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| By Anita Martin |
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| Medical school
sharpens the senses. Eyes detect subtle imbalances,
hands track changes, and ears listen with heightened
diagnostic awareness. But anatomical savvy and keen
diagnoses alone won’t cut it in today’s medical
world. The various views and priorities of
humanity’s diverse cultures rival—and perhaps
surpass—the complexity of the human body itself.
Culture informs a patient’s perception of, and
decisions about, health care. |
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| From 1990 to 2000,
the United States Census saw an increase in every
minority population, including a 23 percent jump in
the Hispanic population. Columbus, Ohio, is home to
growing enclaves of East Asian Indian, African and
other minority populations. “You don’t have to go
very far to encounter enormous diversity,” says Pat
Burnett, Ph.D., director of student affairs at the
Ohio University College of Osteopathic Medicine.
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| That’s why the staff
of OU-COM’s Center of Excellence (COE) is committed
to sharpening the cultural acuity of the college’s
diverse student body. Their latest project: a
professional development seminar conducted by Mark
Orbe, Ph.D., an expert in cross-cultural medical
communication. |
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| Orbe starts each
session of his “Professional Development in Cultural
Competency” series for OU-COM by counting “1 – 2 – 3
…” |
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| “Dumela!” his
students shout on cue. The word dumela is a South
African greeting that also means “I affirm you, I
believe in you, and I see the great potential within
you.” Orbe weaves this theme through the COE’s newly
developed certificate program in intercultural
communication at OU-COM. |
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| As warm and
welcoming as this sounds, Orbe’s program is no
feel-good affirmation fest. In fact, it can be
downright uncomfortable. Participants must
critically examine their own cultural identities,
assumptions and biases; learn to implement
communication principles and practice negotiating
patients’ culturally based beliefs about medical
care through simulated interviews. |
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| “This is not
cultural sensitivity training. This is about
developing strong communication skills so you get
the most meaningful, productive exchange out of a
15–20 minute meeting with a patient,” Orbe says.
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| Developing this
dynamic series was a team effort. Burnett; Ann
Brieck, associate director of student affairs; and
Harold C. Thompson III, D.O., director of
multicultural affairs, worked with Orbe to develop
the OU-COM certificate program in intercultural
communications, which is funded by a federal Health and Human
Services Center of Excellence grant. |
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| “Cultural training
is growing because of the demand of students,”
Thompson says. “Our world is changing, and students
understand the need to grasp it. We want to provide
them with more practice inside and outside of the
classroom.” |
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| As a biracial,
first-generation college student, Orbe was drawn to
the cultural aspects of communication. After earning
his bachelor’s degree at Ohio University, he returned
for a doctorate, also in communication studies,
during which time his wife gave birth to their first
child at O’Bleness Memorial Hospital. He now
teaches intercultural communication at Western
Michigan University. |
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| “There’s an
inextricable relationship between culture and
communication,” he says. “I explore ways in which
that relationship manifests.” |
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| Orbe led his first
OU-COM seminar, called “Physician-Patient
Communication in a Multicultural Society,” during
winter quarter 2006. Participants met twice, for a
total of nine hours. They earned two academic
credits and were given an overview of basic
communication concepts and theories and how they
relate to practical medical settings. |
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| “In terms of
health-care communication, what you say and how you
say it leads to different interpretations among
different people,” says Becky Teagarden, a
second-year medical student who attended this first
seminar. |
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| In addition to
differing disease propensities across cultural
groups, there are differences in healing methods.
Many groups trust traditional remedies—such as
indigenous herbs and healing rituals—to Western
medicine. Cultures can also express differences in
their radius of personal space or level of family
involvement in decision-making. |
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| Such cultural tips
can be helpful, but it’s impossible to memorize the
genetic predispositions, medical practices and
social etiquette of every culture. The trick,
according to Orbe, is to ask probing questions and
cultivate mindfulness. |
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| “Most of us don’t
communicate mindfully; we just say what we’re
thinking and assume that there’s a shared meaning,”
Orbe says. “I teach receiver orientation, a concept
that says what’s more important is not what I’m
saying, but how you receive it.” |
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| Burnett, Brieck and
Thompson knew from the overwhelmingly positive
response to the first seminar that they needed to
do more. Orbe returned to speak to OU-COM’s incoming
first-year students in August 2006. They all
participated in Orbe’s four-hour presentation on
intercultural communication as it relates to medical
practice. |
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| Meanwhile,
second-year students who had attended Orbe’s winter
quarter two-credit class and wanted more could
attend a refresher course. Both groups had the
option to attend three subsequent five-hour classes,
but they earned the certificate in intercultural
communication only if they attended all three.
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| About 50 percent of
this year’s first-year class completed this elective
course. It’s no small feat considering the seminar’s
extensive reading list and the fact that sessions
are often on Friday evening or Saturday morning.
This is in addition to the students’ already
rigorous medical training schedule. |
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| “It’s a significant
time commitment, but what you get out of it is well
worth the hours you give up,” Teagarden says. “At
medical school you’re so bombarded with the science
that you don’t take the time to appreciate how
intricately individual each situation is.”
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| Through Orbe’s
seminar, students gain new levels of cultural
competency and mindful physician-patient
communication, but they also deepen their bond with
one another. |
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| Before bringing the
final seminar class to a close, Orbe gathers his
students into a circle and tosses a colorful ball of
yarn to a young woman across the room. Still holding
onto his end of the yarn, he affirms the humanity of
that student, who tosses the yarn to another, and he
to another. Soon multi-hued strands, each
representing gratitude, admiration or appreciation,
crisscross into an elaborate network of yarn.
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| “It is through
communication that we establish this web of dumela—of
affirmation,” Orbe says. “Even though you didn’t
speak to everyone in this room, and despite our many
differences—look: we’re all connected.” |
