Cultural Competency Training for Public Health Students: Integrating Self, Social, and Global Awareness Into a Master of Public Health Curriculum

摘要

Cultural competency training in public health, medicine, social work, nursing, dental medicine, and other health professions has been a topic of increasing interest and significance. Despite the now burgeoning literature that describes specific knowledge, attitudes, and skills that promote cultural “competence,” fully defining this complex, multidimensional term and implementing activities to enhance it remain a challenge. We describe our experiences in introducing a mandatory, full-day workshop to incoming Master of Public Health students, called “Self, Social, and Global Awareness: Personal Capacity Building for Professional Education and Practice.” The purpose of the program is to provide a meaningful, structured environment to explore issues of culture, power, privilege, and social justice, emphasizing the centrality of these issues in effective public health education and practice. In recent years, the need for and benefits of cultural competency training in public health, social work, medicine, nursing, dental medicine, and other health professions has been a topic of increasing interest, significance, and debate. In 2006, the American Public Health Association included “Diversity and Culture” among its essential cross-cutting competency domains for the Master of Public Health (MPH) degree, listing 10 specific competencies essential to this building block of public health education. 1 These competencies were again emphasized in the 2008 report from the Association of Schools and Programs of Public Health, not only as critical principles of a MPH curriculum but also as essential components of that organization’s action plan for the reduction of racial/ethnic health disparities in the United States. 2 More recently, a 2012 report from a joint expert panel representing both the Association of Schools and Programs of Public Health and the Association of American Medical Colleges recognized cultural competence as, “a critical, influencing factor common to all forces of change in health care and public health.” 3 (p2) This echoes the notion that ultimately such competence can be leveraged toward the aim of eliminating disparities in health and health care. The panel proposed a competency set, as well as collaborative learning experiences, research, scholarship, field activities, and case studies to help embed cultural competence training in medical and public health education. Other professional organizations in the health arena have released similar reports and articles, all of which emphasize the vital importance of cultural competency in improving the quality and availability of health services and improving health outcomes in diverse populations. 4–8 Despite a now burgeoning literature describing specific knowledge, attitudes, and skills that promote cultural “competence,” fully defining this complex, multidimensional term, and implementing activities to enhance it, remains a challenge. Our purpose is to describe our experiences in introducing a mandatory, full-day workshop called “Self, Social, and Global Awareness: Personal Capacity Building for Professional Education and Practice” (SSGA) to incoming MPH students at the Mailman School of Public Health, Columbia University. The overall purpose of the program was to provide a meaningful, structured environment to explore issues of culture, power, privilege, and social justice. Toward this end, our primary objective was to encourage self-awareness and reflection around these and other key concepts, as well as provide space for students to share those reflections with their peers. Follow-up sessions expounded upon initially introduced themes, with the objective of offering concrete examples from public health practice in which identified themes emerged and played an important role in interactions among practitioners, other individuals, groups, and communities.