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Societies
Special Issues
Cultural Competence in Healthcare and Healthcare Education
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Cultural Competence in Healthcare and Healthcare Education

A special issue of Societies (ISSN 2075-4698).

Deadline for manuscript submissions: closed (20 May 2022) | Viewed by 39095

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Prof. Dr. Costas S Constantinou

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Guest Editor
Medical School, University of Nicosia, Nicosia 2417, Cyprus
Interests: illness experience; illness narratives; aging; organ donation and transplantation; cultural competence; teaching medical sociology; medical education; social theory; qualitative research methodology
Special Issues, Collections and Topics in MDPI journals
Dr. Panayiota Andreou

E-Mail Website
Guest Editor
Medical School, University of Nicosia, Nicosia 2417, Cyprus
Interests: rationing or missed care in clinical settings; dementia care and caregiver burden; older age and health behaviour change; cognitive and behavioural factors underlying primary care consultation visits
Dr. Monica Nikitara

E-Mail Website
Guest Editor
Nursing, University of Nicosia, Nicosia 2417, Cyprus
Interests: cultural competence in nursing education; patient education; transcultural nursing; diabetes education
Dr. Alexia Papageorgiou

E-Mail Website
Guest Editor
Medical School, University of Nicosia, Nicosia 2417, Cyprus
Interests: cultural competence in medical education; clinical communication in health care; personality and its role in changing health behaviours; psychiatric and medical advance statements

Special Issue Information

Dear Colleague,

Inequalities in healthcare constitute the main challenge in contemporary societies and a domain that needs immediate attention in an era of globalization, diversity and multiculturalism. The cultural competence of healthcare professionals has been acknowledged as an important skill for helping reducing health disparities and it is supported by research, indicating a link with patient satisfaction and adherence to therapy.

This Special Issue invites researchers, teachers and academics to submit their work on cultural competence in healthcare and healthcare education. Articles, reviews and concept papers could focus on cultural competence or other related concepts, such as diversity competence, structural competence, intercultural communication, cultural awareness, cultural humility, cultural sensitivity, cultural empathy, cultural intelligence etc., in relation to the following:

  • Definition and measurement tools
  • Curriculum
  • Teaching and/or assessment methods or models
  • Integration of sociology and anthropology in healthcare education
  • Allied healthcare sciences (physiotherapy, psychology, social work etc.)
  • Health outcomes and adherence to therapy
  • Patient satisfaction
  • Racism and xenophobia
  • Working with interpreters
  • Clinical communication
  • Intersectionality
  • Working with diverse populations (i.e., patients, students, colleagues)
  • Critical reflection on own beliefs
  • Social and cultural determinants of health, illness and healthcare
  • COVID-19, pandemics
  • Other topics that relate to working effectively with patients regardless of their social and cultural background, and lifestyle and identity

Note: In the event that your work is not reflected in the list above and you are interested in submitting to this Special Issue, please contact Dr Costas S Constantinou [email protected].

Dr. Costas S Constantinou
Dr. Panayiota Andreou
Dr. Monica Nikitara
Dr. Alexia Papageorgiou
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as conceptual papers are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Societies is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cultural competence
  • diversity
  • healthcare
  • healthcare education
  • clinical communication
  • health inequalities

Published Papers (10 papers)

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Editorial

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4 pages, 198 KiB  
Editorial
Cultural Competence in Healthcare and Healthcare Education
by Costas S. Constantinou, Panayiota Andreou, Monica Nikitara and Alexia Papageorgiou
Societies 2022, 12(6), 178; https://0-doi-org.brum.beds.ac.uk/10.3390/soc12060178 - 29 Nov 2022
Cited by 1 | Viewed by 2599
Abstract
Cultural competence in healthcare has been defined in many ways; however, it generally refers to knowledge of social and cultural factors that influence illness and related behaviour, and actions taken to provide the best of quality care considering each patient’s background [...] Full article
(This article belongs to the Special Issue Cultural Competence in Healthcare and Healthcare Education)

Research

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17 pages, 287 KiB  
Article
The Impact of Information Sessions on Women’s Anxiety When Facing a Voluntary Termination of Pregnancy (VTP)—A Case Study about Geneva University Hospitals (Switzerland)
by Eva Medina
Societies 2022, 12(5), 126; https://0-doi-org.brum.beds.ac.uk/10.3390/soc12050126 - 09 Sep 2022
Cited by 2 | Viewed by 1703
Abstract
Women going through a termination of their pregnancy (VTP) face a stressful situation that should be managed by hospitals in a multidisciplinary way: law, public health, and communication. This paper aims to analyze how the information sessions organized by hospitals influence women’s decisions [...] Read more.
Women going through a termination of their pregnancy (VTP) face a stressful situation that should be managed by hospitals in a multidisciplinary way: law, public health, and communication. This paper aims to analyze how the information sessions organized by hospitals influence women’s decisions when facing a VTP. To achieve that, we resorted to four main methodologies: (a) literature review about law, public health, and communication; (b) a 4-week participant observation at Port Royal Hospital (France) and in a social restaurant in Katowice (Poland), as well as three focus groups in the first institution (2012); (c) an online survey addressed to 500 women in Poland, France, and Switzerland (2012–2014); and (d) two focus groups and one deep interview with doctors and nurses from Geneva University Hospitals and Lausanne University Hospital in Switzerland (2017–2018). Based on our quantitative results, we developed a medical protocol to help doctors interact with patients going through a VTP. This protocol was approved by the Geneva University Hospitals’ Ethics Committee (BASEC 2018-01983). We concluded that women’s informed consent is an intimate, reciprocal decision; doctors should help them to make independent decisions; and hospitals need to establish a harmonized discourse based on a code of internal communication, train their doctors in communication skills, and help them adopt a more flexible approach when taking care of these patients. Full article
(This article belongs to the Special Issue Cultural Competence in Healthcare and Healthcare Education)
20 pages, 337 KiB  
Article
Sickle Cell Disease in Bahia, Brazil: The Social Production of Health Policies and Institutional Neglect
by Clarice Mota, Leny A. B. Trad and Lisa Dikomitis
Societies 2022, 12(4), 108; https://0-doi-org.brum.beds.ac.uk/10.3390/soc12040108 - 18 Jul 2022
Cited by 4 | Viewed by 2295
Abstract
A disease is considered neglected when it is not given due priority in health policies despite the social relevance of that disease, either in terms of the number of individuals affected by it or its morbidity or mortality. Although the causes are structural, [...] Read more.
A disease is considered neglected when it is not given due priority in health policies despite the social relevance of that disease, either in terms of the number of individuals affected by it or its morbidity or mortality. Although the causes are structural, neglect in health does not occur in a vacuum. In this paper, we explore how sickle cell disease (SCD) is constructed and neglected in Brazil, based on insights from our long-term participatory qualitative research in the state of Bahia. We present five overarching themes relevant to the social production of SCD, and associated health policies in Brazil: (1) The achievements and setbacks to overcome neglect in SCD, (2) Continuity of comprehensive SCD care; (3) Social movements of people with SCD; (4) Biocultural citizenship; and (5) Academic advocacy. We conclude that it is insufficient to merely recognize the health inequities that differentiate white and black populations in Brazil; racism must be understood as both a producer and a reproducer of this process of neglect. We conclude with a set of recommendations for the main SCD stakeholder groups committed to improving the lives of people living with SCD. Full article
(This article belongs to the Special Issue Cultural Competence in Healthcare and Healthcare Education)
20 pages, 2232 KiB  
Article
Embedding Behavioral and Social Sciences across the Medical Curriculum: (Auto) Ethnographic Insights from Medical Schools in the United Kingdom
by Lisa Dikomitis, Brianne Wenning, Andrew Ghobrial and Karen M. Adams
Societies 2022, 12(4), 101; https://0-doi-org.brum.beds.ac.uk/10.3390/soc12040101 - 30 Jun 2022
Cited by 2 | Viewed by 2539
Abstract
Key concepts and theories that are taught in order to develop cultural competency skills are often introduced to medical students throughout behavioral and social science (BSS) learning content. BSS represents a core component of medical education in the United Kingdom. In this paper, [...] Read more.
Key concepts and theories that are taught in order to develop cultural competency skills are often introduced to medical students throughout behavioral and social science (BSS) learning content. BSS represents a core component of medical education in the United Kingdom. In this paper, we examine, through (auto)ethnographic data and reflections, the experiences of BSS in medical education. The empirical data and insights have been collected in two ways: (1) through long-term ethnographic fieldwork among medical students and (2) via autoethnographic reflexive practice undertaken by the co-authors who studied, worked, examined, and collaborated with colleagues at different UK medical schools. Our findings indicate that despite BSS constituting a mandatory, essential component of the medical curriculum, medical students did not always perceive BSS as useful for their future practice as doctors, nor did they find it to be clinically relevant, in comparison to the biomedical learning content. We suggest that it is paramount for all stakeholders to commit to cultivating and developing cultural competency skills in medical education, through robustly embedding BSS learning content across the undergraduate medical curriculum. We conclude with recommendations for a wide range of educational practices that would ensure a full integration of BSS in the medical curriculum. Full article
(This article belongs to the Special Issue Cultural Competence in Healthcare and Healthcare Education)
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14 pages, 577 KiB  
Article
Standing Up for Culturally Competent Care in Portugal: The Experience of a “Health in Equality” Online Training Program on Individual and Cultural Diversity
by Violeta Alarcão, Sandra Roberto, Thais França and Carla Moleiro
Societies 2022, 12(3), 80; https://0-doi-org.brum.beds.ac.uk/10.3390/soc12030080 - 17 May 2022
Cited by 2 | Viewed by 2324
Abstract
Health professionals play an essential role in the protection and promotion of health rights without distinction of sex, sexual orientation, gender identity and expression, ethnicity/race, nationality and migration status, age, functional diversity, or any other individual and/or cultural positions. With the growing diversity [...] Read more.
Health professionals play an essential role in the protection and promotion of health rights without distinction of sex, sexual orientation, gender identity and expression, ethnicity/race, nationality and migration status, age, functional diversity, or any other individual and/or cultural positions. With the growing diversity of patient populations, health professionals must be able to identify and be responsive to individual and cultural diversity, ensuring equity in access to high-quality individually-centered care. For this, it is fundamental to promote training in cultural competence, understood as responsivity and the ability to work the valorization of multiple and intersectional identities throughout life. The paper aims to describe the experience of the implementation of the program “Health in Equality”, aimed at training the primary healthcare workforce in Portugal, which was based on Sue and Sue’s (2008) three-dimensional model of multicultural skills, which champions cultural best practices in an intersectional perspective. Based on the trainees’ and trainers’ evaluation of four completed editions developed online between March and July 2021, this study discusses ways to improve the impact of the training program and amplify the number of leaders and role models for other health care providers towards culturally competent healthcare systems and organizations. Full article
(This article belongs to the Special Issue Cultural Competence in Healthcare and Healthcare Education)
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12 pages, 278 KiB  
Article
On the Role of Structural Competency in the Healthcare of Migrant with Precarious Residency Status
by Jérémy Geeraert
Societies 2022, 12(2), 54; https://0-doi-org.brum.beds.ac.uk/10.3390/soc12020054 - 25 Mar 2022
Cited by 1 | Viewed by 2041
Abstract
The literature on the health care of migrant patients has often emphasized the importance of cultural skills and cultural humility that caregivers must bring to their care. Recent work has emphasized the importance of adopting a structural reading of this competency. Based on [...] Read more.
The literature on the health care of migrant patients has often emphasized the importance of cultural skills and cultural humility that caregivers must bring to their care. Recent work has emphasized the importance of adopting a structural reading of this competency. Based on two empirical surveys conducted in France and Germany in facilities providing access to care for migrants with precarious residency status, this article demonstrates the importance of competency linking in terms of what is produced by structures and institutions and what is produced during medical interactions between patients, medical professionals, and volunteers. The complexity of accessing health protection systems for migrants with precarious residency status is often the main structural and institutional barrier to care. To remove this barrier, health professionals can develop legal and administrative competency regarding residency and health rights. They can also develop institutional and practical competency regarding the possibilities of access to health care for people without health coverage in the local geographical context. Structural competency is also effective in deconstructing the stigma and discrimination that minority groups experience in the healthcare system. Full article
(This article belongs to the Special Issue Cultural Competence in Healthcare and Healthcare Education)
11 pages, 261 KiB  
Article
Cultural Competence and the Role of the Patient’s Mother Tongue: An Exploratory Study of Health Professionals’ Perceptions
by Isabel García-Izquierdo and Vicent Montalt
Societies 2022, 12(2), 53; https://0-doi-org.brum.beds.ac.uk/10.3390/soc12020053 - 23 Mar 2022
Cited by 3 | Viewed by 2980
Abstract
The role of the patient’s mother tongue in clinical communication is of vital importance and yet it is not always dealt with adequately by healthcare professionals and healthcare systems. Cultural competence should deal with and redress asymmetries in doctor–patient communication, including those having [...] Read more.
The role of the patient’s mother tongue in clinical communication is of vital importance and yet it is not always dealt with adequately by healthcare professionals and healthcare systems. Cultural competence should deal with and redress asymmetries in doctor–patient communication, including those having an impact on the patient’s mother tongue. The aim of this study was to answer a research question: what are the health professionals’ perceptions of the importance and role of the patients’ mother tongue in diglossic situations? To answer our research question, we carried out two focus groups, one with doctors and another with nurses working in public hospitals in the Valencian Community (Spain) where two languages share officiality, Catalan and Spanish. Yet, Catalan is a right and Spanish a duty. The results showed that perceptions of professionals in relation to the importance of the patient’s mother tongue in situations in which two official languages coexist in an asymmetric relationship vary a great deal and seem to form a continuum of positive and negative judgements. Different values were represented in the participants’ perceptions, ranging from respect for and full alignment with the patient’s perspective to negative perceptions. More qualitative and quantitative research on health professionals’ attitudes and values is needed to understand the role of the patient’s mother tongue in clinical communication. Educational and institutional efforts are also needed to redress the linguistic and cultural asymmetries that have a negative impact on patients in terms of inequality, inefficiency, and even exclusion. Full article
(This article belongs to the Special Issue Cultural Competence in Healthcare and Healthcare Education)
23 pages, 754 KiB  
Article
Diversity Competence in Healthcare: Experts’ Views on the Most Important Skills in Caring for Migrant and Minority Patients
by Sandra Ziegler, Camilla Michaëlis and Janne Sørensen
Societies 2022, 12(2), 43; https://0-doi-org.brum.beds.ac.uk/10.3390/soc12020043 - 09 Mar 2022
Cited by 9 | Viewed by 9090
Abstract
Many researchers and practitioners agree that a specific skillset helps to provide good healthcare to migrant and minority patients. The sciences offer multiple terms for what we are calling ‘diversity competence’. We assume that teaching and developing this competence is a complex, time-consuming [...] Read more.
Many researchers and practitioners agree that a specific skillset helps to provide good healthcare to migrant and minority patients. The sciences offer multiple terms for what we are calling ‘diversity competence’. We assume that teaching and developing this competence is a complex, time-consuming task, yet health professionals’ time for further training is limited. Consequently, teaching objectives must be prioritised when creating a short, basic course to foster professionals’ diversity competence. Therefore, we ask: ‘What knowledge, attitudes and skills are most important to enable health professionals to take equally good care of all patients in evermore diverse, modern societies that include migrant and (ethnic) minority patients?’ By means of a modified, two-round Delphi study, 31 clinical and academic migrant health experts from 13 European countries were asked this question. The expert panel reached consensus on many competences, especially regarding attitudes and practical skills. We can provide a competence ranking that will inform teaching initiatives. Furthermore, we have derived a working definition of ‘diversity competence of health professionals’, and discuss the advantages of the informed and conscious use of a ‘diversity’ instead of ‘intercultural’ terminology. Full article
(This article belongs to the Special Issue Cultural Competence in Healthcare and Healthcare Education)
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Review

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20 pages, 882 KiB  
Review
The Use of Interpreters in Medical Education: A Narrative Literature Review
by Costas S. Constantinou, Andrew Timothy Ng, Chase Beverley Becker, Parmida Enayati Zadeh and Alexia Papageorgiou
Societies 2021, 11(3), 70; https://0-doi-org.brum.beds.ac.uk/10.3390/soc11030070 - 01 Jul 2021
Cited by 1 | Viewed by 2943
Abstract
This paper presents the results of a narrative literature review on the use of interpreters in medical education. A careful search strategy was based on keywords and inclusion and exclusion criteria, and used the databases PubMed, Medline Ovid, Google Scholar, Scopus, CINAHL, and [...] Read more.
This paper presents the results of a narrative literature review on the use of interpreters in medical education. A careful search strategy was based on keywords and inclusion and exclusion criteria, and used the databases PubMed, Medline Ovid, Google Scholar, Scopus, CINAHL, and EBSCO. The search strategy resulted in 20 articles, which reflected the research aim and were reviewed on the basis of an interpretive approach. They were then critically appraised in accordance with the “critical assessment skills programme” guidelines. Results showed that the use of interpreters in medical education as part of the curriculum is scarce, but students have been trained in how to work with interpreters when interviewing patients to fully develop their skills. The study highlights the importance of integrating the use of interpreters in medical curricula, proposes a framework for achieving this, and suggests pertinent research questions for enriching cultural competence. Full article
(This article belongs to the Special Issue Cultural Competence in Healthcare and Healthcare Education)
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Other

13 pages, 244 KiB  
Concept Paper
Cultural Competence in Healthcare Leadership Education and Development
by Steve Gulati and Catherine Weir
Societies 2022, 12(2), 39; https://0-doi-org.brum.beds.ac.uk/10.3390/soc12020039 - 02 Mar 2022
Cited by 2 | Viewed by 8352
Abstract
Cultural competence is a phenomenon that straddles many disciplines and fields of study. There is no settled definition of the term, and it is argued that this is not necessary to explore or discuss the phenomenon as it is context-dependent across diverse societies. [...] Read more.
Cultural competence is a phenomenon that straddles many disciplines and fields of study. There is no settled definition of the term, and it is argued that this is not necessary to explore or discuss the phenomenon as it is context-dependent across diverse societies. Explorations of cultural competence in clinical education and training are well-established, but there has been less attention towards its expression in the field of developing healthcare leaders. There is a debate about whether cultural competence is best achieved primarily through training-based educational inputs or by being infused in all areas of curriculum development. Using an exploration of selected literature followed by the case of an ambitious set of leadership development programmes in the English National Health Service, this paper explores the balance and interdependencies of cultural competence in healthcare leadership development as knowledge, skills and attitudes. The paper concludes that it is important for educators in this field to provide space for reflection, develop skills of reflexivity and facilitate sensitive discussions of sometimes contested ideas and concepts. A further evaluation of the impact of teaching and learning interventions, while mapping developments in perceptions of knowledge, skill and attitudes would be an area ripe for future research. Full article
(This article belongs to the Special Issue Cultural Competence in Healthcare and Healthcare Education)
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