Guidelines for teaching culturally
appropriate health care published
A national medical journal has published curriculum guidelines for teaching
culturally sensitive and competent health care to family medicine residents
and other health professions students. Based on ten years of development
by members of the Society of Teachers of Family Medicine (STFM), these guidelines
are intended to inform both the teaching and practice of primary health
care delivery to culturally diverse populations.
"The delivery of high quality primary care that is meaningful, acceptable,
accessible, effective, and cost-efficient requires a deeper understanding
of the sociocultural background of patients and their families," said
Dr. Robert C. Like, an author of the guidelines and medical faculty member
at the University of Medicine & Dentistry of New Jersey-RWJ Medical
School. "Understanding these sociocultural variables in health care
settings can result in more favorable outcomes for patients. They can also
increase the potential for a more satisfying interpersonal experience between
health care providers and patients."
"As providers, we also have to become more aware of how our own
personal cultural values, assumptions, and beliefs influence how we provide
care, and how the relationships we have and the places we live and work
influence us," Like said.
The STFM Task Force on Cross-Cultural Experiences began developing the
curriculum guidelines ten years ago after a national survey of family practice
residency programs indicated that few training programs provided any formal
instruction about culture and health. The Task Force coordinated the work,
and solicited contributions from behavioral and social scientists and other
STFM members interested in minority and multicultural health care and education.
The guidelines introduce topics related to culture, health, and illness
into residency training and graduate medical education. They are based on
the premise that health care professionals can develop competency to recognize
bias when it occurs, and can use cultural resources to overcome barriers
and enhance primary care.
Written in outline form, the guidelines include a suggested list of appropriate
attitudes, knowledge, and skills for clinicians; methods of implementing
the curriculum into clinical instruction; and bibliographic references and
resources for experiential teaching techniques. The format follows curricular
guidelines previously published by the American Academy of Family Physicians,
but is general enough for adaptation to educational and training programs
for a variety of medical specialties, health professionals, and clinical
and administrative staff working in health care settings.
The authors faced several difficult issues as they were developing the
guidelines. As the preamble states, "[we] attempted to become aware
of our own medicocentric and ethnocentric biases during the drafting of
this document." They also wanted to avoid stereotyping groups of people
while acknowledging the presence of common sociocultural attributes. The
guidelines attempt to enlarge the view of culture beyond ethnic differences
to include socioeconomic, religious, and other concerns pertinent to health
and health care.
The "Recommended Core Curriculum Guidelines on Culturally Sensitive
and Competent Health Care" have been endorsed by the American Academy
of Family Physicians and the Society of Teachers of Family Medicine Board.
They appear in the April/May 1996 issue of the journal Family Medicine (Volume
28, No. 4, 1996).
reprinted from Cross Currents, Spring 1995 | 
