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

Abstract

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

Toward diversity-responsive medical education: taking an intersectionality-based approach to a curriculum evaluation

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