Context Recent attention has focused on whether government health service institutions,
particularly in the United Kingdom, reflect cultural sensitivity and competence
and whether medical students receive proper guidance in this area.
Objective To systematically identify educational programs for medical students
on cultural diversity, in particular, racial and ethnic diversity.
Data Sources The following databases were searched: MEDLINE (1963–August 1998);
Bath International Data Service (BIDS) Institute for Scientific Information
science and social science citation indexes (1981–August 1998); BIDS
International Bibliography for the Social Sciences (1981–August 1998);
and the Educational Resources Information Centre (1981–August 1998).
In addition, the following online data sets were searched: Kings Fund; Centre
for Ethnic Relations, University of Warwick; Health Education Authority; European
Research Centre on Migration and Ethnic Relations, University of Utrecht;
International Centre for Intercultural Studies, University of London; the
Refugee Studies Programme, University of Oxford. Medical education and academic
medicine journals (1994-1998) were searched manually and experts in medical
education were contacted.
Study Selection Studies included in the analysis were articles published in English
before August 1998 that described specific programs for medical students on
racial and ethnic diversity. Of 1456 studies identified by the literature
search, 17 met the criteria. Two of the authors performed the study selection
Data Extraction The following data were extracted: publication year, program setting,
student year, whether a program was required or optional, the teaching staff
and involvement of minority racial and ethnic communities, program length,
content and teaching methods, student assessment, and nature of program evaluation.
Data Synthesis Of the 17 selected programs, 13 were conducted in North America. Eleven
programs were exclusively for students in years 1 or 2. Fewer than half (n=7)
the programs were part of core teaching. Only 1 required program reported
that the students were assessed on the session in cultural diversity.
Conclusions Our study suggests that there is limited information available on an
increasingly important subject in medical education. Further research is needed
to identify effective components of educational programs on cultural diversity
and valid methods of student assessment and program evaluation.