Implementation
Each National Center of Excellence in Women’s Health sent a faculty representative to Boston in June 2003 to undergo training in this curriculum. In exchange, the faculty representatives agreed to implement components of the curriculum at the home institutions. At the June training, the faculty representatives brainstormed barriers and facilitators to curricular implementation, listed below.
Strategies For Implementation
- Integrate curriculum into existing learning opportunities
- Start small
- Identify other allies
- Assess which faculty could serve as additional cultural competency teachers so that you are not working in isolation
- Meet with Center of Excellence in Women’s Health Directors to assess possibilities for strategically implementing curriculum
- Integrate faculty education in Ground Rounds
- Use cases that reflect the biomedical model
- Make a case for relevance
- Link patient satisfaction data to patient care
- Describe demographics of community served
- Conduct a needs assessment so that you can tailor the curriculum to your environment
- Seek external validation and experience. Speak in your community and at other academic institutions about cultural competency. Such speaking engagements will increase the value of what you do at your home institution.
- Build in time to summarize key issues and discuss next steps at the end of your cultural competency lectures, discussions, and other learning opportunities.
- Share resources with colleagues
Barriers to Teaching about Cultural Competency
- Cultural competency is not a physical condition and is therefore less valued by the medical field as a whole
- Providers view themselves as altruistic and believe that they already sensitive to the needs of their patients
- Medicine reflects society’s ills
- Medicine focuses on diagnosis and treatment of specific diseases
- Cultural competency is not as “black or white” as some medical decision making is; it is less familiar
- Diversity is not valued; there is cultural blindness
- “Evidence” is needed to show the field of medicine that cultural competency is valuable. How do you measure this?
- Lack of time and competing topics
- Cultural competency is seen as “extra” versus integral to medical education
- Systems issues to implementation also include a lack of resources, funding, expert faculty, and an appropriately developed infrastructure
- Too big, overwhelming—frustration over making a difference. Differences can take a long time to become apparent.
- Cultural competency is marginalized
- Lack of awareness that increased cultural competence will improve care for everyone
- Conflicts and other emotions can arise from cultural competency topics. There is often a lack of knowledge about how to respond to these emotions or discomfort in addressing them, so issues are not dealt with effectively.
- Power and control in status quo
- Lack of awareness among leaders
- Lack of power among advocates for change
We welcome your comments about cultural competency curricular implementation. Please send us anecdotes about your successes, roadblocks, and ideas.
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