Medical Education for a Changing World: Moving Beyond Cultural Competence into Transnational Competence

Abstract

Given rapidly changing global demographic dynamics and the unimpressive evidence regarding health outcomes attributable to cultural competence (CC) education, it is time to consider a fresh and unencumbered approach to preparing physicians to reduce health disparities and care for ethnoculturally and socially diverse patients, including migrants. Transnational competence (TC) education offers a comprehensive set of core skills derived from international relations, cross-cultural psychology, and intercultural communication that are also applicable for medical education. The authors discuss five limitations (conceptual, vision, action, alliance, and pedagogical) of current CC approaches and explain how an educational model based on TC would address each problem area.The authors then identify and discuss the skill domains, core principles, and reinforcing pedagogy of TC education. The five skill domains of TC are analytic, emotional, creative, communicative, and functional; core principles include a comprehensive and consistent framework, patient-centered learning, and competency assessment. A central component of TC pedagogy is having students prepare a "miniethnography" for each patient that addresses not only issues related to physical and mental health, but also experiences related to dislocation and adaptation to unfamiliar settings. The TC approach promotes advances in preparing medical students to reduce health disparities among patients with multiple and diverse backgrounds, health conditions, and health care beliefs and practices. Perhaps most important, TC consistently directs attention to the policy and social factors, as well as the individual considerations, that can alleviate suffering and enhance health and well-being in a globalizing world.

Promoting Quality Care for Recently Resettled Populations: Curriculum Development for Internal Medicine Residents

“…13 The second is that of transnational competence, in which competence represents aptitude in 5 distinct skill sets: analytical, emotional, creative, communicative, and functional. 14 …”

Développement professoral : hier, aujourd’hui et demain Guide AMEE n°36

“…L'éducation transnationale est définie comme étant « l'intersection d'étudiants internationaux, d'enseignants internationaux et d'un curriculum international adapté aux besoins locaux » [96] , alors que la « compétence transnationale » fait référence à la formation médicale qui traite de la santé dans le contexte de la migration mondiale [162] . Puisque l'éducation médicale transnationale (menant à la compétence transnationale) doit former et fournir des étudiants internationaux, le curriculum doit combler les besoins locaux et internationaux en santé [94,155] .…”

Exploring the Theoretical Framework of Cultural Competency Training

“…[1][2][3][4][5][6][7] Cultural competency training in medical education has been emphasized since the early 2000s. [8][9][10][11][12][13] The phrase "cultural competence" has been defined as the ability of a medical provider to possess the cultural awareness, knowledge, and skills to effectively and respectfully obtain a thorough medical history that will enable the provider to accurately diagnose the medical problem and collaborate with the patient to develop a management plan.…”