Critical elements of culturally competent communication in the medical encounter: A review and model

Teal, Cayla R.; Street, Richard L.

doi:10.1016/j.socscimed.2008.10.015

Cited by 174 publications

(132 citation statements)

References 53 publications

Supporting

Mentioning

120

Contrasting

Unclassified

Order By: Relevance

“…More and more healthcare professionals will be caring for people whose cultural backgrounds and perspectives are different from their own. [77][78][79] Cultural competency is a skill that healthcare providers including pharmacists will need to possess in order to interact effectively with patients.…”

Section: Cultural or Language Barriersmentioning

confidence: 99%

Hospital pharmacists' perceptions of medication counseling: A focus group study

Chevalier

Watson

Barras

et al. 2016

Research in Social and Administrative Pharmacy

View full text Add to dashboard Cite

BackgroundMedication counselling sessions are key times for a pharmacist to speak to patients about their medications and the changes made to their therapies during their hospital stay. ObjectivesTo explore hospital pharmacists' perceptions of their roles and goals in patient medication counselling, and perceived barriers and facilitators to achieving their goals. MethodsHospital pharmacist focus groups were held in two tertiary referral hospitals. Eligible pharmacists had provided medication counselling within the previous six months in inpatient and/or outpatient settings. Interested pharmacists attended a focus group designed to elicit their opinions and perceptions of patient medication counselling. Focus groups were audio recorded and transcribed verbatim. Inductive thematic analysis was applied to the data to identify initial patterns (codes) which were then organized into common overarching themes using NVivo ® software. The codes were reviewed for reliability by pharmacists independent of the focus groups. ResultsSix, one-hour focus groups were conducted with a total of 24 pharmacists participating. Saturation of information was determined after four focus groups. Greater than 80% consensus was achieved for reliability of the identified codes. A number of themes emerged from these codes around the goals, roles, and the barriers and facilitators to meeting these goals. Pharmacists' patient-centred goals in medication counselling were to build rapport, to empower patients and to improve patients' experience, health and safety. These goals would be accomplished through specific roles such as being an assessor, educator and problem-solver. Pharmacists frequently cited time pressures caused by systemic (hospital), and pharmacy specific processes as key challenges to achieving their goals. Factors that enabled pharmacists to meet their goals were those related to effective interprofessional collaboration and the quality of professional practice (such as training, expanded roles and advanced planning for discharge). ConclusionsHospital pharmacists emphasised patient-centred goals in medication counselling and outlined the challenges to meet those goals. The findings from this study will be used to develop strategies for effective communication and inform pharmacy practice changes to improve patient care. Key Words Hospital pharmacist Focus group Goal Role Communication M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPTPage 2 of 27 IntroductionDischarge from hospital to community or to other healthcare facilities marks an important transition in care for patients. Discharge and other transitions such as admission to hospital or transfers within a hospital have been identified as particular times when patients may be at risk of experiencing medication errors and adverse events. 1-3 Medication counselling opportunities are key times for pharmacists to speak to patients about their medications and the changes made to their therapies during their hospital stay. 2,[4][5][6][7] Failure by a hospital phar...

show abstract

Section: Cultural or Language Barriersmentioning

confidence: 99%

Hospital pharmacists' perceptions of medication counseling: A focus group study

Chevalier

Watson

Barras

et al. 2016

Research in Social and Administrative Pharmacy

View full text Add to dashboard Cite

show abstract

“…They need skills to adapt their communication style to particular patients to ensure that they properly understand the patient's problem and present information to the patient in a form the patient can understand. In the case of language barriers, this includes skills to adequately estimate patients' levels of language mastery and comprehension and to make effective use of (in)formal interpreters [13], [21].…”

Section: Communicationmentioning

confidence: 99%

How should ethnic diversity be represented in medical curricula? A plea for systematic training in cultural competence

Knipper

Seeleman

Essink-Bot

2010

TS MEDISCH ONDERWIJS

View full text Add to dashboard Cite

Ethnic diversity has become a common reality in European societies, including those of Germany and the Netherlands. Given that ethnic Michael Knipper 1 Conny Seeleman 2 minority groups and immigrants are known to be especially vulnerable Marie-Luise Essink-Bot 2 to inequalities in health, access to services and quality of care, the need for cultural competency training in medical education is widely acknowledged. This paper presents four key issues in providing medical stu- different teaching programmes depending on specific local conditions. In the conclusions, emphasis is placed on the need for systematic approaches that do not limit their focus to patients and groups of specific ethnic or migration backgrounds. Issues of culture, communication and research in relation to ethnically diverse populations are magnifications of general problems in medicine and healthcare. Explicit attention to ethnic diversity thus offers a view through a 'magnifying glass' of subjects of much broader importance and can be a means for improving health care in general. IntroductionDespite regional specificities, ethnic diversity has become a common reality of all European societies and will increasingly be so in the future. [7]. However, this general statement does not apply to all migrants or members of ethnic minority groups. Variation predominates and migration background or foreign ethnicity should not be regarded as general risk factors for disease or problems in health care. However, it has been shown that in the case of migrants, for example, physicians are more likely to conduct unnecessary diagnostic procedures or to prescribe drugs without properly defined indication [8], [9]. Providing medical students and physicians with the knowledge, attitudes and skills to adapt medical care to ethnically diverse populations is the goal of cultural competence training [10], [11], [12], [13]. In this paper, we will introduce the key topics for cultural competence training and then describe two cultural competence programmes, one at the Academic Medical Centre (AMC) / University of Amsterdam in the Netherlands and one at Giessen University Medical School in Germany. These descriptions will show that the translation of abstract educational concepts into learning objectives can lead to differing teaching programmes in line with local specificities. We end by underlining the importance of systematic cultural competence training in medical education, not only to prevent that 'ethnic diversity issues' are taught without appropriate theoretical foundation and context, but also to show that cultural competence can be a vehicle for improving health care in general [10] Key issuesBased on a framework, recently published by Seeleman and colleagues [13], we propose the following key topics for cultural competence training:1/5

show abstract

“…Many programs now focus on building clinicians' general knowledge of social and cultural barriers to care and common sources of cross-cultural misunderstanding. Combined with the teaching of clinical ethnography and intercultural communication skills, this more nuanced approach aims to encourage clinicians to identify individual manifestations of core cultural issues rather than assume adherence to cultural group characteristics related to race or ethnicity, and to explore a wide range of social and cultural factors that may influence a patient's health and health care (Carrillo et al 1999;Green et al 2002;Kleinman & Benson 2006;Jirwe et al 2009;Teal & Street 2009;Betancourt & Green 2010;Ho et al 2010). …”

Section: Introductionmentioning

confidence: 99%