teaching tool. The cultural competence OSCE station may be one pedagogic method for incorporating cross-cultural care into medical school curricula.