An Overview of Undergraduate Training in Cultural Competency and Cross-Cultural Psychiatry (original) (raw)
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Cultural competency training in psychiatry
European Psychiatry, 2008
Recent reports indicate that the quality of care provided to immigrant and ethnic minority patients is not at the same level as that provided to majority group patients. Although the European Board of Medical Specialists recognizes awareness of cultural issues as a core component of the psychiatry specialization, few medical schools provide training in cultural issues. Cultural competence represents a comprehensive response to the mental health care needs of immigrant and ethnic minority patients. Cultural competence training involves the development of knowledge, skills, and attitudes that can improve the effectiveness of psychiatric treatment. Cognitive cultural competence involves awareness of the various ways in which culture, immigration status, and race impact psychosocial development, psychopathology, and therapeutic transactions. Technical cultural competence involves the application of cognitive cultural competence, and requires proficiency in intercultural communication, the capacity to develop a therapeutic relationship with a culturally different patient, and the ability to adapt diagnosis and treatment in response to cultural difference. Perhaps the greatest challenge in cultural competence training involves the development of attitudinal competence inasmuch as it requires exploration of cultural and racial preconceptions. Although research is in its infancy, there are increasing indications that cultural competence can improve key aspects of the psychiatric treatment of immigrant and minority group patients.
Training Clinicians in Cultural Psychiatry: A Canadian Perspective
Academic Psychiatry, 2008
The authors summarize the pedagogical approaches and curriculum used in the training of clinicians in cultural psychiatry at the Division of Social and Transcultural Psychiatry, McGill University. We reviewed available published and unpublished reports on the history and development of training in cultural psychiatry at McGill to identify the main orientations, teaching methods, curriculum, and course content. Student evaluations of teaching were reviewed. The training strategies and curriculum are related to the larger social context of Canadian society including the history of migration, current demography, and policies of multiculturalism. The McGill program includes core teaching, clinical rotations, an intensive summer program, and annual Advanced Study Institutes. The interdisciplinary training setting emphasizes general knowledge rather than specific ethnocultural groups, including: understanding the cultural assumptions implicit in psychiatric theory and practice; exploring the clinician's personal and professional identity and social position; evidence-based conceptual frameworks for understanding the interaction of culture and psychopathology; learning to use an expanded version of the cultural formulation in DSM-IV for diagnostic assessment and treatment planning; and developing skills for working with interpreters and culture-brokers, who mediate and interpret the cultural meaning and assumptions of patient and clinician. An approach to cultural psychiatry grounded in basic social science perspectives and in trainees' appreciation of their own background can prepare clinicians to respond effectively to the changing configurations of culture, ethnicity, and identity in contemporary health care settings.
A Cultural Sensitivity Training Workshop for Psychiatry Residents
Academic Psychiatry, 2000
Efforts have been made to develop a core curriculum for cultural sensitivity training for psychiatry residents. There is a lack of literature reporting effectiveness of various teaching modalities for such training. The authors report their experience with a 4-hour pilot workshop to teach psychiatry residents ethnic and cultural issues in patient care. Pretest and posttest questionnaires were designed to measure residents' knowledge of cultural issues. There was statistically significant improvement in performance on questionnaires after the workshop (F;6.03ס PϽ0.001). Further studies are necessary to examine teaching modalities in residency education. (Academic Psychiatry 2000; 24:77-84)
Guidelines for Training in Cultural Psychiatry
2012
Canada is a highly diverse society and Canadian scholars and clinicians have been world leaders in efforts to understand the impact of culture on mental health. However, to date, there have been no national guidelines for the integration of culture in psychiatric education and practice. This paper, prepared by the Section on Transcultural Psychiatry of the Canadian Psychiatric
Harvard Review of Psychiatry, 2010
"In the past decade, notions of “cultural competence” and “cultural sensitivity” have gained rapid ascendance within American medical education in general and within psychiatric residency programs in particular. These innovations in medical education are elements of a multi-pronged, health sector-wide response to vast racial/ethnic disparities in health outcomes recently identified in the United States. The vast scope and magnitude of these disparities came to light at the turn of the millennium with the publication of the Institute of Medicine’s 2002 report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, and the Surgeon General’s landmark 2001 supplemental report, Mental Health: Culture, Race, Ethnicity, among other studies. These disturbing findings were quickly interpreted as a clarion call to prompt and decisive action, and the field of medical education has been especially responsive to this call. One key consequence of this call has been a comprehensive effort to sensitize clinicians-in-training to the roles they might play – often unwittingly – in producing and reinforcing disparities in treatment and health outcome. Although a wide variety of educational interventions have been implemented across medical school and residency training programs in recent years, it is striking how little is known about the on-the-ground challenges, problems, and pitfalls that arise when clinician-educators attempt to render issues of racial/ethnic and cultural difference “teachable” and “learnable.” In this commentary, we address this glaring absence from the literature by reporting findings of an innovative qualitative research study conducted at a major teaching hospital in the northeastern United States."
A Randomised Control Trial (RCT) of Undergraduate Cross-Cultural Psychiatry Training
2000
Rationale of study: Ethnic diversity in the UK requires doctors to be aware of the impact of culture on the clinical assessment, diagnosis and treatment of mental health problems. One way of improving practice is to add specific teaching on the subject of cultural psychiatry to medical school teaching but there is no evidence- base to support this. Aim: To
Academic Psychiatry, 2013
Background/Objective: Almost no literature compares current approaches to teaching cultural issues across U.S. psychiatry residency programs; the authors addressed this comparison. Methods: The authors administered semistructured interviews of 20 instructors with substantial experience in the teaching of cultural issues in U.S. psychiatry residency programs, regarding the content, teaching techniques, institutional context, and evaluation of their curricula over time.
Culture, Psychiatry and Cultural Competence
Mental Illnesses - Understanding, Prediction and Control, 2012
Why the study of culture and its clinical application is important in mental health training and service? Mental health and illness is a set of subjective experience and a social process and thus involves a practice of culture-congruent care. Series of anthropological, sociological and cross-cultural research has clearly demonstrated a very strong ground in favour of this contention. An individual's cultural background colours every facets of illness, from linguistic or
acad.ro
Cultural competence tends to become more and more important for the clinical practice in many European countries where the recent migration flow has created bigger demographic, ethnic and cultural heterogeneity. Yet, it has been promoted especially in the countries that, already for several decades, have evolved also on the political plan, from monoculturalism to bi- or even multiculturalism, such as Australia, New Zeeland, Canada or USA. Situated in the larger context of globalization, of the economic development still unequal between North and South, of the various changes of the policies regarding the labour right in the EU Members, but also of the international armed conflict areas leading to forced migration towards zones that can provide basic surviving conditions, Romania participates to the same population flow in which immigration and emigration are more and more dynamic. It can be foreseen that both the economic migration and the forced one will create also in our country a much higher ratio of communities with different cultural and linguistic origins (CALD - Cultural and Linguistic Diversity). Under these circumstances, providing competent and efficient mental health services and equal access to medical services will involve the development of training programmes for health professionals in order to offer them the cultural knowledge, the abilities and skills necessary for communicating with patients from other cultures. In this regard, an essential role is played by the medical anthropology whose potential is still unexplored in our country. The purpose of this article is to present some debates in the scientific literature, dedicated to cultural competence and its role in the field of clinical psychiatric practice, with a special focus on some of our contributions to modelling a culturally competent approach in the case of patients suffering from various psychiatric disorders.