| Summary: | Cultural competence is a topic that concerns social scientists and medical
anthropologists who pay attention to demographic changes and health disparities.
This study demonstrates practical approaches to developing cultural competence in
medical education by using factors from the social environment to develop protocols
for action. With current concerns in domestic and global health care, it is evident that
health care organizations struggle to deliver culturally appropriate services.
Additionally, educational institutions also struggle to evaluate culturally applied
medical practices and competencies. Unlike medical competence, cultural competence
is seldom evaluated, and as a result, a gap exists in health care delivery. The purpose
of this research is to examine the changes in self-assessment of physician assistant
(PA) medical students and graduates, as indications of changes in their medical
practice and attitudes. Key objectives explore how PA medical students self-assess
their own cultural competence; what factors impact their evaluation, and if change
indicates cultural competence.
The methodology consisted of a qualitative approach designed to conduct
focus group discussions, in-depth interviews, and field work, while results of existing
quantitative data was used to inform the study. Triangulation methods substantiated
the findings along with environmental and data analysis to provide rigor to this
investigation. Participants were students and graduates from a Physician Assistant
Studies Program in Oregon.
Major findings showed changes in participants' cultural competence self
assessment due to a change in self-awareness, exposure and experiences with diverse
underserved populations, in domestic and international encounters with the real world.
In conclusion, change in self assessment had actually occurred, but the change in the
quantitative results really portrayed a level of development on a cultural competency
continuum, but not cultural competence itself.
It followed from these findings that using components which influenced
change along with external and internal environmental factors, provided a basis for a
model to establish procedures for action. This strategic model, the praxis of cultural
competence, takes critical elements or protocols to move medical students from theory
to practice. From the results of this study we can see evidence of closing the gap
between the theory of cultural competence and culturally competent practices. === Graduation date: 2005
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