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The Experience of Colombian Medical Students in a Pilot Cultural Safety Training Program: A Qualitative Study Using the Most Significant Change Technique.
Pimentel, Juan; Kairuz, Camila; Merchán, Claudia; Vesga, Daniel; Correal, Camilo; Zuluaga, Germán; Sarmiento, Iván; Andersson, Neil.
Afiliação
  • Pimentel J; CIET-PRAM, Department of Family Medicine, McGill University, Montreal, Quebec, Canada.
  • Kairuz C; Department of Family Medicine and Public Health, Faculty of Medicine, Universidad de La Sabana, Chía, Colombia.
  • Merchán C; Traditional Health Systems Studies Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia.
  • Vesga D; Department of Family Medicine and Public Health, Faculty of Medicine, Universidad de La Sabana, Chía, Colombia.
  • Correal C; Department of Family Medicine and Public Health, Faculty of Medicine, Universidad de La Sabana, Chía, Colombia.
  • Zuluaga G; Department of Family Medicine and Public Health, Faculty of Medicine, Universidad de La Sabana, Chía, Colombia.
  • Sarmiento I; Department of Family Medicine and Public Health, Faculty of Medicine, Universidad de La Sabana, Chía, Colombia.
  • Andersson N; Traditional Health Systems Studies Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia.
Teach Learn Med ; 33(1): 58-66, 2021.
Article em En | MEDLINE | ID: mdl-32812831
Problem: The Colombian government provides health services grounded in the Western biomedical model, yet 40% of the population use cultural and traditional practices to maintain their health. Adversarial interactions between physicians and patients from other cultures hinder access to quality health services and reinforce health disparities. Cultural safety is an approach to medical training that encourages practitioners to examine how their own culture shapes their clinical practice and how to respect their patients' worldviews. This approach could help bridge the cultural divide in Colombian health services, improving multicultural access to health services and reducing health disparities. Intervention: In 2016, we conducted a pilot cultural safety training program in Cota, Colombia. A five-month training program for medical students included: (a) theoretical training on cultural safety and participatory research, and (b) a community-based intervention, co-designed by community leaders, training supervisors, and the medical students, with the aim of strengthening cultural practices related to health. Evaluation used the Most Significant Change narrative approach, which allows participants to communicate the changes most meaningful to them. Using an inductive thematic analysis, the authors analyzed the stories and discussed these findings in a debriefing session with the medical students. Context: Cota is located only 15 kilometers from Bogota, the national capital and biggest city of Colombia, so the small town has gone through rapid urbanization and cultural change. A few decades ago, inhabitants of Cota were mainly peasants with Indigenous and European traditions. Urbanization displaced agriculture with industrial and commercial occupations. One consequence of this change was loss of cultural health care practices and resources, for example, medicinal plants, that the community had used for centuries. Impact: A group of 13 final-year medical students (ten female and three male, age range 20-24) participated in the study. The medical students listed four areas of change after their experience: increased respect for traditional health practices to provide better healthcare; increased recognition of traditional practices as part of their cultural heritage and identity; a desire to deepen their knowledge about cultural practices; and openness to incorporate cultural practices in healthcare. Lessons Learned: Medical students reported positive perceptions of their patients' cultural practices after participating in this community-based training program. The training preceded a positive shift in perceptions and was accepted by Colombian medical students. To the best of our knowledge, this was the first documented cultural safety training initiative with medical students in Colombia and an early attempt to apply the cultural safety approach outside the Indigenous experience.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estudantes de Medicina / Serviços de Saúde Rural / Educação de Graduação em Medicina / Competência Cultural / Medicina Tradicional Tipo de estudo: Prognostic_studies / Qualitative_research Aspecto: Equity_inequality / Patient_preference Limite: Adult / Female / Humans / Male País/Região como assunto: America do sul / Colombia Idioma: En Revista: Teach Learn Med Assunto da revista: INFORMATICA MEDICA / MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Canadá País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estudantes de Medicina / Serviços de Saúde Rural / Educação de Graduação em Medicina / Competência Cultural / Medicina Tradicional Tipo de estudo: Prognostic_studies / Qualitative_research Aspecto: Equity_inequality / Patient_preference Limite: Adult / Female / Humans / Male País/Região como assunto: America do sul / Colombia Idioma: En Revista: Teach Learn Med Assunto da revista: INFORMATICA MEDICA / MEDICINA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Canadá País de publicação: Estados Unidos