Cultural Competency of Medical Students: An Asian Context

@#Introduction: People of different cultures perceive health and disease differently. A culturally competent healthcare team is needed to provide quality healthcare. In Asian medical schools, less emphasis is laid on cultural competency training. In this context, the study aims to assess the cultural competency of medical students in Malaysia and to fathom the demographic factors influencing it. Methods: A cross sectional survey was conducted on students from all five years of a Malaysian medical school using an adapted version of Clinical Cultural Competency Questionnaire (CCCQ) to tap the self-perceived knowledge, skills, comfort level in cross-cultural encounters and attitude towards cultural competency. Descriptive and inferential statistics was used to analyse the data. Results: Among the 291 respondents, the cultural competency was found to be significantly different among medical students of different year of study, age, and ethnicity. However, with regards to gender, country of birth or the number of languages spoken, the difference was insignificant. The clinical year students had significantly higher scores on the knowledge, skills, comfort level and attitude domains of cultural competency when compared to the preclinical students. Chinese students’ perception on cultural competence was significantly distinct from Indian and Malay students. Conclusion: Exposure to cross cultural encounters in clinical settings and personal experiences seem to influence cultural competency of the medical students. It provides valuable data to plan for interventions, training and self-development strategies aimed at providing culturally attuned patient centred care.

The Applicability of Experiential Learning Theory to Complex Work-based Learning Situations

@#Introduction: The objective of the study was to explore the aspects of work-based learning environments and to identify the factors that stimulate or inhibit learning based on the theoretical framework of experiential learning. Utilizing Kolb’s learning cycle, the authors aimed to describe, compare and analyze two learning situations in undergraduate medical education, and to consolidate recommendations based on the theoretical principles. Methods: Data collection was done through a qualitative approach by interviews and observations at two institutes for 4th year undergraduate medical students in a tertiary hospital in Malaysia and in Singapore. Results: Kolb’s learning cycle stages can be linked to the learning situations. Both institutions had the problem of high student to educator ratios. There was limited opportunity for the students to examine and present patients. Time limitation was another constraint as not all students could perform physical examinations. These inadequate opportunities to apply knowledge and active participation limited the “concrete experience”. As discussion and feedback sessions were insufficient, the “reflective observation” and “conceptualization” stages were also compromised. Educators had difficulty determining if students made sense of the cases and if their learning was adequate. “Active experimentation” was also limited to end-of-posting examination only. Conclusion: Kolb’s learning cycle from the experiential learning theory can be used in these learning contexts to identify methods to improve students’ knowledge and skills acquisition, as well as to encourage reflection and applied learning.