A framework for enhancing and assessing cultural competency training.

The globalization of medical practice using accepted evidence-based approaches is matched by a growing trend for shared curricula in medicine and other health professions across international boundaries. Interest in the common challenges of curricular design, delivery and assessment is expressed in conferences and dialogues focused on topics such as teaching of professionalism, humanism, integrative medicine, bioethics and cultural competence. The spirit of collaboration, sharing, acknowledgment and mutual respect is a guiding principle in cross-cultural teaching. This paper uses the Tool for Assessing Cultural Competency Training to explore methods for designing and implementing cultural competency curricula. The intent is to identify elements shared across institutional, national and cross-cultural borders and derive common principles for the assessment of learners and the curricula. Two examples of integrating new content into existing clerkships are provided to guide educators interested in an integrated and learner-centered approach to assimilate cultural competency teaching into existing required courses, clerkships and elective experiences. The paper follows an overarching principle that "every patient-doctor encounter is a cross-cultural encounter", whether based on ethnicity, age, socioeconomic status, sex, religious values, disability, sexual orientation or other differences; and whether the differences are explicit or implicit.