I will be conducting a training for a research product. The research utilizes ethnographic concepts and methods to teach medical students valued skills in cultural humility at end of life. Please see abstract below.
ABSTRACT
Background: The Association of American Medical Colleges recommends that medical students be able to demonstrate cultural competence. However, structured guidance on providing such training is lacking. Death and dying are among the most culturally diverse human experiences and represent an inevitable aspect of a physician’s practice. End-of-life training provides opportunity for physicians to gain skills in cross-cultural communication and cultural humility. Medical students are less comfortable with palliative care than their colleagues in social work, nursing and chaplaincy, with only 19% of medical students and 50% of residents appropriately discussing death with patients. Training the physician as an ethnographer with an obligation to consider beliefs, rituals and traditions offers a novel approach to delivering insightful patient care.
Description: This study explores the value of a novel end-of-life training created for the Y2 cancer survivorship elective at Frank H. Netter MD School of Medicine. Grounded in ethnographic principles and participatory learning, this material was built to prompt student discussions on how beliefs may influence communication and end-of-life care. To initiate discussion, Y2 students were provided material on commonly held beliefs pertaining to death, preparation of the body, and funeral practices. Students then engaged in training on ethnographic methods of learning about patients and their wishes. To assess their progress, students participated in a partner activity, using “wish cards” to practice their ability to appropriately and comfortably engage in end-of-life conversation.
Evaluation: Pre- and post-training surveys were conducted to evaluate students’ comfort with end-of-life dialogue. Survey findings were analyzed and compared to assess students’ perceptions of what it means to be a physician in a culturally diverse community. Findings revealed that students had expanded and enhanced their perceptions of culturally-sensitive end-of-life care.
Impact: This training provides a framework for better preparing students to engage with diverse patients at end of life and throughout cancer care. Future iterations or applications of this training may help students develop stronger abilities to demonstrate curiosity, communicate cross-culturally, and deliver high-quality patient care.
LEARNING OBJECTIVES: The participant will be able to (1) identify at least two ethnographic techniques that can be used to learn about culturally diverse cancer patients; (2) articulate the value of wish cards as a practical activity to prepare undergraduate medical students to discuss end-of-life care; and (3) recognize end-of-life care as a meaningful platform for physician training in cultural competence.
