Abstract
Although education about culture, race and ethnicity has increasingly been viewed as an important addition to the medical undergraduate curriculum, internationally the evidence of its effectiveness is mixed. Research to date fails to show why. We chose to explore how contrasting approaches to learning about cultural diversity impacted on medical students. The views of second year students towards teaching about cultural diversity at two UK medical schools, with differently structured curricula, were explored using a series of focus groups (7). The findings, using a methodology based on a combination of grounded theory and thematic analysis identified two potentially competing views espoused by the students at both sites. First, they claimed that although cultural diversity was important, their medical schools marginalised and failed to adequately support effective teaching. Second, in contrast, they claimed that the medical school was an ‘inappropriate’ setting for successful teaching about cultural diversity. Students did not consider the subject matter to be of central relevance to biomedicine. They felt it should be learnt experientially in the workplace and socially among peers. These narratives represent two potentially conflicting standpoints, which might be understood through the sociological concept of ‘habitus’, where students conform to the institution’s dominant values in order to succeed. The tensions identified in this study cannot be ignored if effective learning about race, ethnicity and culture is to be achieved. Early introduction to understanding the delivery of health care to diverse populations is needed. This should be accompanied by more open collaborative debate between tutors and students on the issues raised.
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Acknowledgments
We thank all the students who took part in the study and the staff at both medical schools for their help with organisation, particularly Dr. Ioan Davies.
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Appendix
Appendix
Topic guide part 1
Now, we’re going to turn our attention to your experiences of studying medicine at A/B
Students: Have you covered topics in your PBL group which refer to cultural issues for patients and doctors?
If so, how was it done?
Expand: relevant? enjoyable? useful?
Have your friendships with fellow students played a part in your understanding of cultural issues?
Have you or your family any healthcare experiences of intercultural care which have taught you something?
B students
How did you find the PPD session on attitudinal awareness and barriers to communication? Expand: relevant? enjoyable? useful?
Have your friendships with fellow students played a part in your understanding of cultural issues?
Have you had much experience meeting patients from different cultural backgrounds to yourself?
What have you learnt from this?
Have you or your family any healthcare experiences of intercultural care which have taught you something?
Part 2
We would like you to comment on the following words of phrases as your thoughts focus. There are no right or wrong answers and we are not looking for dictionary definitions. Please feel free to contribute. Four ‘flashcards’, with the words: “race”, “ethnicity”, “culture”, “cultural diversity”, were then raised consecutively.
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Roberts, J.H., Sanders, T., Mann, K. et al. Institutional marginalisation and student resistance: barriers to learning about culture, race and ethnicity. Adv in Health Sci Educ 15, 559–571 (2010). https://doi.org/10.1007/s10459-010-9218-7
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DOI: https://doi.org/10.1007/s10459-010-9218-7