Posted: June 10, 2013

The Need for Cultural and Linguistic Competence Training in Medical Education: Preparing Physicians to Meet the Needs of a Changing Society

Description

As America moves toward full implementation of the Affordable Care Act (ACA), Cultural and Linguistic Competency (CLC) becomes a center-stage issue, with CLC as a component of the ACA's implementation. CLC, in fact, is no longer considered a nice addition to the HR checklist, but rather as the foundation of professionalism itself. Traditional medical school programs have not included CLC curriculum as an integral part of medical students' overall education. Indeed, it is only in 1989 that the term was even coined, and only in the past 10 years that it has come on the radar screen of most universities and other academic institutions. The term CLC, as described by Terry Cross and colleagues, involves among other things consideration of individuals and the environments in which they live. It is a concept in which individuals are able to communicate with and interact appropriately among those with whom they do or do not share similar backgrounds, lifestyles, or life experiences and expectations. Effective communication is an (ACGME) American College of Graduate Medical Education (ACGME) required competency and is also one of the attributes of physician qualities identified by the Institutes of Medicine (IOM). When applied to the medical setting, CLC is perhaps best exemplified in patient-centered care and communication. Combined with the emergence of patient- and provider-friendly technology in the healthcare setting, the need for formalized instruction and well-developed curricula becomes as important as any other element in the overall medical education experience.

This presentation will draw on explanation of CLC in terms of patient-centered communications and its inherent philosophy which embodies those of culturally and linguistically competent practices. Issues of technology inherent in this discuss are providers' and patients' access to, experience with, understanding of, applications to, and influences of health communications and behaviors. The authors will describe specifics of the ACA, as well as the ACGME requirements, the IOM standards, and the various Milestones projects which are being implemented for evaluation of medical student and resident evaluation. Additionally the authors will outline how CLC drives the topic of professionalism in each of these items, with its footprint being visible in almost all. A detailed listing of primary topics within CLC, including technology and its place in provider decision making and patient-provider interactions, will be used as a starting point for arguing that medical education must embrace and envelop cultural and linguistic competency as central to success in all clinical settings.

*Presented at 2013 SGEA/SGSA Regional Conference

Keywords

Communication, Health Equity Research, Patient-Centered Care, Cultural Competence, Affordable Care Act, Cultural and Linguistic Competence, Milestones

Authors

Mobeen Rathore, MD, CPE, FIDSA, FAAP, FACPE, University of Florida College of Medicine

Heidi Saliba, BA, University of Florida College of Medicine

Nicole Brunner, BHS, University of Florida


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