An exploration into the awareness and perceptions of medical students of the psychosociocultural factors which influence the consultation: implications for teaching and learning of health professionals

ABSTRACT

Background. South African society is undergoing rapid changes; and includes people from different cultures; beliefs and social backgrounds. Research suggests that these contextual influences have an important bearing on how patients present and relate to healthcare providers. Medical students; too; have a life-world based on their own backgrounds and cultures; and may find relating to a patient with a different life-world challenging. Objectives. To explore students' awareness and perceptions of how psychosociocultural factors in a multicultural society influence the consultation; and to suggest adaptations for teaching. Methods. Focus group discussions were conducted with final-year medical students in the Family Medicine rotation. Some of the students had viewed a video of a consultation with an isiZulu-speaking patient; and completed a self-reflection learning task. Audio recordings were transcribed and analysed thematically. Results. Exposure to patients in the clinical years had made students aware of the challenges of cultural diversity; although they felt under-prepared to deal with this. Students alluded to the influences of their own cultures; of cultural similarities as well as differences; the roles and behaviours of doctors and patients in cross-cultural consultations; the potential knowledge and experience gap that exists across cultures; and an awareness of the need for patient-centredness. Conclusion. Students should be assisted to improve their cultural competence. Recommendations are made for using various methods; including critical incidents and visual learning to provide opportunities for reflexive practice and transformative learning. Educators must be equipped to address learning objectives relating to cultural competence