Given that understanding the sociocultural dimensions underlying a patient's health values, beliefs, and behaviors is critical to a successful clinical encounter, cross-cultural curricula have been incorporated into undergraduate medical education. The goal of these curricula is to prepare students to care for patients from diverse social and cultural backgrounds, and to recognize and appropriately address racial, cultural, and gender biases in health care delivery. Despite progress in the field of cross-cultural medical education, several challenges exist. Foremost among these is the need to develop strategies to evaluate the impact of these curricular interventions. This article provides conceptual approaches for cross-cultural medical education, and describes a framework for student evaluation that focuses on strategies to assess attitudes, knowledge, and skills, and the impact of curricular interventions on health outcomes.
Dr. Betancourt is senior scientist, Institute for Health Policy, and program director, multicultural education, Massachusetts General Hospital, Boston, Massachusetts, and assistant professor of medicine, Harvard Medical School, Boston.
Correspondence and requests for reprints should be addressed to Dr. Betancourt, 50 Staniford Street, Suite 942, Boston, MA 02114; telephone: (617) 724-9713; fax: (617) 724-4738; e-mail: 〈firstname.lastname@example.org〉.
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 thanks Drs. J. Emilio Carrillo and Alexander R. Green for their continued support and collaboration. Their expertise in cross-cultural education is unparalleled, and many of the principles outlined in this article emerged from five years of developing and teaching cross-cultural curricula in partnership with them.
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.