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).

了解并提供文化上合格的护理是创建医疗保健系统和劳动力的核心，为全体人民提供可及且有效的医疗保健服务。1然而，尽管文化教育的重要性已在很大程度上得到全球卫生学校的认可，但培训仍然分散，缺乏培训。结构、内容和过程缺乏一致性。2,3 对于学生如何发展他们的文化能力 (CC) 知之甚少。4 我的博士学位通过以下方式解决了知识差距：a) 对英国医学院的文化教育进行了概述，并b) 提供对内部和外部因素的丰富描述可能有助于学生 CC 发展的教育环境。民族志5被采纳为我的总体方法论。采用了参与式方法6，包括文件审查、参与观察、个人访谈和焦点小组。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。研究结果提供了对来自不同文化背景的学生的个人经历和围绕 CC 发展的多方面因素的见解。研究表明，学生在课堂正式教学、临床实习和课外活动中有意识和无意识地发展了他们的CC。他们在每个环境中的学习经历都是相互关联、不断互动的，从而累积地促进了他们的CC发展。整合结果和讨论使我能够生成一个理论模型来概念化医学生的 CC 发展。由于对医学教育背景的理解不断加深，提出了由 12 条教育技巧组成的 EDUCATIONIST 指南，为教学发展提供信息。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预注册医疗保健项目（例如护理、助产、牙科、药剂学、物理治疗、营养和饮食学），并系统地探索目前在这些健康项目中如何教授CC。增加的研究部分将产生对跨预注册医疗保健学科的 CC 教育的全面了解。综合结果可以让健康教育工作者制定和评估策略，以支持跨医疗保健项目的文化课程的加强和发展。这项研究的主要优势在于其探索性，以及它有助于了解全球背景下医疗保健学生 CC 发展的潜力。有效支持预注册医疗保健学生发展他们的 CC 也将有助于医疗保健专业人员之间的多学科工作，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期刊上，并在国际会议（例如 BSC 年会、医学社会学会议、AMEE 会议）上发表。在奖学金期间，我将扩大我与领先的 CC、健康教育和医学社会学研究小组的网络。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。为了确保研究结果惠及更广泛的受众，我将通过在院系研究研讨会（例如免疫学和微生物科学学院每周的“研究更新会议”）、大学指定团体（例如教师平等、多元化和包容性委员会/Athena Swan）、学生团体（例如医学生协会/促进 KCL 课程包容性的学生指导小组）以及网络与相关学术团体（例如英国医学和医疗保健多样性小组）。