Kirmayer Laurence J, Rousseau Cécile, Guzder Jaswant, Jarvis G Eric
Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
Acad Psychiatry. 2008 Jul-Aug;32(4):313-9. doi: 10.1176/appi.ap.32.4.313.
The authors summarize the pedagogical approaches and curriculum used in the training of clinicians in cultural psychiatry at the Division of Social and Transcultural Psychiatry, McGill University.
We reviewed available published and unpublished reports on the history and development of training in cultural psychiatry at McGill to identify the main orientations, teaching methods, curriculum, and course content. Student evaluations of teaching were reviewed. The training strategies and curriculum are related to the larger social context of Canadian society including the history of migration, current demography, and policies of multiculturalism.
The McGill program includes core teaching, clinical rotations, an intensive summer program, and annual Advanced Study Institutes. The interdisciplinary training setting emphasizes general knowledge rather than specific ethnocultural groups, including: understanding the cultural assumptions implicit in psychiatric theory and practice; exploring the clinician's personal and professional identity and social position; evidence-based conceptual frameworks for understanding the interaction of culture and psychopathology; learning to use an expanded version of the cultural formulation in DSM-IV for diagnostic assessment and treatment planning; and developing skills for working with interpreters and culture-brokers, who mediate and interpret the cultural meaning and assumptions of patient and clinician.
An approach to cultural psychiatry grounded in basic social science perspectives and in trainees' appreciation of their own background can prepare clinicians to respond effectively to the changing configurations of culture, ethnicity, and identity in contemporary health care settings.
作者总结了麦吉尔大学社会与跨文化精神病学系在培训临床医生文化精神病学时所采用的教学方法和课程设置。
我们查阅了有关麦吉尔大学文化精神病学培训历史与发展的已发表和未发表报告，以确定主要方向、教学方法、课程设置和课程内容。对学生的教学评价进行了审查。培训策略和课程设置与加拿大社会的更广泛社会背景相关，包括移民历史、当前人口统计学和多元文化政策。
麦吉尔大学的项目包括核心教学、临床轮转、强化暑期项目和年度高级研习班。跨学科培训环境强调一般知识而非特定的民族文化群体，包括：理解精神病学理论和实践中隐含的文化假设；探索临床医生的个人和职业身份以及社会地位；基于证据的概念框架，用于理解文化与精神病理学的相互作用；学习使用《精神疾病诊断与统计手册》第四版（DSM-IV）中文化表述的扩展版本进行诊断评估和治疗规划；以及培养与口译员和文化中介合作的技能，他们能调解和解读患者与临床医生的文化意义和假设。
一种基于基础社会科学视角以及受训者对自身背景认识的文化精神病学方法，能够使临床医生做好准备，在当代医疗环境中有效应对文化、种族和身份的不断变化格局。
