A wide range of approaches are used to teach cultural competency to medical and health professional students in the state of Maryland, ranging from self directed learning, reflective exercises, didactic lectures, case discussions in small groups, and standardized patient cases to medical Spanish courses and community practice experiences.
The University of Maryland School of Medicine’s Program in Minority Health and Health Disparities Education and Research (Dr. Carter-Pokras is a member) educates current and future health professionals about issues related to health disparities, supports relevant multidisciplinary research and fosters quality clinical care for minorities and diverse populations. The University of Maryland School of Medicine curriculum committee has approved inclusion of cultural competency into all four years of the medical school curriculum, and a process to identify faculty interested in teaching cultural competency and health disparities has been established. For more information about this program, see: http://medschool.umaryland.edu/minorityhealth.asp
During 2006-2007 alone, cultural competency and health disparities education activities under this grant reached approximately 260 first and second year medical students, 150 first year dental students, 20 family medicine residents, 20 pediatric and family medicine primary care research fellows, 75 health professional educators, 100 practicing physicians, and 100 other health professionals.
Under this grant, small group case discussions have been developed for use with first and second year medical students (e.g., Bidil, sleepwalking, LEARN model). Case vignettes were developed for physician CME cultural competency training document released by Informed. Also, an asthma care vignette was developed for use in emergency department provider training. Additional small group case discussion guides, publications and presentations prepared under this grant are available here.
During the past few years, Maryland legislation recommending cultural competency education and training for health professionals, and/or supporting cultural diversity in institutions of higher education have been signed into law:
First year medical students and second year dental students are asked to complete the Office of Minority Health Family Physician's Guide to Culturally Competent Care as part of their professionalism coursework. The online program is free. You can earn 9 free CME credits (Physicians), 9 CME credits (Physician Assistants), 9 CNE credits (Nurses) or 9 contact hours (0.9 CEUs; Pharmacists) while exploring engaging cases and learning about cultural competency in health care.
The Office of Minority Health Culturally Competent Nursing Care: A Cornerstone of Caring is a free online educational program addressing cultural competency in healthcare designed specifically for nurses. It is accredited by the National Association of Social Workers and American Nurses Credentialing Center for 9.0 contact hours for nurses.
The American Association of Medical Colleges' Tool for Assessing Cultural Competence Training (TACCT) is an important instrument for measuring cultural competence in the undergraduate medical school curriculum at the University of Maryland. Each year, the following domains are addressed:
A 5-page inventory of online training resources on cultural competency and health disparitities, some of which are available on this site, is available here.
School of Medicine
The University of Maryland School of Medicine offers a Medical Spanish elective class for first and second year medical students. The class is 10 weeks long and is offered each semester at beginner, intermediate, and advanced levels. You can find out more information here.
School of Nursing
NURS 418/NURS 724: Health, HealthCare and Culture, 3 credits
Concepts, theories and methodologies from Transcultural nursing, sociology and medical anthropology are used to provide a theoretical and conceptual basis for the provision of health services to culturally diverse individuals, families and communities. The course focus is on the exploration of cultural variations among the values and beliefs held by both health care worker and recipients of care, and issues that address cultural competence as related to the delivery of care in a multi-racial, multi-ethnic and multicultural society. Students engage in a range of learning experiences, including, seminar discussion, fieldwork assignment, oral presentations, readings, simulation experiences, individual and group exercises, and self-directed activities that foster experiential learning.
NURS 418: Work, Stress and Health Disparities, 3 credits
This seminar will integrate psychological, sociological and social epidemiological perspectives on the relationship between social inequality, work, and health. We will examine the organization and content of the psychosocial work environment and the impact of occupational stress exposures on health and illness. Particular attention will be given to the work environment of health care workers. The contribution that work makes to the ongoing health disparities in the U.S. will also be examined. PREQUISITES: There are no formal prerequisites for this course, although the permission of the instructor is required for undergraduate students.
NURS 418: Rural Health, 3 credits
This course provides students with an introduction to rural health care and its implications to nursing practice across the health care continuum. Students will explore the epidemiological and health system delivery characteristics that distinguish rural health care as a unique setting for nursing and health care services. Site visits and speakers from rural health care programs across Maryland will be offered and will allow students to integrate class discussions, case studies and course content into real life rural health care settings.
NURS 418: Spec/ Intro to Spanish for the Healthcare Provider, 3 credits
The student will develop basic Spanish language conversation skills for the health care setting. Emphasis will be on correct pronunciation and oral comprehension. Topics will include: basic phrases used for patient interviews, health care terminology, patient instructions, health education, and cultural considerations for clinical settings. Students will be expected to do weekly homework and to come prepared to actively practice Spanish conversation during class time. Prerequisite: One introductory Spanish course
NURS 769 Society, Health and Social Justice, 3 credits
This course examines social, cultural, and political-economic determinants of health from sociological and social epidemiology perspectives. The concept of social justice is used as a conceptual framework to investigate population health inequities that exist in social class, race, ethnic and gender groups in the United States. The course addresses the central question: How does the structure of the society influence the health and illness experience of its population? The course examines what a 'society' is, and how it works, and what the pathways are through which social forces differentially impact class, race, and gender groups. The course will focus on specific mesosocial contexts, such as the workplace, the community and the physical environment, which are particularly important in transmitting macrosocietal forces to the individual. The process of globalization and the role of social movements in shaping public health will also be discussed. The course concludes by examining innovations in health policy and practice that are currently emerging in an effort to address the adverse health impact of inequitable social environments. Prerequistes: Permission of instructor for undergaraduate students.
School of Law
LAW 521K Race, Civil Rights and Access to Health Care Seminar, 3 credits
When one thinks of civil rights and discrimination, the first things that come to mind are usually Brown v. Board of Education, police brutality, employment discrimination and racial profiling. Health care is a forgotten frontier of civil rights. This seminar will examine a range of civil rights challenges in the health care setting. How do race and ethnicity affect access to health care? Is access to health care a civil rights challenge? Is racial discrimination a problem that affects the health care profession? The seminar will focus on the intersection between health care and civil rights in a variety of areas. Papers written for this seminar will not satisfy the Advanced Writing Requirement.
School of Social Work
SOWK 765:The Nature of Health and Illness, 3 credits
A bio-psychosocial model of health and illness is developed in this course, where biological, psychological, social, cultural, and environmental factors and their interactions are explored. A framework of individual and family development is used to study common diseases throughout the life course.
SOWK 783: Qualitative Ethnocultural Research, 3 credits
Qualitative research methods are an important part of social work practice. Each student independently conducts a qualitative research project from beginning (formulation of research question and planning) to end (submission of a written research report). An ethnocultural study population and a cultural question for study are selected by the student for the project.
SOWK 764: Multicultural Perspectives: Implications for Practice, 3 credits
This course is an intensive examination of the dynamics of racism and other forms of oppression in our society and within ourselves, and how those dynamics are intertwined with social welfare policy and social work practice. The course places racism, sexism, ethnocentrism, and other forms of oppression in the historical and current economic, political, and social context of the United States. It is designed to prepare students to analyze racism, sexism, and ethnocentrism as they operate at the individual, community, and institutional levels, and to understand how they shape the lives of men and women of all backgrounds and identities. A major theme of the course is the social worker's professional responsibility to help achieve a non-racist, multicultural, and egalitarian society. This course fulfills the diversity requirement.
University of Maryland, College Park (Graduate Courses)
EPIB 622 Social Determinants of Health, 3 credits
Prerequisite: EPIB610.Overview of the major social variables that affect public health, including socioeconomic status, poverty, income distribution, race, social networks/support, community cohesion, psychological stress, gender, and work and neighborhood environment.
EPIB 623 Epidemiology of Health Disparities, 3 credits
Prerequisite: EPIB610 Determinants that influence health outcomes of the most disadvantaged populations in the United States. Focus on social factors contributing to health disparities and inequities in the US.
FMSC 606 Ethnic Families and Health Disparities, 3 credits
Historical, psychosocial, economic, and political factors influencing the structure and functioning of ethnic families. Overview of racial/ethnic health disparities over the life course and ways in which they are influenced by multi-level contextual factors. Cultural competency in research, service delivery, and development of family/health policy initiatives for ethnic families.
FMSC 720 Perinatal, Child and Adolescent Health, 3 credits
Prerequisite: permission of instructor.Examination of major problems and issues associated with the health status of women of reproductive age, infants, toddlers, children and adolescents. Analysis of biological, environmental, psychosocial, and cultural determinants of health or the target populations. Overview of prevention and intervention programs for children and youth.
FMSC 745 Gender and Ethnicity in Family Therapy and Service Delivery, 3 credits
Major critiques of sources of racial, cultural, and gender bias in marital and family therapy and family service delivery. Addresses these issues in program development and clinical practice.
HLSA 720 Health Law and Ethics, 3 credits
The legal system helps determine the relationships prevailing among individuals, institutions and governments by setting out the rights, duties and powers of the various parties. This course will look at some of the more important concepts the law uses within the context of health services and public health.
University of Maryland, College Park (Undergraduate Courses)
FMSC 330 Family Theories and Patterns, 3 credits
Theory and research on the family, including a cross-cultural analysis of family patterns.
HLTH 460 Minority Health, 3 credits
Health concerns of U.S. ethnic minority groups and factors placing them at elevated risk for disease and injury. Health education concepts and strategies to reduce disparities between their health status and the health status of the general population.
The University of Maryland School of Medicine offers a Medical Spanish elective class for first and second year medical students. The class is 10 weeks long and is offered each semester at beginner, intermediate, and advanced levels. You can find out additional information here.
Medical Interpreter Training
A jointly funded (Johns Hopkins Urban Institute) 40-hour medical interpreter training was piloted with undergraduate pre-med students at Johns Hopkins, and thirteen medical, nursing and dental students from the University of Maryland. Cross Cultural Health Care based the training on their 40-hour 'Bridging the Gap' medical interpreter training program. Five community interpreters also participated in the training; students appreciated hearing real-life stories about medical interpretation. The training included assessment of language skills for students (the only cost that students had to pay). It is important to note that approximately one out three interested students did not pass the language exam (including some native speakers and “Advanced Medical Spanish” students). This is important since most schools do not conduct an independent assessment of language skills, and do not train students in doing medical interpretation before sending them out to do similar community service. Students completing the program appreciated learning more about differences between the US health care system and other countries. Although students were asked to provide 100 hours of free interpretation for the community, it was challenging to coordinate this service activity. Undergraduate volunteer medical interpreter placements were coordinated with Programa Salud, a student organization at Johns Hopkins University. Advanced medical Spanish medical students at the University of Maryland School of Medicine are now continuing this activity under the medical Spanish course.
Information on community service opportunities for students at the University of Maryland Baltimore can be found here:
Information on community service opportunities for students at the University of Maryland at College Park can be found here: