Components of Culture in Health for Medical Students' Education

Tervalon, Melanie MD, MPH

Academic Medicine:
Special Theme: Cultural Competence: SPECIAL THEME ARTICLES
Abstract

Medical educators across the United States are addressing the topics of culture, race, language, behavior, and social status through the development of cross-cultural coursework. Dramatic demographic changes and nationwide attention to eliminating racial and ethnic health disparities make educating medical students about the importance of the effects of culture on health a 21st-century imperative. Despite the urgent need for including this topic material, few medical schools have achieved longitudinal integration of issues of culture into four-year curricula. The author makes the practical contribution of describing key themes and components of culture in health care for incorporation into undergraduate medical education. These include teaching the rationale for learning about culture in health care, “culture basics” (such as definitions, concepts, the basis of “culture” in the social sciences, relationship of culture to health and health care, and health systems as cultural systems), data on and concepts of health status (including demographics, epidemiology, health disparities, and the historical context), tools and skills for productive cross-cultural clinical encounters (such as interviewing skills and the use of interpreters); characteristics and origins of attitudes and behaviors of providers; community participation (including the use of expert teachers, community-school partnerships, and the community as a learning environment); and the nature of institutional culture and policies.

Author Information

Dr. Tervalon is assistant adjunct professor in anthropology, history, and social medicine, University of California, San Francisco, School of Medicine, San Francisco, California.

Correspondence and requests for reprints should be sent to Dr. Tervalon, Children's Hospital and Research Center at Oakland, Office of Multicultural Health, 747 Fifty Second Street, Oakland, CA 94609-1809; telephone: (510) 428-3043; e-mail: 〈mtervalon@earthlink.net〉.

This work was supported by The Commonwealth Fund, a New York City–based private, independent foundation. The views presented here are those of the author and not necessarily those of The Commonwealth Fund, its directors, officers, or staff.

The author dedicates this article with much love to her parents, Marie Jones and Albert Louis Tervalon, Sr.

This is an edited version of a paper prepared for the Association of American Medical Colleges' Commonwealth Fund Project: Medical Education and Cultural Competency: A Strategy to Eliminate Racial and Ethnic Disparities in Health Care.

© 2003 Association of American Medical Colleges