title: Cultural hegemony? Educators' perspectives on facilitating cross-cultural dialogue.
abstract: BACKGROUND
  We live in an age when education is being internationalized. This can confront students with 'cultural hegemony' that can result from the unequal distribution of power and privilege in global society. The name that is given to awareness of social inequality is 'critical consciousness'. Cross-cultural dialogue provides an opportunity for learners to develop critical consciousness to counter cultural hegemony. The purpose of this research was to understand how learners engage with cross-cultural dialogue, so we can help them do so more effectively in the future.
  
  
  METHODS
  The setting for this research was an online discussion in an international health professions educator fellowship program. We introduced scenarios with cultural references to study the reaction of participants to cultural conversation cues. We used an inductive thematic analysis to explore power and hegemony issues.
  
  
  RESULTS
  Participants reflected that personally they were more likely to take part in cross-cultural discussions if they recognized the context discussed or had prior exposure to educational settings with cultural diversity. They identified barriers as lack of skills in facilitating cross-cultural discussions and fear of offending others. They suggested deliberately introducing cultural issues throughout the curriculum.
  
  
  CONCLUSIONS
  Our results indicate that developing critical consciousness and cross-cultural competency will require instructional design to identify longitudinal opportunities to bring up cross-cultural issues, and training facilitators to foster cross-cultural discussions by asking clarifying questions and navigating crucial/sensitive conversations.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA; Zareen.zaidi@medicine.ufl.edu.
authors.forename: Zareen
authors.initials: Z
authors.lastname: Zaidi
authors.affiliation: Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Daniëlle
authors.initials: D
authors.lastname: Verstegen
authors.affiliation: FAIMER (Foundation for Advancement of International Medical Education and Research), Philadelphia, PA, USA.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Vyas
authors.affiliation: Quality & Academic Accreditation Unit, Medical Education Department, Faculty of Medicine, King Abdulaziz University (KSA), Jeddah, Saudi Arabia.|Cairo University, Egypt.
authors.forename: Omayma
authors.initials: O
authors.lastname: Hamed
authors.affiliation: Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Dornan
authors.affiliation: FAIMER Institute, Drexel University College of Medicine, Philadelphia, PA, USA.
authors.forename: Page
authors.initials: P
authors.lastname: Morahan
mesh_terms: D003142:Communication; D054521:Cultural Competency / Q000193:education*; D005180:Faculty, Medical; D006801:Humans
keywords: critical consciousness; cross-cultural communication; culturally responsive andragogy; discourse analysis; educational cultural hegemony