title: Training a medical workforce to meet the needs of diverse minority communities.
abstract: BACKGROUND
  The growing demand for a competent health workforce to meet the needs of increasingly diverse societies has been widely acknowledged. One medical school in New Zealand explored the integration of the commonly used patient-centred model approach, with an intersectional framework in the development of a cultural competency training programme. In the Pacific Immersion Programme, medical students in their fourth year of training are given the opportunity to learn about different factors that influence the health and health care of a minority community through immersion in that community. The programme objectives include enabling students to learn through experience living within the local community context, and supporting them to re-evaluate their own personal beliefs, assumptions and/or prior prejudices. This study evaluates the usefulness of this programme in the training of medical students to work in diverse communities.
  
  
  METHODS
  Two analytical approaches were used for evaluation. Deductive and inductive analyses were conducted on 235 reflective essays completed by three cohorts of students from 2011 to 2013 to ascertain the value of the programme for student learning. In addition, one cohort was invited to complete a pre and post-programme questionnaire.
  
  
  RESULTS
  Overall, the students found the programme to be a valued learning environment. They found living within a Pacific family environment to be an eye opening experience. It increased students comfort level in cross cultural engagement and emphasised the importance of patient's perspectives in health care provision. Students' self-reported knowledge about Pacific cultural values, protocols, traditional beliefs and the main health challenges increased significantly after the programme. They appreciated learning directly from community members, and through observations about how culture, beliefs and the socio-economic environment influence peoples' health and wellbeing.
  
  
  CONCLUSIONS
  Medical schools are required to train a competent health workforce to meet the needs of diverse communities. The Pacific Immersion Programme provides a unique learning environment which can improve the training of doctors to work in diverse communities. The key to its success is enabling students to be engaged learners from "the inside" rather than an "outsider looking in". The Programme enables experiential learning in a sensitive and meaningful way and can be useful for training in other institutions.
authors.affiliation: Department Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 913, , Post Code 9054, Dunedin, New Zealand. tai.sopoaga@otago.ac.nz.
authors.forename: Faafetai
authors.identifier: http://orcid.org/0000-0002-8509-8726
authors.initials: F
authors.lastname: Sopoaga
authors.affiliation: Department of Biochemistry, University of Otago, P.O. Box 56, , Post Code 9054, , Dunedin, New Zealand.
authors.forename: Tony
authors.initials: T
authors.lastname: Zaharic
authors.affiliation: Pacific Islands Research & Student Support Unit, Division of Health Sciences, University of Otago, P.O. Box 56, , Post Code 9054, Dunedin, New Zealand.
authors.forename: Jesse
authors.initials: J
authors.lastname: Kokaua
authors.affiliation: Pacific Islands Research & Student Support Unit, Division of Health Sciences, University of Otago, P.O. Box 56, , Post Code 9054, Dunedin, New Zealand.
authors.forename: Sahra
authors.initials: S
authors.lastname: Covello
mesh_terms: D054521:Cultural Competency / Q000193:education*; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D054525:Minority Health / Q000193:education*; D009520:New Zealand; D018794:Problem-Based Learning / Q000379:methods*; D016730:Program Development; D015397:Program Evaluation; D012577:Schools, Medical / Q000458:organization & administration / Q000639:trends; D013337:Students, Medical / Q000523:psychology / Q000706:statistics & numerical data
keywords: Cultural competency; Culture; Diversity; Immersion programme; Medical students; Pacific health