DIVERSITY AND CULTURAL COMPETENCY CASE STUDIES
Cultural Beliefs in a Scientific Presentation
A Hispanic female medical student is doing a case representation of a Hispanic female patient to a white male attending physician. The presentation includes a sympathetic recounting of the patient’s beliefs, including naive ideas about illness, ideas of spirit possession and exorcism, and comfort from religious faith. The attending finds the presentation “excessively informal and unscientific,” and suggests that the student includes this material because, “You’re from her race, and are sympathetic to her.” He scolds her that they are working at a prestigious medical center and suggests she make more conventional presentations.
Possible Questions for Discussion:
Why would the attending physician be so unsympathetic
to this style of presentation and these aspects of a patient’s life?
Is his behavior appropriate?
The attending physician is unsympathetic to the style of presentation of the female Hispanic medical student and to the different aspects of the patient’s life because the physician is not of the same race with the medical student. The physician is ethnocentric meaning he doesn’t view/ value other culture aside from his own culture. He has different perspectives about the aspects of patient’s life that is rooted on his own culture that is contrary/ not in line with the perspective of the medical student.Thus, leading him to have prejudices and not culturally competent in his profession.
Lastly, the behavior of the attending physician is inappropriate because he doesn’t act professionally.
If you were the student how would you feel?
How would you react?
If I were the student, I will initially feel shame because I was scolded, and discouragement to continue because my superior (physician) thinks that my presentation is absurd/ inaccurate. But, despite of this, I will still be optimistic- look at it in the positive side that it is just a challenge for me that need to be surpassed. I will feel great that I am not like the physician who is an ethnocentric but rather I’m a culturally sensitive health care provider because I know how to respect and understand one’s culture.
I would react to it positively by telling to the physician politely that what I included in the presentation is relevant because it is part of our culture; and treating patient should not only be limited to physical aspects but we have to treat them holistically- we should also consider the other aspects/ dimensions of man’s life such as psychosocial where culture is incorporated, spiritual, psychological, and the like.
How can medical school faculty become better informed
about the relevance of racial and cultural issues in patient care?
Medical school faculty become well informed about the relevance of racial and cultural issues in patient care by talking to medical school faculty and informing them directly about racial and cultural issues. Voicing out concerns regarding racial and cultural issues will make medical school faculty aware about the problem thus, alarming them to make a move to prevent such occurrences for the benefit of patients as well as their institution.
How can a resident or medical student best learn to incorporate
both scientifically and culturally relevant issues within a brief presentation?
Resident or medical student best learn to incorporate both scientifically and culturally relevant issues within a brief presentation through one’s experience. The medical student need to experience these things personally so as for him/ her to inculcate it in his/ her mind, and learn from it as days passes by; as what they say, “Experience is the best teacher”.
Since understanding cultural factors appears crucial for patient compliance,
how should a resident or medical student become knowledgeable about these cultural factors considering the vast diversity of cultures currently within the United States?
Medical student become knowledgeable about the various cultural factors by widening/ broadening his/ her mind about other cultures. He/ She should not be ethnocentric in order for him/ her to understand, consider, and respect other cultures. Through this, medical students will become culturally competent and culturally sensitive one day.
What is the attending physician accomplishing with his attitude?
What value is given to the knowledge possessed by the Hispanic physician regarding Hispanic culture? What other responses are possible?
The attending physician wants to accomplish authority with his kind of attitude because he is using his position as physician to impose power over his subordinates to control/ direct them to what he wants to be. It is evident in the situation wherein he reprimands the medical student that his presentation is informal and unscientific, and he wants the student to make a more scientific presentation because the presentation of the student is not in line with the perspective of the physician.
The value given to the knowledge possessed by Hispanic physician regarding Hispanic culture is the value of respect. Hispanic physician knows how to respect his/ her own culture, and knows how to look back to the culture that molded him/ her to what he/ she is now unlike others who tend to forget their own culture and adapt another one because of certain reason. Thus, making this Hispanic physician culturally competent.
Does your school have an established protocol for minority students to report racially-related incidents?
I am not aware if our school has a protocol for minority students to report racially- related incidents because racial discrimination is not rampant/ rare case in our school. All I know is that, minority students are given discount on their tuition fees to help them pursue and finish their studies. They formed an organization called “BIBAK” for minority students that help aid the needs of minority students financially, and the like.
A middle-aged, Caucasian faculty member reassures a Native American student that no matter what kind of performance the student does, his work will be accepted, because “It’s important that we have at least one Native American student matriculate each year, and you’re the only one this year.”
Possible Questions for Discussion:
How do you imagine the student feels?
I imagined that the student feels sad upon hearing the words of the faculty member because the faculty member sees the student worthless. There is special treatment in a good way but saying these words may degrade the morale/ self-esteem of the student. The student is just like a front to fill in the philosophy of the institution that there should be one minority student that is studying each year.
If you were the student, what would you say to the faculty member?
If I were the student, I would respond positively. I would be great that I am the minority student that is studying in the institution and that it is an honor for me. But, I would say to the faculty member politely that I should be treated equally with other students so as to prevent envy/ jealousy in their part thus, preventing racial discrimination. The rules and regulations of the institution regarding academic performance should also be applied to me and the consequences of it should also be implied to me just like the other students.
What is your opinion about whether disadvantaged students should be accepted and maintained preferentially in training programs, even if their performance is poor?
For me, disadvantaged students should not be accepted and maintained preferentially in training programs if the performance is poor because it will bring envy/ jealousy to other students. All students whether minority or not, should be treated and given importance equally. Thus, being fair to all students.
Has a situation like this ever occurred in your experience?
In my 20 years of existence, I never experienced any situation like this; and I’m so thankful about it because everyone is treated equally in our home, our school, and our community.
Do faculty think that there are different admissions criteria for minority students?
If so, in what ways?
In the situation above, yes, the faculty thinks that there should be different admissions criteria for minority students because minority students are exempted in the rules and regulations of the institution because of their philosophy that there should be one minority student that is studying in their institution. But, if I were to ask, there should be no different admissions criteria for minority students, every student should be treated equally. Rules and regulations of the institution should govern all students whether that student is a minority or not.
If you are a student, how does this affect your interaction with faculty
in the classroom, laboratories, and clinical rotations?
If I were the student, initially, this will affect my interaction with faculty in the classroom, laboratories, and clinical rotations negatively because they just see me nothing and that I’m just part to fulfill their philosophy. But, as of my character, I would not mind what faculty members think/ see about me; I will act and interact with them normally and that I’ll do my best to prove them wrong. I will persevere to show them my worth even though I am just a minority student.
How much should medical students be allowed to participate in
the selection process of applicants including ethnic minority students?
Medical students should be allowed to participate in the whole process of selection of applicants whether he/ she is a minority or not. Everybody should be given a chance to participate and get involved in each step throughout the selection process. There should be neither special treatment nor preferences in the selection of applicants.
Saint Mary’s University
Bayombong, Nueva Vizcaya
In Partial Fulfillment of the Requirements in
Master of Science in Nursing- Transcultural Nursing
DIVERSITY AND CULTURAL COMPETENCY CASE STUDIES
Mrs. Fe Yolanda G. del Rosario, PhD
Mark Anthony T. Tabago, RN