Serving an Indigenous community: Exploring the cultural competence of medical students in a rural setting

Abstract

Since 2013, medical students from the International Medical University (IMU) in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this community service in their personal and professional development. 
 
 Students who participated in the project were required to complete a questionnaire after each community engagement activity to help them reflect on the above areas. We analysed the responses of students from January to December 2015 using a thematic analysis approach to identify overarching themes in the students’ responses.
 
 Students had differing perceptions of culture and worldviews when compared to the indigenous people. However, they lacked the self-reflection skills necessary to understand how such differences can affect their relationship with the indigenous people. Because of this, the basis of their engagement with the indigenous community (as demonstrated by their views of community service) is focused on their agenda of promoting health from a student’s perspective rather than connecting and building relationships first. Students also lacked the appreciation that building cultural competency is a continuous process.
 
 The results show that the medical students have a developing cultural competence. The project in Kampung Sebir is an experiential learning platform of great value to provide insights into and develop the cultural competency of participating students. This study also reflects on the project itself, and how the relationship with stakeholders, the competence and diversity of academic staff, and the support of the university can contribute toward training in cultural competence.

Responding to change in a medical student rural community service: Insights from activity theory

“…2 Its theoretical underpinnings can be attributed to John Dewey, who posited that the key to learning is the interaction of knowledge and skills with experience. 3,4 Numerous studies have presented benefits of service-learning during health care training, such as gaining intra-/interpersonal skills [5][6][7][8][9] and acquiring both academic and professional skills. [10][11][12] Furthermore, service-learning has led to civic engagement and social responsibility.…”

“…16 However, given sociocultural differences as compared with Western contexts, most community service-learning in Asian countries has been student-initiated and voluntary. 9,17,18 Moreover, the biomedical model of treating disease and organic malfunction prevails within the Asian context.…”

“…Over the past decade, medical schools have begun to incorporate community service into their official structured curriculum in response to the need for a greater focus on rural community health 16 . However, given socio‐cultural differences as compared with Western contexts, most community service‐learning in Asian countries has been student‐initiated and voluntary 9,17,18 . Moreover, the biomedical model of treating disease and organic malfunction prevails within the Asian context.…”

Ethical collaboration and the need for training: Partnerships between Native American Tribes and climate science organisations

“…Second, further research is needed at the Tribe-CSO nexus to develop ethical STEM training and evaluation. Literature on training scientists to engage with diverse communities is sparse and often related to medical research (Beach et al 2005;Minkler 2005;Wong et al 2017), thus not addressing the specific challenges that climate change researchers might encounter when working with Indigenous peoples. Several training activities were identified by our interviewees, with most CSOs engaging in some training activities.…”