Abdesalam Soudi, Jeannette South-Paul
ABSTRACT
Described in this paper is an example of integrating humanities into health interventions or clinical care via a Masters course for graduate students in medical education. The paper outlines the background of the authors (a linguist and a family physician) and explores how their diverse experiences have impacted course development. It describes an increasing number of clinical cases in a large academic health center that spotlight cultural discordancy and subsequent barriers to quality clinician-patient communication and decision-making. It focuses on cultural and linguistic competency and demonstrates how these skills enhance our understanding of social determinants of health. Lastly, it identifies new areas for improving the quality of care in our increasingly diverse community.
KEYWORDS
Cultural competence; medical education; doctor-patient interaction; social determinants; language barriers in healthcare; medical discourse; Limited English Proficiency (LEP) populations; minorities; immigrant and refugee health, person centered health
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REFERENCES
Camille, R. (2013). Language use in the United States: 2011, American Community Survey. U.S. Census Bureau. Available at: https://www.census.gov/prod/2013pubs/acs-22.pdf (Last accessed 15 June 2017).
Miles, A., Asbridge, J.E. & Caballero, F. (2015). Towards a person-centered medical education: challenges and imperatives. Educación Médica 16 (1) 25-33.
Miles, A. & Asbridge, J.E. (2017). Person-Centered Healthcare - moving from rhetoric to methods, through implementation to outcomes. European Journal for Person Centered Healthcare 5 (1) 1-9.
Liaison Committee on Medical Education. (2016). Functions and Structure of a Medical School: Standards for Accreditation of Medical Education Programs Leading to the MD Degree. Available at: https://med.virginia.edu/ume-curriculum/wp content/uploads/sites/216/2016/07/2017-18_Functions-and-Structure_2016-03-24.pdf (Last accessed 8 July 2017).
U.S. Department of Health and Human Services, Office of Minority Health. (2016). National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care: Compendium of State-Sponsored National CLAS Standards Implementation Activities. Washington, DC: U.S. Department of Health and Human Services. Available at: https://www.thinkculturalhealth.hhs.gov/assets/pdfs/CLASCompendium.pdf (Accessed 4 June 2017).
Allegheny County Health Department. (2015). Community Health Assessment. Available at: http://www.achd.net/cha/CHA_Report-Final_42815.pdf
Gallagher, P. (2017). Pittsburgh Myth, Paris Reality. Science 356 (6343) 1103.
Mansouri-Rad, P., Mahmood, M.A. & Thompson, S.E. (2013). Culture matters: Factors affecting the adoption of telemedicine. System Sciences IEEE 2013, 46th Hawaii international conference, Hawaii, 7-10 January 2013, pp. 2525-2524.
Stillman, P., Regan, M. & Swanson, D. (1987). Diagnostic fourth-year performance assessment. Archives of Internal Medicine 19, 1981-1985.
Schyve, P. (2007). Language differences as a barrier to quality and safety in health care: The Joint Commission perspective. Journal of General Internal Medicine 22 (S2) 360-361.
Baker, E. A., Metzler, M.M. & Galea, S. (2005). Addressing social determinants of health inequities: learning from doing. American Journal of Public Health 95 (4) 553-555.
Kiesling, S. (2009). Style as stance: Can stance be the primary explanation for patterns of sociolinguistic variation? In: Sociolinguistic Perspectives on Stance. Alexandra Jaffe (ed.) pp. 171-194. Oxford: Oxford University Press.
Kiesling, S. & Paulston, C. (2005). Intercultural Discourse and Communication: The Essential Readings. Malden, MA: Blackwell Publishers.
Gumperz, J. (1982). Discourse strategies. Cambridge: Cambridge University Press.
Tannen, D. (1984). Conversational Style: Analyzing Talk Among Friends. Oxford: Oxford University Press.
Heritage, J. & Maynard, D.W. (2006). Communication in medical care: Interaction between primary care physicians and patients. Cambridge: Cambridge University Press.
Mishler, E. (1984). The discourse of medicine: Dialectics of medical interviews. Norwood, NJ: Ablex.
Cooper-Patrick, L. (1999). Race, gender, and partnership in the patient-physician relationship. Journal of the American Medical Association 282 (6) 583-589.
Soudi, A. (2016) What’s in your culture box, Pitt Chronicle. September 19, 2016.
Available at: http://www.chronicle.pitt.edu/story/first-person-what%E2%80%99s-your-culture-box (Last accessed 25 May 2017).
Bennett, M.J. (1986). A developmental approach to training for intercultural sensitivity. International Journal of Intercultural Relations 10, 179-196.
Soudi, A., Chang, J., Gooden, S., Kiesling, S. & South-Paul, J. (2016). Humanities in Health Conference (HinH 2016). Being human: the year of the humanities in the university. Available at: http://www.linguistics.pitt.edu/humanitiesinhealth/HinH%20Conference%20Program%20draft%2003042016.pdf (Last accessed 16 June 2017).
Soudi, A., South-Paul, J., Chang, J., Gooden, S. & Kiesling, S. (2017). Cultural and Linguistic Diversity: Living and Working Together. Available at: http://www.linguistics.pitt.edu/CulturalandLinguisticDiversity/Cultural%20&%20LInguistic%20Diversity%20Conference%20Booklet.pdf. (Last accessed 17 July 2017).