title: Cross-cultural comparison of the patient-centeredness of the hidden curriculum between a Saudi Arabian and 9 US medical schools.
abstract: BACKGROUND
  The implicit "hidden curriculum" strongly influences medical students' perceptions of the importance of patient-centeredness. A new instrument, the Communication, Curriculum, and Culture Survey (C3), already used to assess this hard-to- access part of the curriculum in the US, has potential for use in cross-cultural comparisons.
  
  
  OBJECTIVE
  To use the C3 to perform a pilot cross-cultural comparison of the patient-centeredness of the hidden curriculum between a Saudi medical school and 9 U.S. medical schools.
  
  
  METHODS
  Senior Saudi medical students completed the C3 and a second instrument, the Patient-Provider Orientation Scale (PPOS), which measured their attitudes toward patient-centered behavior.
  
  
  METHODS
  Senior Saudi medical students.
  
  
  RESULTS
  139/256 (54%) Saudis completed the C3; 122/256(48%) completed the PPOS. Means for 2 out of 3 of the C3's domains (0-100 scale) were lower for the Saudis than those for the Americans (95% confidence intervals in parentheses): 47 (45, 50) vs. 55 (53, 58); 54 (50, 58) vs. 68 (67, 70); they overlapped in the third: 60 (57, 63) vs. 62 (60, 63). The mean Saudi PPOS score was 4.0 (3.9, 4.1); for the American medical schools, 4.8 (4.8-4.8) (1-6, least to most patient-centered).
  
  
  CONCLUSIONS
  In this preliminary study the data suggest that the patient-centeredness of the hidden curriculum differs in Saudi and US medical schools in 2 out of 3 domains. Cross-cultural use of instruments such as the C3 can highlight such important differences and help educators evaluate their curriculum from an international, as well as a local perspective. Use of instruments across borders is a growing trend and an indicator of the increasing globalization of medical education.
authors.affiliation: Department of Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
authors.forename: Rasha
authors.initials: R
authors.lastname: Al-Bawardy
authors.forename: Benjamin
authors.initials: B
authors.lastname: Blatt
authors.forename: Saad
authors.initials: S
authors.lastname: Al-Shohaib
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Simmens
mesh_terms: D003431:Cross-Cultural Comparison; D003479:Curriculum; D003625:Data Collection; D004501:Education, Medical; D005260:Female; D006801:Humans; D008297:Male; D018802:Patient-Centered Care; D012529:Saudi Arabia; D012577:Schools, Medical; D013337:Students, Medical / Q000523:psychology*; D014481:United States