The recent murders of George Floyd and Breonna Taylor have brought light to many problematic and systemic issues. Many have battled against these cruel crimes by protesting all around the world. People are demanding changes to legal and social institutions to address racism. While these systemic demands need to be made, it is necessary to realize that there are various methods to take action and facilitate change on a professional and personal level.
Education is a leading proponent for battling racism. Terminating implicit biases—attitudes or stereotypes that affect the understanding, actions and decisions in an unconscious manner—can allow many to realize the deadly effects of systemic racism. Moreover, discussions about cultural competency—the ability to understand, communicate with and effectively interact with people across various cultures—have been prevalent in our general community.
With the grandiosity of the problem, a general understanding of culture is not enough, especially in the healthcare field. The rigorous and time-demanding nature of the positions in this field can affect the patient-clinician relationship. It has become more about the quantity of care rather than the quality of care.
Implicit bias has been a common occurrence in the healthcare field. There is much disregard for the patient’s background and value. In the novel “The Spirit Catches You and You Fall Down” by Anne Fadiman, a non-English-speaking Homng family arrives at the emergency room, but the American practitioners do not know how to communicate with them, nor do they understand their cultural values and beliefs. Repeated hospital visits do not improve the child’s condition; instead, the family becomes more confused about the diagnosis due to the lack of proper communication.
Not many practitioners are educated on how to enact culturally competent behaviors. Instead, many take an ethnocentric approach, where all situations are understood from the practitioner’s lens.
Race, gender, ethnicity, values and beliefs are all factors that provide insights to the lives of a patient. If a practitioner lacks open mindedness to others’ cultures, how will they know how to provide proper treatment? Developing an empathetic, understanding relationship between the patient and provider can bring to light the underlying implications and causes of the symptoms.
Education can prosper a change in how practitioners think, and thus a cultural competency educational system needs to be implemented (or in some cases modified). Students, especially those who are choosing to specialize in the healthcare field, need to gain exposure to various cultures and develop compassion for others that are not the “norm.” An attitude-based curriculum could improve provider awareness of the impact of socio-cultural factors on patients’ values and behaviors, as well as how differences in culture affect clinical outcomes. A skill-building educational program can focus on communication skills, with students learning how to collaborate with an interpreter or cultural liaison. These skills can then be applied to understand a patient’s decisions and treatment preferences.
The Association of American Medical Colleges have included a brief curriculum to increase medical cultural competence. However, a brief curriculum is not sustainable, especially at an older age. During this chaotic time, all students need to expand their knowledge on proper culturally-competent behaviors from a younger age to allow an in-depth appreciation of other individuals and exemplifies what it means to become a caregiver. It is not about the duty, it is about achieving a mutual and compassionate relationship for the betterment of the patient.
In this time of crisis and transformation, action within every institution should be taken. There can no longer be excuses. For the betterment of the future, there needs to be improvement in the cultural curriculum for undergraduates on the pre-healthcare pathway. The skills and information learned from a curriculum like this will be indispensable and assist the healthcare community to thrive with greater inclusiveness. While this may seem like an unordinary measure, it is imperative that students take initiatives to foster change that this country—and its people—deserves.