measure outcomes for this standard remains marginal; even the best informed LCME site visitors have no way to assess whether both faculty and students have met the cultural competency (understanding) as set forth. In all likelihood, the visiting team’s focus would center on assessing the types of cultural competency curricular programs available for students and the content of faculty development programs being offered to address this issue.

Having been a site team visitor to several institutions, this author (Wagoner) suggests that once the LCME has strengthened existing standards and instituted new ones, the organization provide a more comprehensive training program for site visitors on how to properly interpret standards.

This critically important standard essentially speaks to the matter of trust, a subject much discussed in health professions’ literature. Trust in the doctor-patient relationship can only be established when physicians overcome preconceived biases and acquire insight and understanding into another person’s values, beliefs, and needs. In the article, “Trust, Patient Well-Being and Affirmative Action in Medical School,” DeVille highlights the importance of trust, calling it “central to the individual physician’s ability to practice good medicine.” He notes that minorities’ historical and current experience with the medical profession and health delivery system frequently breeds suspicion rather than faith. He concludes: “Society and the medical profession have a compelling interest and duty to produce physicians who inspire trust” (DeVille, 1999, p. 247). Although schools can be cited for noncompliance of this standard, this author (Wagoner) knows of no institution that has been cited for failure to achieve the outcome specified by ED–22 or for lacking a mechanism by which to assist individual students in overcoming biases.