A co-designed curriculum for cultural safety training of Colombian health professionals: sequential-consensual qualitative study

Abstract

Background: Although traditional and cultural health practices are widely used in Colombia, physicians are not trained to address intercultural tensions that arise in clinical practice. Cultural safety encourages practitioners to examine how their own culture shapes their clinical practice and to respect their patients’ culture. It requires inviting patients of non-dominant cultures to co-design culturally safe health care. We co-designed a curriculum for cultural safety training of Colombian health professionals. Methods: A sequential-consensual qualitative study defined the learning objectives of the curriculum. Semi-structured questionnaires and focus groups explored the opinions of traditional medicine users, medical students, and intercultural health experts to inform the content of the curriculum. Deliberative dialogue between key intercultural health experts settled the academic content of the curriculum. A member-checking strategy modified and approved the final version. Results: Seven traditional medicine users, six medical students, and four intercultural health experts participated in the study. The stakeholders defined five learning objectives: (a) culturally unsafe practices: acknowledge the intercultural tensions and its consequences; (b) cultural awareness: examine their attitudes, beliefs, and values, and how they shape their professional practice; (c) cultural humility: listen and learn from the patients’ traditional practices; (d) cultural competence: describe current pedagogical approaches to address intercultural tensions; and (e) cultural safety: discuss with patients to reach an agreement on their treatment. Conclusion: This study integrated the perspectives of different stakeholders and proposed new applications of cultural safety that are relevant to other countries. Researchers and educators can use these results to inform future cultural safety initiatives.

The most significant change for Colombian medical trainees going transformative learning on cultural safety: qualitative results from a randomised controlled trial

“…Our narrative assessment confirmed the positive impact of cultural safety training based on our co-designed curriculum [ 24 ] for Colombian medical students and interns. The most significant changes aligned with all seven elements of the CASCADA partial order of intermediate outcomes in behaviour change.…”

“…The intervention was a game jam to create a prototype of an educational game on cultural safety. The activity included: (a) preliminary lecture on cultural safety [ 24 ] and game design; (b) game building session where groups of participants created educational games about cultural safety; and (c) play-test session in which participants played and learned from each other’s games. The lecture was based on our co-designed curriculum [ 25 ] and provided key elements of cultural safety, including (a) the definition of cultural safety; (b) consequences of cultural tensions in health care; (c) self-awareness; (d) Colombian cultural health practices; and (e) respect for patients who use traditional and cultural health practices.…”

“…The control group received a PowerPoint-based standard lecture on cultural safety plus an interactive workshop over several hours in which groups of participants created infographics to communicate selected readings on cultural safety. The control group received the same key concepts of cultural safety based on our previously co-designed curriculum [ 24 ] as the intervention group. The duration of both the intervention and control group activities was the same (eight hours).…”

“…In this qualitative assessment we were not interested in comparing the impact between intervention and control groups. Rather, we were interested in describing the perceptions of the students after receiving cultural safety training based on our co-designed curriculum [ 24 ]. From the 531 students who originally participated in the trial, we invited only medical students involved in supervised clinical practice and medical interns (third to seventh year of medical school) to participate in this part of the RCT ( n = 412).…”

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“…Juan Pimentel and co-authors wrote A co-designed curriculum for cultural safety training of Colombian health professionals: sequential-consensual qualitative study. 4 They addressed intercultural conflicts in clinical practice and designed a curriculum for cultural safety training. Their curriculum included the importance of listening and learning from patients' traditional practices.…”