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Achieving cultural competence in the care of a patient who is a member of an ethnic or racial minority is a multifaceted project involving specific cultural knowledge as well as more general skills and attitude adjustments to advance cross-cultural communication in the clinical encounter. Using the important example of the African American patient, the authors examine relevant historical and cultural information as it relates to providing culturally competent health care. The authors identify key influences, including the legacy of slavery, Jim Crow discrimination, the Tuskegee syphilis study, religion's interaction with health care, the use of home remedies, distrust, racial concordance and discordance, and health literacy. The authors propose that the awareness of specific information pertaining to ethnicity and race enhances cross-cultural communication and ways to improve the cultural competence of physicians and other health care providers by providing a historical and social context for illness in another culture. Cultural education, modular in nature, can be geared to the specific populations served by groups of physicians and provider organizations. Educational methods should include both information about relevant social group history as well as some experiential component to emotively communicate particular cultural needs. The authors describe particular techniques that help bridge the cross-cultural clinical communication gaps that are created by patients' mistrust, lack of cultural understanding, differing paradigms for illness, and health illiteracy.

is a Professor of Engineering at Smith College who teaches courses in engineering science and methods for teaching science and engineering. He received a B.S. in Civil Engineering from Lehigh University and an M.A. and Ph.D. in Civil Engineering and Operations Research from Princeton University. The winner of numerous teaching and research awards, Dr. Ellis received the 2007 U.S. Professor of the Year Award for Baccalaureate Colleges from the Carnegie Foundation for the Advancement of Teaching and the Council for Advancement and Support of Education. His research focuses on creating K-16 learning environments that support the growth of learners' imaginations and their capacity for engaging in collaborative knowledge work. Ms. Isabel Huff, Springfield Technical Community CollegeAfter participating in the instructional design of Through My Window during her four years as an undergraduate, Huff is now its outreach coordinator. She graduated summa cum laude from Smith College with a double major in Economics and Spanish in Spring 2014 and now works on the Springfield Technical Community College side of the Through My Window National Science Foundation grant. Mr. Al Rudnitsky, Smith CollegeAl Rudnitsky teaches Introduction to the Learning Sciences; Thinking, Knowing and the Design of Learning Environments, How Do We Know What Students are Learning?, and instructional methods in elementary and middle school mathematics and science. He has authored books on curriculum design and teaching children about scientific inquiry. Current research interests focus on creating environments for "good talk" in elementary and middle school classrooms, and also on advancing the use of knowledge building pedagogy in higher education. His most recent article (2013) is entitled "Tasks and Talk: The Relationship Between Teachers' Goals and Student Discourse," in Social Studies Research and Practice.

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