Danish Research Centre for Migration, Ethnicity and Health, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5A, 1014, Copenhagen, Denmark.
Academic Medical Center, University of Amsterdam, Department of Public Health, Amsterdam Public Health research institute, P.O. Box 22660, 1100 DE, Amsterdam, The Netherlands.
BMC Med Educ. 2019 Jan 15;19(1):21. doi: 10.1186/s12909-018-1449-y.
Europe is becoming more social and cultural diverse as a result of the increasing migration, but the medical doctors are largely unprepared. The medical education programmes and teachers have not evolved in line with development of the population. Culturally competent curricula and teachers are needed, to ensure cultural competence among medical doctors and to tackle inequalities in health between different ethnic groups. The objective of this EU financed study is therefore to provide a snapshot of the role of cultural competence in European medical educational programmes.
A questionnaire was developed in order to uncover strengths and weaknesses regarding cultural competence in the European medical education programmes. The questionnaire consisted of 32 questions. All questions had an evidence box to support the informants' understanding of the questions. The questionnaire was sent by email to the 12 European project partners. 12 completed questionnaires were returned.
Though over half of the participating medical programmes have incorporated how to handle social determinants of health in the curriculum most are lacking focus on how medical professionals' own norms and implicit attitudes may affect health care provision as well as abilities to work effectively with an interpreter. Almost none of the participating medical programmes evaluate the students on cultural competence learning outcomes. Most medical schools participating in the survey do not offer cultural competence training for teachers, and resources spent on initiatives related to cultural competences are few. Most of the participating medical programmes acknowledge that the training given to the medical students is not adequate for future jobs in the health care service in their respective country regarding cultural competence.
Our results indicate that there are major deficiencies in the commitment and practice within the participating educational programs and there are clear potentials for major improvements regarding cultural competence in programmes. Key challenges include making lasting changes to the curriculum and motivating and engaging stakeholders (teachers, management etc.) within the organisation to promote and allocate resources to cultural competence training for teachers.
由于移民的增加，欧洲变得更加多样化，社会文化更加多元，但医生们在很大程度上准备不足。医学教育课程和教师没有随着人口的发展而发展。需要有文化能力的课程和教师，以确保医生具备文化能力，并解决不同族裔群体之间的健康不平等问题。因此，这项由欧盟资助的研究旨在概述文化能力在欧洲医学教育课程中的作用。
为了揭示欧洲医学教育课程中文化能力的优势和劣势，我们开发了一份问卷。问卷包括 32 个问题。所有问题都有一个证据框，以支持受访者对问题的理解。我们通过电子邮件将问卷发送给 12 个欧洲项目合作伙伴。共收到 12 份完整的问卷。
尽管超过一半的参与医学课程已经将处理健康的社会决定因素纳入课程，但大多数课程都没有关注医疗专业人员自己的规范和隐含态度如何影响医疗保健服务提供以及与口译员有效合作的能力。参与的医学课程中几乎没有一个评估学生在文化能力学习成果方面的情况。参与调查的大多数医学院都不为教师提供文化能力培训，与文化能力相关的举措所花费的资源也很少。大多数参与医学课程的人都承认，为医学生提供的培训不足以让他们在各自国家的医疗保健服务领域胜任未来的工作，尤其是在文化能力方面。
我们的研究结果表明，参与的教育项目在承诺和实践方面存在重大缺陷，在课程的文化能力方面有很大的改进潜力。关键挑战包括对课程进行持久的改变，以及激励和调动组织内的利益相关者（教师、管理层等），以促进和分配资源用于教师的文化能力培训。
