Researching Intercultural Competence of Medical Students: Erika Marek in Nicosia

written by Erika Marek

Dr Erika Marek, senior lecturer represented our department and gave oral presentation at the 2nd International Congress of Health Workforce Education and Research organized by the European University Cyprus in Nicosia, Cyprus between 9th – 10th May 2019.

The title of the presentation: Medical students’ self-assessed level of intercultural competence: first results of a Hungarian survey.

This research and the conference participation was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences. The support period of this stipend is 2017/09/01-2020/08/31. „Supported BY the ÚNKP-18-4 New National Excellence Program of the Ministry of Human Capacities”

Please find below the abstract of this study:

Since 2013 the rapidly growing international migration in Europe has posed new challenges to the EU healthcare systems. Due to the crisis situation in 2015 a „High-level meeting on Refugee and Migrant Health” was organised by World Health Organization (WHO) and its Outcome Document emphasizes the importance of ’providing migrant-sensitive health care and the periodic assessment of the sufficiency and preparedness of the health system capacity which can adapt and respond to the needs of a changing population and take account of cultural, religious, linguistic and gender diversity. Training of health professionals and relevant non-health actors is a key element to achieve this purpose’. Along these WHO recommendations a comprehensive questionnaire survey was conducted between Sept, 2016 and May, 2018 at Medical School (MS), University of Pécs (UP), Hungary aiming to assess the medical students’ actual level of intercultural competence (ICC): their awareness, skills, and attitudes regarding the health and healthcare for migrant populations, as well as to identify the areas for improvement. We collected data of participants’ previous ICC trainings as well as the students’ opinion, expectations and recommendations about incorporating intercultural contents into the medical curricula. The survey was conducted in three languages: Hungarian, English and German, the 3 languages ​​of the international medical training programs at MS-UP. The target groups for the research were both freshmen and senior students, and as this latter group already obtains clinical experiences, this may allow comparisons and data regarding the effects of the current curriculum on students’ ICC level. The questionnaire used was the ‘Clinical Cultural Competence Questionnaire (CCCQ)’, which was translated and modified with the permission of its author, Professor Robert C. Like (New Brunswick University, US). Altogether more than 1200 medical students completed our anonymous questionnaire survey, and the final analysis of the total results is currently ongoing. Based on the preliminary results – which are covered in the current study – (involving 244 persons, grade 4 students), no significant difference was found between sex, and age regarding the 4 main examined domains: ‘Knowledge’, ‘Skills’, ‘Attitudes’ and ‘Comfort-level in Intercultural Situations’. Compared by study programs, the students of the German Program demonstrated significantly higher scores for ‘Knowledge’ domain, while students of the Hungarian Program had higher scores for the ‘Skills’ domain. The longer time interval one has spent or lived abroad showed higher ‘Comfort-level’ scores, but –unexpectedly- showed no relation with better intercultural knowledge, skills and attitudes. Significantly higher scores were clearly demonstrated in terms of ’better language competencies’ for all of the 4 examined domains, while ’previously completed intercultural training programs’ were only related to a higher level of ’Knowledge’ and had no effect on the participants’ ’Skills’, ’Attitudes’ and ’Comfort-level in intercultural situations’.

Based on our preliminary results (ie. previous ICC trainings resulted in students’ better ‘Knowledge’ but had no effect on their ‘Skills’, ‘Attitudes’ and ‘Comfort level in cross-cultural situations’), we concluded that future training programs at medical schools, in addition to improving students’ awareness, shall focus more on developing skills and enhancing attitudes using various interactive teaching methods. Our study highlighted some specific areas to consider during future curriculum developments, such as ’providing culturally-sensitive end-life care’ as our study participants demonstrated the lowest ‘Skill’-scores regarding this issue. Another important area to focus on is to improving students’ coping strategies when dealing with derogatory remarks from colleagues and patients on ethnicity (both on their own and others’ ethnicity, including the patients). It is encouraging, that study participants considered it really important to offer ICC training for healthcare workers, and a great majority (80%<) of them expressed interest and willingness to participate on future trainings which aim to improve their intercultural competencies. Considering our study participants’ concerns and recommendations regarding the development and launch of a new optional ICC course at the University will surely contribute to its success in the close future.