Letters to the Editor
Dr. Weissman’s thoughtful comments are very much appreciated. My coauthors and I agree that 43 hours of instruction in the first year of medical school as a single, stand-alone experience is insufficient to produce a durable awareness of the complexity of one’s self. We acknowledged this in our article, stating, “We recognize that sociomedical learning requires longitudinal approaches to reinforcement and retention that go beyond single-semester courses.”1 In recognizing this, we have sought to extend the concepts, frameworks, and pedagogy of the Introduction to Medicine and Society (IMS) course across our entire professionalism and humanism curriculum at the Perelman School of Medicine.
Dr. Weissman is also correct in pointing out that the language of “cultural competence,” as typically applied, is problematic, an issue we noted in the introduction of the article. This is especially the case when the skills we are seeking to develop are not technical (e.g., learning to tie a knot) but instead involve ongoing, iterative, and intentional approaches at monitoring, sculpting, and transforming one’s thinking. In preparing the article there were extended debates among the authors about including the phrase “cultural competence” in the title. We decided to use it given how deeply entrenched it is in the language of medical education, with the expectation that the reader would see that the IMS model represents a significantly different approach for students to engage the influences of social, cultural, and structural processes on physician relationships. Finally, we readily endorse, as is emphasized in the IMS model, that “self-awareness … is the foundation for cultural awareness.”
Horace M. DeLisser, MD
Associate professor of medicine and associate dean for diversity and inclusion, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; firstname.lastname@example.org.
1. Dao DK, Goss AL, Hoekzema AS, et al. Integrating theory, content, and method to foster critical consciousness in medical students: A comprehensive model for cultural competence training. Acad Med. 2017;92:335–344.