141019L - LESSON PLAN CROSS CULTURAL COMMUNICATION

Lecture for medical students KFMC on October 19, 2014 by Prof Omar Hasan Kasule Sr.

1.0 AIM:

To introduce students to some broad issues in cross cultural communication

2.0 ACTIVITIES/LEARNING OBJECTIVES/LEARNING OUTCOMES

1.      Define and describe socio-cultural variation among patients: age, gender, education, social class, and health-related behavior

2.      Describe socio-cultural barriers to doctor patient communication and how they can be mitigated

3.      Conduct an interview with a person of a different socio-cultural background and identify communication barriers

3.0  SESSION AGENDA

·        Culture

·        Interviewer respect for other cultures

·        Why doctors fear raising cross cultural issues

·        Advice on cross cultural communication

·        Cultural do’s

·        Don’ts  of cross cultural communication

·        Common mistakes in language use

·        Common mistakes in manner of speaking

·        Common mistakes in body language

·        Dealing with the family

4.0 CULTURE:

·        Definition

·        Relativity

·        Underlying value systems and world view

·        Different is not the same as wrong

·        Non western cultures including the Islamic one are holistic in outlook. 

5.0 INTERVIEWER RESPECT FOR OTHER CULTURES

·        Interviewer should be aware of his cultural values and avoid imposing them on others.

·        Interviewer should avoid a stereotyped conceptualization of other’s cultural values it is better to ask rather than assume.

·        Interviewer should respect cultural values of the interviewee regarding disease definition, disease causation, and disease treatment and should build further communication on this understanding.

·        Interviewer should identify cultural values and practices that can interfere with scientific medical treatment and try to find a midway solution.

6.0 WHY DOCTORS FEAR RAISING CROSS CULTURAL ISSUES:

·        Fear of being called racist or prejudiced

·        Feeling inadequate or inexperienced

·        Ignorance of the culture

·        Fear of misunderstanding

·        Fear of rejection

·        Uncertainty about patient’s cultural background (lloyd and Bor p 89)

7.0 ADVICE ON CROSS CULTURAL COMMUNICATION:

·        Be aware of your cultural values,

·        Learn the cultural background,

·        Learn which cultural differences affect treatment,

·        Show patients you respect cultural differences,

·        Build on what is common between you and the patient,

·        Be open minded about unfamiliar cultural differences,

·        Accommodate cultural ideas if they do not compromise treatment,

·        explain you are not an expert in cultures (lloyd and bor p. 89)

8.0 CULTURAL DO’S:

·        Use open questions,

·        Explore cultural differences only if necessary,

·        Be honest about what is not clear to you,

·        Show respect to cultural differences. (lloyd and bor p.90)

9.0 DON’TS OF CROSS CULTURAL COMMUNICATION: 

·        Pretend to understand cultures unclear to you,

·        Being judgmental,

·        Making assumptions

·        Assuming cultural issues are unimportant (lloyd and bor p.90)

10.0 COMMON MISTAKES IN LANGUAGE USE:

·        Misunderstanding/misinterpretation of common terms and phrases

·        Technical vs common language,

·        Formal vs colloquial language,

·        Meanings of words determined by the local context,

·        Words with different philosophical / conceptual origins and implications.

·        Distorted translations by the family of official interpreters who say what they think the patient should have said.

11.0 COMMON MISTAKES IN MANNER OF SPEAKING:

·        Speed of speaking vs speed of information processing: variation by gender, social class

·        A volley of questions with no time to digest and respond

·        Interviewer and interviewee speaking at the same time.

12.0 COMMON MISTAKES IN BODY LANGUAGE / NON VERBAL COMMUNICATION:

·        Eye contact,

·        Touching

13.0 DEALING WITH THE FAMILY:

·        who speaks and decides for the patient: individualistic vs communalist approaches

REFERENCES

Managing the cross cultural interview ‘advice on cross cultural communication with patients’ in Lloyd M and Bor R (2^nd edition) Communication Skills in Medicine. Churchill Livingstone London 2004.