Medical residents' feedback on needs and acquired skills following a short course on cross-cultural competence

Objectives The purpose of this study is to assess short and long term changes in knowledge, attitudes, and skills among medical residents following a short course on cultural competency and to explore their perspectives on the experience. Methods Eighteen medical residents went through a short training programme comprised of two seminars lasting 30' and 60' respectively over two days. Three months later, we conducted three focus groups, with 17 residents to explore their thoughts, perspectives and feedback about the course. To measure changes over time, we carried out a quantitative sequential survey before the seminars, three days after, and three months later using the Multicultural Assessment Questionnaire. Results Residents expressed a wide variety of perspectives on the main themes related to the content of the training - culture, trialogue, stereotypes, status, epidemiology, history and geopolitics - and related to its organization - relevance, volume, timing, target audience, training tools, and working material. Using the MAQ, we observed a higher global performance score (n=16) at three days (median=38) compared to results before the training (median=33) revealing a median difference of 5.5 points (z=2.4, p=0.015). This difference was still present at three months (∆=4.5, z=2.4, p=0.018), mainly due to knowledge acquisition (∆=3) rather than attitudes (∆=0) or skills (∆=1). Conclusions Cross-cultural competence training not only brings awareness of multicultural issues but also helps participants understand their own cultures, perception of others and preconceived ideas. Physicians' education should however also focus on improving implementation of acquired knowledge in cross-cultural competence.

Teaching cross-cultural competence and CLIL: a CLIL approach in International Relations University Courses

International relations professionals need cross-cultural competence and English language communication skills to function in the international arena (Graddol 1997). English language communication skills are necessary not only to communicate with foreign colleagues (Bocanegra-Valle 2014) but also to access the vast amount of knowledge transmitted in English over the internet (Ku, Zussman 2010). This work reports the use of CLIL and cross-cultural training in the University of Messina International Relations Advanced Degree Program as a method to raise students’ level of English as quickly as possible while giving them the essential intercultural skills for work in the international field. The researchbased course program combined cross-cultural communication training (Storti, 1997; Lewis, 1999; Gannon, 2004, Harris and Moran, 2007; U.S Peace Corps Training Handbook 2012,) and intercultural competence skill development (Bennett, 1998). Two objectives were proposed: 1) develop cross-cultural communication competence; 2) bring students up to a B2 level as fast as possible. The final exam demonstrated significant growth in the areas of cross-cultural competence as well as an increase in European Common Framework level ranging from .5 to 1.0 depending on the student. Students expressed their belief that what they had learned would be useful for their future career. Combining CLIL with intercultural competence building seems to be effective in meeting two objectives: increasing English language fluency and developing cross-cultural communication competence. More research is recommended to further document this method for increasing English communication proficiency while developing interculturally competent international professionals.

Representations of cultural encounters in the global business press – The importance of cross-cultural competence

This qualitative study has started from the interest to examine how the reality of crosscultural encounters is presented in the global business press. The research paper emphasizes different ways to classify culture and cross-cultural competency, both from the point of view of individuals and organizations. The analysis consists of public discourses, where cross-cultural realities are created through different persons, stories and contexts For data collection, a comprehensive database search was performed and 10 articles from the widely known worldwide business magazine The Financial Times were chosen as the data for the study paper. For the functions of addressing the research study questions, Thematic Content Analysis (TCA) and also Discourse Analysis (DA) are utilized, added with the continuous comparison method of grounded theory in the formation of the data.The academic references consist of literary works and articles presenting relevant concepts, creating a cross-cultural framework, and it is designed to assist the reader in the navigation through the topics of culture and cross-cultural competency. The repertoires were formed from the data and following, the first repertoire is contrast difference between home and target culture that the individual was able to discern. As a consequence of the first repertoire, the companies then offer cultural training to their employees to prepare them to situations of increasing levels of cultural variation. The third repertoire is increased awareness of other cultures, which is conveyed as a result of cultural training and contextual work experience. The fourth repertoire is globalization as an international business environment, where the people in the articles perform their job functions. It is stated in the conclusions that the representations emphasize Western values and personal traits in leadership.

Responding to Changing Student Demographics in Finland: A Study of Teachers’ Developing Cultural Competence

The aim of this dissertation was to examine the skills and knowledge that pre-service teachers and teachers have and need about working with multilingual and multicultural students from immigrant backgrounds. The specific goals were to identify pre-service teachers’ and practising teachers’ current knowledge and awareness of culturally and linguistically responsive teaching, identify a profile of their strengths and needs, and devise appropriate professional development support and ways to prepare teachers to become equitable culturally responsive practitioners. To investigate these issues, the dissertation reports on six original empirical studies within two groups of teachers: international pre-service teacher education students from over 25 different countries as well as pre-service and practising Finnish teachers. The international pre-service teacher sample consisted of (n = 38, study I; and n = 45, studies II-IV) and the pre-service and practising Finnish teachers sample encompassed (n = 89, study V; and n = 380, study VI). The data used were multi-source including both qualitative (students’ written work from the course including journals, final reflections, pre- and post-definition of key terms, as well as course evaluation and focus group transcripts) and quantitative (multi-item questionnaires with open-ended options), which enhanced the credibility of the findings resulting in the triangulation of data. Cluster analytic procedures, multivariate analysis of variance (MANOVA), and qualitative analyses mostly Constant Comparative Approach were used to understand pre-service teachers’ and practising teachers’ developing cultural understandings. The results revealed that the mainly white / mainstream teacher candidates in teacher education programmes bring limited background experiences, prior socialisation, and skills about diversity. Taking a multicultural education course where identity development was a focus, positively influenced teacher candidates’ knowledge and attitudes toward diversity. The results revealed approaches and strategies that matter most in preparing teachers for culturally responsive teaching, including but not exclusively, small group activities and discussions, critical reflection, and field immersion. This suggests that there are already some tools to address the need for the support needed to teach successfully a diversity of pupils and provide in-service training for those already practising the teaching profession. The results provide insight into aspects of teachers’ knowledge about both the linguistic and cultural needs of their students, as well as what constitutes a repertoire of approaches and strategies to assure students’ academic success. Teachers’ knowledge of diversity can be categorised into sound awareness, average awareness, and low awareness. Knowledge of diversity was important in teachers’ abilities to use students’ language and culture to enhance acquisition of academic content, work effectively with multilingual learners’ parents/guardians, learn about the cultural backgrounds of multilingual learners, link multilingual learners’ prior knowledge and experience to instruction, and modify classroom instruction for multilingual learners. These findings support the development of a competency based model and can be used to frame the studies of pre-service teachers, as well as the professional development of practising teachers in increasingly diverse contexts. The present set of studies take on new significance in the current context of increasing waves of migration to Europe in general and Finland in particular. They suggest that teacher education programmes can equip teachers with the necessary attitudes, skills, and knowledge to enable them work effectively with students from different ethnic and language backgrounds as they enter the teaching profession. The findings also help to refine the tools and approaches to measuring the competencies of teachers teaching in mainstream classrooms and candidates in preparation.

Exploring the Perceptions of Cultural Competence Among Personal Support Workers in an Ontario Long-Term Care Home: A Case Study

Personal Support Workers (PSWs) spend a large amount of time with long-term care (LTC) home residents providing assistance with their activities of daily living. The s limited research on their perceptions of cultural competence presents the need to bridge this knowledge gap. The researcher conducted a qualitative case study at a LTC home in Ontario. Data were collected by conducting a policy document analysis, a key informant interview with the Director of Care (DOC), and two focus groups with PSWs. The five major overarching themes were: The Culture of the LTC Home, Provision of a Supportive Environment, Collaborative Team Approach to Care, Building a Relationship with the Residents, and Maintenance of Staff Morale. The findings illuminated the broad nature of culture, connections to person centered care, and the factors that facilitate or hinder PSWs’ culturally competent care. The ambiguous perception of cultural competence among PSWs suggests further research and education on cultural competence in LTC home settings.

Cultural competence in an HIV dedicated dental clinic: Application of the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS)

This dissertation investigated perspectives on cultural competence among African-American women patients, staff, and the administrator of a dental clinic serving people living with HIV/AIDS; and evaluated the role of the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS) in advancing the provision of culturally competent care in the clinic. ^ The study was qualitative with data collection via focus groups and individual interviews with a sample of African-American women patients, and individual interviews with a sample of staff and the clinic administrator. Transcripts were coded and themes identified using the software program ATLAS.ti. A cultural audit template was developed and applied to evaluate cultural competency. ^ Among attitudes and behaviors that contributed to the provision of culturally competent care at the clinic were respect and empathic communication. Formal cultural competency was not featured strongly in the methods by which the staff learned to work with diverse populations. Instead cultural competence among the staff was based on thoughtful hiring practices, natural aptitude and a climate that encouraged learning through informal sharing of experiences. The staff and administrator felt that an African-American dentist would be an asset in improving culturally competent care at the clinic. Previous research and national policy also promote the provider-patient racial/ethnic concordance to improve care. In this study, however, the patients were happy with the care provided regardless of the race/ethnicity of the staff, probably reflecting the well developed cultural competence skills of clinic staff overall. ^ The clinic administrator was unaware of the CLAS standards although the clinic was implicitly operated under their mandates. This occurred because the clinic is supported by federal funding and the CLAS standards were incorporated into the requirements. Incorporation into and monitoring of the CLAS standards in federally funded programs therefore appears to be an effective means for ensuring that they are implemented. ^ This study illustrates that cultural competence, though not universally understood, can be systematically investigated to identify what constitutes appropriate care and the factors that support or inhibit it. Among important elements of culturally competent care are respect and empathic communication. ^

Cultural Competence

In this editorial the author describes the essential nature and characteristics of cultural competence.

The journey towards cultural competence

Graduates increasingly need to operate across national and cultural boundaries. This paper discusses the need to ensure that all students are equipped to operate within complex and diverse multicultural environments. The work builds on three earlier studies. Using these, the author has created a new theoretical framework and designed an intervention which aimed to increase diverse students' awareness of intercultural differences and their ability to function effectively in multicultural learning (and thus work) environments. The paper evaluates this highly innovative training. It concludes that it was effective in making a wide range of students aware of issues around cultural difference and competence. The training significantly changed the outlook of students who took part in it. Whilst the framework was robust, effective, and generalisable to other contexts, there are a number of issues which will be addressed in the re-running the programme.

The journey towards cultural competence: first interventions

Graduates worldwide are increasingly entering a global workplace which will require them to operate across national and cultural boundaries. This paper discusses the need to ensure that all students are equipped to work within this increasingly complex multi-cultural environment. It examines the issues which occur in preparing students within a UK Higher Education environment so that they are able to operate effectively within the international work situations in which they find themselves. This research builds on earlier research, which found that the effectiveness of an individual to work across cultural boundaries, in terms of work and communication, was increased by the number of international or intercultural experiences that a person has. Using this as a premise, an intervention was designed which aimed to increase students’ awareness of intercultural differences and their ability to function effectively in multicultural groups. This paper analyses the effectiveness of this highly innovative training intervention. It concludes that it was an effective way of making students aware of some of the issues around cultural competence is groups. In fact, the training was seen as most effective by students in addressing issues round group dynamics. The training obviously changed the outlook of a number students who took part it. There are, however, a number of issues which need to be addressed the re-running the training. These are notably, at what time in a student’s academic career such intervention is given, its integration into the curriculum and managing of student expectations.

Journey towards cultural competence:developing university teachers

Purpose - This paper examines the importance of intercultural training for lecturers; describes innovative training to address this, based on a new theoretical framework; and evaluates training and framework. Background - UK HE is becoming increasing internationally diverse. The UK HEI population is also very multicultural. The proportion of lecturers who come from outside the UK has risen. It is, therefore, important that students develop intercultural awareness. One way of doing this is to work with students. A more sustainable approach focusses training on lecturers who will embed cultural awareness into their practice. Method - This paper sets out a theoretical framework which underpins training developed for lecturers as part of a Postgraduate Certificate. The paper describes the training and evaluates the effectiveness of this. Findings and results - Findings show that participants were apprehensive about the training. Afterwards they expressed surprise at the participative approach, but were pleased with outcomes. They enjoyed the exercises and the training appeared to have opened up their outlook. They praised the freedom to share thoughts with others. Conclusions - Findings show that participants learnt intercultural skills to use in class. This was due to the design. The nature of the training encouraged reflection on cultural diversity and participants attested to the effects this would have on their teaching. These results replicate other studies Implications - The implications are immediate in the design of intercultural training in different contexts. It has already been used to design innovative training for students and managers. In both cases the same far-reaching results were achieved.