Transferring a medical curriculum to Malaysia

Abstract

Objective: To explore the cultural challenges that emerge when delivering part of a Western medical curriculum (communication skills) in Malaysia and to generate possible solutions. The franchise of Western higher education programmes to the East is a growing phenomenon, yet there is a scarcity of discourse around curricular transfer. Methods: This was a qualitative, explorative, study drawing from the tradition of ethnography. Data collection included: participant observation, semi-structured interviews and focus group discussions. Thematic analysis followed Spradley's ethnographic technique of domain, taxonomic, componential and cultural analysis. Results: Thirty eight cultural themes emerged relating to three levels of challenge to teaching communication skills in Malaysia: Practical challenges, implementation challenges and deeper concepts. The practical level covered linguistic, translation and teaching material issues. The implementation level related to the challenge of implementing the taught communications skills (CS) into busy Malaysian clinical practice and clear differences in expectations of the doctor-patient consultation. Finally, more complex challenges to CS teaching emerged related to behavioural, emotional and cultural concepts. Conclusions: A novel conceptual framework classifying the challenges and offering potential solutions to CS teaching at NUMed has emerged based around three levels: Practical challenges including the 'localising' of content and contextual components of the course. Implementation challenges that highlight contextual differences that require further exploration within the Malaysian and other resourcelimited contexts. Deeper challenges that require local in-depth discussion and international study. This original conceptual framework addresses the complex issue of transferring curricula to cross-cultural contexts, facilitates further critical research and informs practice.