title: Recommendations for medical training: a Native Hawaiian patient perspective.
abstract: BACKGROUND
  Culturally competent health care providers are needed to eliminate healthcare disparities. In the State of Hawai'i, Native Hawaiians suffer some of the worst health disparities. Prior to implementing a cultural competency curriculum to address these disparities, the John A. Burns School of Medicine's Department of Native Hawaiian Health Cultural Competency Curriculum Development team asked Native Hawaiian patients about their experiences and recommendations.
  
  
  METHODS
  We conducted four focus groups of Native Hawaiians to obtain recommendations on physician training, to be incorporated into the curriculum. Participants came from both rural and urban areas. Classical qualitative analysis of data identified recurrent themes.
  
  
  RESULTS
  Five primary themes, arising in all four groups, were: (1) customer service; (2) respect for the patient; (3) inter-personal skills; (4) thoroughness of care; and (5) costs of medical care. Secondary themes, occurring in three of the four groups, were: (1) cultural competency training; (2) the training of medical office staff; (3) continuity of care; and (4) the role of the patient. Participants specifically requested that medical students receive cultural competency training about the host culture, its history, values, and traditional and alternative healing practices.
  
  
  CONCLUSIONS
  The emphasis participants placed on the need for cultural competency training of physicians supports the need to address the role of culture in medical education. Although most of the issues raised are not unique to Hawai'i, participants' recommendations to teach students about the host culture and traditional healing practices identify important themes not usually found in medical school curricula.
authors.affiliation: Department of Native Hawaiian Health, University of Hawai'i John A. Burns School of Medicine, 677 Ala Moana Blvd., Honolulu, HI 96813, USA. martinak@hawaii.edu
authors.forename: Martina L
authors.initials: ML
authors.lastname: Kamaka
authors.forename: Diane S L
authors.initials: DS
authors.lastname: Paloma
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Maskarinec
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054521:Cultural Competency; D003479:Curriculum; D004501:Education, Medical / Q000379:methods*; D005260:Female; D017144:Focus Groups; D006254:Hawaii; D006801:Humans; D007198:Indians, North American; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D005791:Patient Care / Q000379:methods*; D036301:Qualitative Research; D018570:Risk Assessment; D012577:Schools, Medical; D013637:Tape Recording; D055815:Young Adult