An anthropological approach to teach and evaluate cultural competence in medical students - the application of mini-ethnography in medical history taking.
OBJECTIVE
To use mini-ethnographies narrating patient illness to improve the cultural competence of the medical students.


METHODS
Between September 2013 and June 2015, all sixth-year medical students doing their internship at a medical center in eastern Taiwan were trained to write mini-ethnographies for one of the patients in their care. The mini-ethnographies were analyzed by authors with focus on the various aspects of cultural sensitivity and a holistic care approach.


RESULTS
Ninety-one students handed in mini-ethnographies, of whom 56 were male (61.5%) and 35 were female (38.5%). From the mini-ethnographies, three core aspects were derived: 1) the explanatory models and perceptions of illness, 2) culture and health care, and 3) society, resources, and health care. Based on the qualities of each aspect, nine secondary nodes were classified: expectations and attitude about illness/treatment, perceptions about their own prognosis in particular, knowledge and feelings regarding illness, cause of illness, choice of treatment method (including traditional medical treatments), prejudice and discrimination, influences of traditional culture and language, social support and resources, and inequality in health care.


CONCLUSIONS
Mini-ethnography is an effective teaching method that can help students to develop cultural competence. It also serves as an effective instrument to assess the cultural competence of medical students.
Department of Family Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan.
Jyh-Gang
JG
Hsieh
Department of Human Development and Psychology, Tzu Chi University, Hualien, Taiwan.
Mutsu
M
Hsu
Department of Family Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan.|Department of Medical Humanities, School of Medicine, Tzu Chi University, Hualien, Taiwan; drywwang@gmail.com.
Ying-Wei
YW
Wang
cultural competence; holistic care; mini-ethnography; narratives
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