O'Reilly Sharleen L, Milner Julia
School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
International Business School Suzhou, Xi'an Jiaotong-Liverpool University, 111 Ren Ai Road, Dushu Lake Higher Education Town, Suzhou Industrial Park, Suzhou, Jiangsu, 215123, China.
BMC Med Educ. 2015 Oct 15;15:175. doi: 10.1186/s12909-015-0458-3.
Increasing proportions of Culturally and Linguistically Diverse (CALD) students within health professional courses at universities creates challenges in delivering inclusive training and education. Clinical placements are a core component of most health care degrees as they allow for applied learning opportunities. A research gap has been identified in regard to understanding challenges and strategies for CALD students in health professional placements.
A key stakeholder approach was used to examine barriers and enablers experienced by CALD students in clinical placement. Semi-structured focus groups with healthcare students (n = 13) and clinical placement supervisors (n = 12) were employed. The focus groups were analysed using open coding and thematic analysis.
Three main barrier areas were identified: placement planning and preparation; teaching, assessment and feedback; and cultural and language issues. Potential solutions included addressing placement planning and preparation barriers, appropriate student placement preparation, pre-placement identification of higher risk CALD students, and diversity training for supervisors. For the barrier of teaching, assessment & feedback, addressing strategies were to: adapt student caseloads, encourage regular casual supervisor-student conversations, develop supportive placement delivery modes and structures, set expectations early, model the constructive feedback process, use visual aids, and tailor the learning environment to individual student needs. The enablers for cultural & language issues were to: build language and practical approaches for communication, raise awareness of the healthcare system (how it interacts with healthcare professions and how patients access it), and initiate mentoring programs.
The findings suggest that teaching and learning strategies should be student-centred, aiming to promote awareness of difference and its impacts then develop appropriate responses by both student and teacher. Universities and partnering agencies, such as clinical training providers, need to provide an inclusive learning environment for students from multiple cultural backgrounds.
大学健康专业课程中文化和语言背景多样（CALD）的学生比例不断增加，这给提供包容性培训和教育带来了挑战。临床实习是大多数医疗保健学位的核心组成部分，因为它们提供了应用学习的机会。在理解CALD学生在健康专业实习中的挑战和策略方面，已发现存在研究空白。
采用关键利益相关者方法来研究CALD学生在临床实习中遇到的障碍和促进因素。对医疗保健专业学生（n = 13）和临床实习督导（n = 12）进行了半结构化焦点小组访谈。使用开放式编码和主题分析对焦点小组进行了分析。
确定了三个主要障碍领域：实习计划与准备；教学、评估与反馈；以及文化和语言问题。潜在的解决方案包括解决实习计划与准备障碍、进行适当的学生实习准备、在实习前识别风险较高的CALD学生以及为督导提供多样性培训。对于教学、评估与反馈障碍，应对策略包括：调整学生工作量、鼓励督导与学生定期进行非正式交流、开发支持性的实习提供模式和结构、尽早设定期望、示范建设性反馈过程、使用视觉辅助工具以及根据学生个体需求调整学习环境。文化和语言问题的促进因素包括：建立语言和实用的沟通方法、提高对医疗保健系统的认识（它如何与医疗保健专业互动以及患者如何获取服务）以及启动指导计划。
研究结果表明，教学策略应以学生为中心，旨在提高对差异及其影响的认识，然后由学生和教师制定适当的应对措施。大学和合作机构，如临床培训提供商，需要为来自多元文化背景的学生提供一个包容性的学习环境。
