Culture & medicine: Expanding a community-based cross-cultural and diversity inclusiveness training curriculum into an undergraduate special topics course

A persistent challenge in health science education is how to introduce issues of cultural competence in meaningful, effective, and practical ways to time-pressed and overworked students. In response to this challenge, the Hispanic Health Council (HHC), a community-based organization located in Hartford Connecticut, partnered with the University of Hartford to develop “Culture & Medicine.” Piloted in the spring 2010, this undergraduate course offered students a foundation of cross-cultural knowledge, attitudes and skills.

Using a social justice framework and expanding upon HHC's comprehensive Cross-Cultural & Diversity Inclusiveness Training model, the course incorporated theoretical content on the topics of culture, oppression, health inequities, social determinants of health, patient-centered care, cultural competency, and the federal CLAS Standards. Through complementary participatory exercises and self-reflection, students explored the dimensions of their own identities, issues of bias and stereotyping, internalized oppression, and blaming the victim. Additionally, students practiced communication skills and cultural brokering using role plays.

The goals of the course were to: • Develop critical thinking and analytical approaches to address health inequalities; • Understand the social, economic, and political contexts of the health and illness; • Understand how issues of oppression create barriers to the successful use of health and human services, and to overall well-being; and • Develop individualized skills and strategies for enhancing cultural competence.

Student performance was assessed through reflective journaling, a personalized cultural competence action plan, and a case study analysis incorporating cumulative course content. Additionally, the course evaluation included self-reported pre/post assessments of participants' cross-cultural knowledge, attitudes, and skills.