Preparing to Care for a Culturally and Linguistically Diverse UK Patient Population: How Healthcare Students Develop Their Cultural Competence

准备照顾文化和语言多样化的英国患者群体：医疗保健学生如何发展他们的文化能力

• 批准号: ES/W004860/1
• 负责人: Jia Liu
• 金额: $ 14.02万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FW004860%2F1
• 关键词: Preparing; Care; Culturally; Linguistically; Diverse

Understanding and providing culturally competent care is core to create a healthcare system and workforce that can deliver accessible and effective healthcare for the whole population.1 However, although the importance of cultural education has been largely recognised by health schools globally, training remains fragmented with a lack of consistency in structure, content, and process.2,3 Little is known about how students develop their cultural competence (CC).4 My PhD addressed the gaps of knowledge by a) generating an overview of cultural education in UK medical schools and b) providing a rich description of the factors, both within and outside the educational settings, which may contribute to students' CC development. Ethnography5 was adopted as my overarching methodological approach. A participatory approach6 was adopted by including document review, participant observation, individual interviews, and focus groups. The document review showed that successful CC delivery relies on both strong institutional recognition (e.g. faculty development) and systematic educational interventions. The findings provided insights into the personal experiences and multi-faceted factors around CC development among students who themselves come from culturally diverse backgrounds. The study showed that students develop their CC both consciously and unconsciously in classroom-based formal teaching, clinical placements, and extracurricular activities. Their learning experiences in each setting are interrelated and constantly interacting with each other, which accumulatively contributes to their CC development. Integrating the results and discussions allowed me to generate a theoretical model that conceptualises medical students' CC development. As a result of increased understanding in the context of medical education, the EDUCATIONIST guide, which consists of 12 educational tips, was proposed to inform pedagogical development. During the ESRC Postdoctoral Fellowship, I plan to expand my PhD research to other pre-registration healthcare programmes (e.g. nursing, midwifery, dentistry, pharmacy, physiotherapy, nutrition and dietetics) and systematically explore how CC is currently been taught in these health programmes. The added research component will generate a comprehensive understanding of CC education across pre-registration healthcare disciplines. The consolidated results may allow health educators to develop and evaluate strategies to support the enhancement and development of cultural curricula across healthcare programmes. The key strength of this research is in its exploratory nature and its potential to shed light on understanding the development of CC among healthcare students in a global context. Effectively supporting pre-registration healthcare students to develop their CC will also contribute to the multidisciplinary work among healthcare professionals and improve patient-centred care. Findings from the ESRC fellowship research will be published in leading medical education journals and presented at international conferences (e.g. the BSC Annual Conference, the Medical Sociology Conference, the AMEE Conference). During the fellowship, I will expand my network with leading CC, health education, and medical sociology research groups. I will receive training to consolidate and improve my methodological skills, particularly in conducting mixed-method health research. To ensure findings reach a wider audience, I will disseminate the results of my research via presenting in department research seminars (e.g. the weekly 'Research Update Conference' at the School of Immunology and Microbial Sciences), university designated groups (e.g. the Faculty Equality, Diversity and Inclusion Committee/Athena Swan), student groups (e.g. Medical Students' Association/Student Steering Groups to Promote Curriculum Inclusivity at KCL), and networking with relevant academic groups (e.g. the UK Group in Diversity in Medicine and Healthcare).

了解并提供有文化能力的医疗保健是创建一个能够为所有人提供可获得和有效的医疗保健的医疗保健系统和劳动力的核心。1然而，尽管全球卫生学校在很大程度上认识到文化教育的重要性，但培训仍然支离破碎，在结构、内容和过程上缺乏一致性。2，3关于学生如何发展他们的文化能力，我们知之甚少。4我的博士学位通过a)概述英国医学院的文化教育和b)丰富地描述教育环境内外的因素，这些因素可能有助于学生的文化能力发展，从而解决了知识的空白。民族志5被采纳为我的主要方法。采用了参与式方法6，包括文件审查、参与者观察、个别访谈和焦点小组。文件审查表明，成功的CC交付依赖于强有力的机构认可(例如，教师发展)和系统的教育干预。这一发现为来自不同文化背景的学生提供了关于CC发展的个人经历和多方面因素的见解。研究表明，学生在基于课堂的正规教学、临床实习和课外活动中都会有意识和无意识地发展他们的CC。他们在每个环境中的学习经历是相互关联的，不断地相互作用，这积累了对他们CC发展的贡献。将结果和讨论整合在一起，使我能够生成一个理论模型，将医学生的CC发展概念化。随着人们对医学教育认识的增加，提出了教育家指南，其中包括12个教育技巧，以指导教育学的发展。在ESRC博士后奖学金期间，我计划将我的博士研究扩展到其他注册前医疗保健课程(例如护理、助产、牙科、药剂学、物理治疗、营养和营养学)，并系统地探索目前这些健康课程是如何教授CC的。增加的研究部分将产生对跨注册前医疗保健学科的CC教育的全面了解。综合结果可能使健康教育工作者能够制定和评估战略，以支持在卫生保健方案中加强和发展文化课程。这项研究的关键优势在于它的探索性和它的潜力，以揭示在全球背景下在医疗保健学生中理解CC的发展。有效地支持注册前的医学生发展CC也将有助于医疗专业人员的多学科工作，并改善以患者为中心的护理。ESRC奖学金研究的结果将发表在领先的医学教育杂志上，并在国际会议(如BSC年会、医学社会学会议、AMEE会议)上发表。在团契期间，我将与领先的CC、健康教育和医学社会学研究小组扩大我的关系网。我将接受培训，以巩固和提高我的方法技能，特别是在进行混合方法健康研究方面。为了让更多的人了解我的研究结果，我将在系研究研讨会(例如免疫学和微生物科学学院每周的“研究更新会议”)、大学指定的小组(例如学院平等、多样性和包容性委员会/雅典娜·斯旺)、学生小组(例如促进吉隆坡课程包容性的医学生协会/学生指导小组)以及与相关学术小组(例如英国医学与医疗多元化小组)建立联系，以传播我的研究结果。