I am totally on board with the importance of cultural competency in medicine. I used to get very excited about seeing it on the syllabus. I was an anthropology major, I want to work with underserved populations. Trust me, I get it – it’s IMPORTANT. But I know it’s going to be awful.
Example: this week we had a large group session on cultural competency. We had to read an article about 1) the importance of spirituality in health, 2) a prospective study on the effectiveness of phone vs. in-person translation and 3) unequal treatment of black Americans in the healthcare system. These articles were valuable and thought provoking and worth reading and discussing. Except that we didn’t discuss them. We watched a movie about an Afghan man getting lost in translation and not receiving chemotherapy as a result. Also worth discussing. Except that they squashed any meaningful discussion by forcing each group to answer a very specific, often repetitive question.
In contrast, our small groups are run very well this year. They give us articles like the ones described above, or about the importance of hand washing, minors and gardasil, or cardiovascular risk factors and we have constructive discussion and get to learn from our very amazing, knowledgeable small group leaders.
Anything they do in large groups – “discussions” or lectures are useless and leave me banging my head against the wall, along with the rest of my classmates. It’s a shame because these are extremely important issues. We need to face our own biases and prejudices and understand the effect of time pressure on obtaining a translator. These issues will affect our patients’ outcomes. So why do they bollocks it up so badly? I know these are relatively recent additions to medical education, and they (obviously) haven’t figured out how to teach it yet. But really? Telling us translation is important and respecting our patients’ culture is important is like telling us that HPV causes cervical cancer. Most of us know that much at this point, so don’t waste 2 hours telling me that (It leads to days like this). I can handle something slightly more advanced.