Turning cross-cultural medical education on its head:Learning about ourselves and developing respectful curiosity

Cross-cultural education is often understood to mean acquiring cultural knowledge about different cultural groups in order to serve people from diverse groups equitably.However,this article argues that to work effectively in cross-cultural situations,we need to learn about our own culture and develop an approach of respectful curiosity.The first goal of cross-cultural education is to understand how culture influences our thoughts,perceptions,biases,and values at an unconscious level.The second goal is to understand the nature of individual cultural identity as a multidimensional and dynamic construct through exploration of our own cultural identity.This exploration helps us understand the limitations of learning about‘others’through learning categorical information and helps us limit the effect of our implicit biases on our interactions.The approach of respectful curiosity is recommended to question our assumptions,understand each unique individual patient,connect with each patient,and build the therapeutic relationship.

Patient-centered care in a multicultural world

Introduction To be a good clinician in 2016 is challenging-not only do we have to ensure that our biomedical knowledge is up to date,but increasingly we need to practice medicine within the much broader context of patient-centered care(PCC)in diverse populations.The knowledge,skills,and attitudes required to deliver good PCC in these settings are the same in whatever part of the world we practice.However,PCC presents considerable challenges to us that are highlighted and magnified when we are delivering care to individuals outside our own culture.A particular issue is not only that PCC has yet to be accepted as the‘cultural norm’by patients and clinicians alike,but also increasingly,sophisticated knowledge and skills are required by clinicians to address the complexities inherent in consulting within diverse populations.

An evaluation of a health screening program for migrant women to Taiwan,China

Objective:We aimed to evaluate an integrated screening program for female migrants to Taiwan.Method:We performed a mixed methodological evaluation of a public health nurse(PHN)-led intervention to promote an integrated screening program for female migrants to Taiwan.The clini-cal case yield was determined by an audit,and staff/client questionnaires were used for the evalua-tion.Screening comprised surveillance for four untreated chronic diseases(hypertension,diabetes mellitus,tuberculosis,and liver disease),four cancers(mouth,bowel,liver,and cervix),parasitic infection,and hyperlipidemia.Results:Three hundred and thirty-six PHNs and 4751 immigrant women-with an average age of 29.2 years,most of whom were from Vietnam(44%)or China's Mainland(41%)-took part in the programme.Two thirds of screened women had no abnormalities.Further investigation was required in 1523 women,of whom 1220 were found to have significant disease.The majority of 280 PHNs(85%)found the content,processes,and waiting time to be‘highly acceptable’and thought the program was worthwhile and could be incorporated into standard care.Conclusions:The Taipei County Comprehensive Health Screening Programme provided an accessible,free-of-charge,and preventative intervention for female migrants to Taiwan and had a good clinical case yield.

老年人的慢性肾脏疾病：是疾病，还是疾病标签？

大约有一半年龄在75岁以上的人符合当前慢性肾脏疾病（CKD）的诊断标准。但是，给这些人都打上“患者”的标签是颇具争议的，并且造成了不必要的担心。用于描述老年人群CKD流行趋势的分类体系，主要被当作一个对流行风险进行分层的工具，而不是指导临床诊疗的辅助手段。我们需要强调的讨论重点是改善以患者为中心的结局，而不是仅仅识别在平均风险水平以上的每个个体。