Gill, Elaine Elizabeth

Li, Shuangyu

Liu, Jia

The UK General Medical Council stipulates that medical graduates should be able toprovide culturally sensitive care to patients of all backgrounds, including those whosefirst language is not English. Cultural competence and diversity education is offered inUK medical schools. However, little is known how students develop their culturalcompetence specially in clinical placements.Ethnography allows researchers to develop rich descriptions and an in-depthunderstanding of the studied population’s lived experience through collecting naturallyoccurring data. Participant observation was combined with interviews and focus groupsto triangulate analysis and generate more reliable accounts. We shadowed five medicalstudents on placements in a central London hospital, interviewed 25 students, andconducted a focus group with five students.We found that students developed their cultural competence via immersion,observation, and interaction. Immersion in a working environment, where diversity wasmanifested through interior design, diverse workforces and patient populations wasshown to raise students’ cultural awareness. Observation of culturally (in)appropriatepractices allowed students to develop their practical skills, including clinicalcommunication. Interaction with other professionals, peers, and patients, allowedstudents to integrate attitudes, knowledge and skills into real-time care provision.Students’ learning varied, depending on luck, individual personalities, the length ofexposure, available support, and the institutional culture of hospitals.This study provides a rare view of how medical students develop cultural competencein clinical placements, which may inform future pedagogic development. Some findingsmay shed light on the learning of other values-based medical subjects, such as clinicalcommunication, professionalism, teamworking and ethics

There is more than what you think--cultural competence development in clinical placements through the eyes of ethnography

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