Within any medical encounter, there are at least two perspectives on the cause and appropriate treatment of the presenting problem: that of the patient and that of the provider. The patient's perspective is framed within his or her cultural perspectives, as is the provider's (most notably, the medical culture). The goal of providing culturally appropriate care is to maximize the common ground between these differing perspectives.
This module is comprised of three cases, each presenting a patient whose culture differs from that of the provider or the student. The goal of each case is to learn fundamental cross-cultural skills and how to utilize them in the provision of health care services.
What is culture?
Culture is a broadly defined term with definitions varying by the context in which it is used.
Anthropologists define it as a set of systems, values, beliefs and behaviors shared by a group of people through which they view the world and one another. It passes from generation to generation via a learned process and influences what a person believes to be “normal” and “right.” It is important to remember that culture is learned through environment, not inherited through genetics. Cultures are not demarcated solely by ethnicity, and within a given culture there can be many sub-cultures. In addition, it is possible to belong to multiple cultures simultaneously. As an example:A child born in the U.S. to Taiwanese immigrant parents may be part of a Taiwanese culture, as well as an immigrant culture. Her family may practice Buddhism and, as such, she is also part of a Buddhist culture. However, by being raised in the U.S., she will attend American schools and will learn American culture from her peers. She may even practice the secular customs of Christmas, though it is not a Buddhist holiday. As she grows older, some ideals of her different cultures may come into conflict, and there may come a time when she is forced to choose certain values of one culture over the values of another, thereby creating her own unique individual culture.
Introduced in the cases below are a number of readings and other resources that may be used in your interactions with patients as well as to enhance your own personal and professional development. Direct links to these resources are provided in the cases, but they may be previewed (and re-viewed!) at The Library.
MedU's Culture in Health Care module is designed for use in both individual and team-based learning plans. See Teaching with Culture in Health Care Cases for more information.
- Case 1: 6-year-old girl with seizures -- Lily (Meghan McCoy, MD Naval Medical Center)
- Case 2: 2-year-old boy with fever and headache -- Bao (Jennifer Koestler, MD Lyuba Konopasek, MD)
- Case 3: 2-year-old with pneumonia and probable empyema -- Kenny (Sandra Sanguino, MD, MPH)
Kimberly Gifford, MD, Geisel School of Medicine (Project Co-Director)
Jerold Woodhead, MD, University of Iowa (Project Co-Director)
Jonathan Gold, MD, Michigan State University
Janice Hanson, PhD, Uniformed Services University of the Health Sciences
Meghan McCoy, MD, Naval Medical Center
Jessica Perkins, Research Assistant, Uniformed Services University of the Health Sciences
Katherine Ratzan, MS4, Geisel School of Medicine
Sandra Sanguino, MD, MPH, Northwestern University Feinberg School of Medicine
Laura Smals, MD, Drexel University College of Medicine
Antoinette Spoto-Cannons, MD, FAAP, University of South Florida College of Medicine
Mariann Suarez, PhD, ABPP, FFACBP, University of South Florida College of Medicine