within limited classroom time. Yet curricular change can serve as an important component of an overall strategy to support and harness the benefits of classroom diversity. Such changes are consistent with the growing need to produce new health professionals who possess cross-cultural skills and can meet the demands of an increasingly diverse patient population (Betancourt et al., 2002; Brach and Fraser, 2000; Tedesco, 2001).

Cross-cultural education strategies—defined as programs to help trainees to understand the sociocultural dimensions underlying a patient’s health values, beliefs, and behavior, with the goal of preparing trainees to care for patients from diverse social and cultural backgrounds and to recognize and address racial, cultural, and gender biases in health-care delivery—are increasingly being developed and implemented in medical, dental, nursing, and professional psychology training settings (Brach and Fraser, 2000). These strategies have been developed to meet at least three demands. First, cross-cultural education is expected to provide students with the skills and knowledge that they will need as future health professionals working with diverse patient populations. Second, cross-cultural education can be expected to help improve patient outcomes and narrow the racial–ethnic gap in health-care quality observed in many studies. Third, such training is increasingly being required by accreditation and licensure bodies (Betancourt, 2003).

Three conceptual approaches are predominant in cross-cultural education models. The first, which emphasizes teaching cultural sensitivity and awareness, is “based on the attitudes central to professionalism—humility, empathy, curiosity, respect, sensitivity, and awareness of all outside influences on the patient” (Betancourt, 2003, p. 561). The primary focus of this approach is to expand trainees’ awareness of the impact of sociocultural factors, such as culture, racism, social class, and the social construction of gender roles, on patients’ health attitudes and behaviors (Brach and Fraser, 2000). Furthermore, this model of training explores how sociocultural factors influence the provision and quality of health care and health-care outcomes (Betancourt et al., 2002). As noted above, such training can be enhanced by the diverse backgrounds and experiences of a multiracial, multiethnic student and faculty body and by the sharing of diverse experiences and perspectives in the classroom.

A second cross-cultural education model, focused on multicultural or categorical approaches, emphasizes the acquisition of knowledge about the attitudes, values, beliefs, and behaviors of cultural groups. Such training, however, risks promoting stereotypes through the use of broad-based generalizations that fail to account for the heterogeneity within cultural groups. Effective forms of this approach train students to develop methods of community assessment and evidence-based facts regarding cultural groups, such



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement