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The praxis of cultural competence in medical education : using environmental factors to develop protocols for actionStohs, Sheryl Magee 26 April 2005 (has links)
Cultural competence is a topic that concerns social scientists and medical
anthropologists who pay attention to demographic changes and health disparities.
This study demonstrates practical approaches to developing cultural competence in
medical education by using factors from the social environment to develop protocols
for action. With current concerns in domestic and global health care, it is evident that
health care organizations struggle to deliver culturally appropriate services.
Additionally, educational institutions also struggle to evaluate culturally applied
medical practices and competencies. Unlike medical competence, cultural competence
is seldom evaluated, and as a result, a gap exists in health care delivery. The purpose
of this research is to examine the changes in self-assessment of physician assistant
(PA) medical students and graduates, as indications of changes in their medical
practice and attitudes. Key objectives explore how PA medical students self-assess
their own cultural competence; what factors impact their evaluation, and if change
indicates cultural competence.
The methodology consisted of a qualitative approach designed to conduct
focus group discussions, in-depth interviews, and field work, while results of existing
quantitative data was used to inform the study. Triangulation methods substantiated
the findings along with environmental and data analysis to provide rigor to this
investigation. Participants were students and graduates from a Physician Assistant
Studies Program in Oregon.
Major findings showed changes in participants' cultural competence self
assessment due to a change in self-awareness, exposure and experiences with diverse
underserved populations, in domestic and international encounters with the real world.
In conclusion, change in self assessment had actually occurred, but the change in the
quantitative results really portrayed a level of development on a cultural competency
continuum, but not cultural competence itself.
It followed from these findings that using components which influenced
change along with external and internal environmental factors, provided a basis for a
model to establish procedures for action. This strategic model, the praxis of cultural
competence, takes critical elements or protocols to move medical students from theory
to practice. From the results of this study we can see evidence of closing the gap
between the theory of cultural competence and culturally competent practices. / Graduation date: 2005
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Interpretations of reality : cross-cultural encounters of Asian students with healthcare at Oregon State UniversityBarclay, Julie Hanson 16 November 1993 (has links)
Enrollments of international students have increased dramatically in
the last several decades. The delivery of health care to these students has
become a topic of study for college health care providers and medical
researchers across the country. The purpose of this study was to explore how
Asian international students cope with illness while in school at Oregon State
University. Interviews were held with international students from Japan,
Korea, China and selected health care providers from the Oregon State
University health center. Information was sought describing health care
issues, and perspectives on medical care. The interplay between the
student's perspectives and experiences and those of health care providers was
explored as they revealed the role of culture in the cross-cultural medical
situation.
In contrast to other findings I maintain that it is the effects of culture,
that is, the envisioning of different realities, in similar situations, that affect
both patients and practitioners in the cross-cultural medical encounter.
American core cultural values, in conjunction with a biomedical paradigm,
formulate a base from which university health care providers interpret their
clinical reality. Asian international students bring with them to the medical
encounter a different paradigm that, for them, provides a definitive view of
illness and health care. It also is grounded in meanings learned from cultural
experiences. The anthropological views presented here are powerful and of
considerable value in clinical settings because they assist individuals in
moving beyond culture-bound realities in order develop a pluralistic
perspective that validates the existence of different illness realities in the
cross-cultural medical encounter. / Graduation date: 1994
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Health care decision-making as a contextual process : anthropological approaches to the study of choice in medically pluralistic societiesStoner, Bradley Philip. January 1984 (has links)
No description available.
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Health care decision-making as a contextual process : anthropological approaches to the study of choice in medically pluralistic societiesStoner, Bradley Philip. January 1984 (has links)
No description available.
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The relationship between leadership styles of directors of accredited higher education respiratory care programs and faculty satisfaction, willingness to exert extra effort, perceived director effectiveness, and program outcomesUnknown Date (has links)
The purpose of this study was to examine the leadership characteristics of respiratory care program directors and determine the relationship between the director's leadership style, effectiveness, faculty satisfaction, extra effort, and program outcomes. Differences between the directors' perceived leadership style and faculties' perception of the directors' leadership style were also examined. Directors' leadership styles were measured by the Multifactor Leadership Questionnaire (MLQ). Director, faculty and program information was measured with a researcher-designed questionnaire. CoARC accredited program directors (n=321) and their full and part-time faculty (n=172) received an e-mail and a web link to obtain demographic information. All participants received an e-mail from Mind Garden, Inc. with a web link to complete the MLQ. Regression analysis and t tests were used to analyze the data. The results found a significant relationship between faculty satisfaction, extra effort, and perceived director effectiveness and each of the predictors transformational, transactional, and passive/avoidant leadership behaviors. There was no relationship between program director leadership style and program outcomes. This study found no difference between the directors' and the faculty's perception of the directors' transformational and transactional leadership behaviors. However, there was a significant difference between the directors' and the faculties' perception of the directors' passive/avoidant behavior. / by Nancy L. Weissman. / Thesis (Ph.D.)--Florida Atlantic University, 2008. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2008. Mode of access: World Wide Web.
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Zafè Neg se Mistè: a grounded theory study of end-of-life decision-making for Haitian American families in south FloridaUnknown Date (has links)
The purpose of this study was to investigate the process used by Haitians and Haitian Americans who must make healthcare decisions for a terminally ill family member. There is a large population of Haitians and Haitian Americans in South Florida and there has been no research regarding their decision-making process about end-of-life healthcare. The study design was descriptive, applying constructivist grounded theory methodology. Data were collected using semi-structured, face-to-face qualitative interviews. Data analysis and collection occurred simultaneously. Participants (n=12) were purposefully recruited, with 11 from a single, faith-based community. The findings resulted in six concepts: (1) imminent or actual death, (2) disrupted unity, (3) managing disrupted unity, (4) consequences, (5) restoring unity, and (6) creating memories you can live with. These six concepts, elaborated by an additional 17 dimensions, were incorporated into a process model relating to the cultural value of communal unity to the end-of-life decision-making process. The implications of this study include a need to improve the congruence between the nursing care provided at this vulnerable time and the cultural values of this population. Successful access to this population through the structure of the faith-based community points the way to increasing access to appropriate end-of-life healthcare. Practice implications informed by caring science include the importance of nurses’ coming to know the family and listening to the unique care needs. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection
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Performing diabetes : balancing between 'patients' and 'carers', bodies and pumps, Scotland and beyondScheldeman, Griet January 2006 (has links)
This study is about young people (age 11-16) with diabetes. Based on fieldwork in a paediatric diabetes centre in Scotland, it describes the ways diabetes is lived and done by young people, their health carers and insulin pumps. This enactment is contrasted with other ways of doing diabetes, as observed on short fieldwork trips to paediatric centres in Brussels, Gothenburg and Boston. I explore the dynamics of diabetes care on two levels. I consider the interaction between health carers and patients. Comparative data from various paediatric centres make apparent how culturally and socially informed approaches towards adolescence, health and illness shape both care practices and patients' experiences, resulting in different medical outcomes. Concretely in the Scottish centre, a non-hierarchical holistic care approach by health carers emphasizing quality of life over health, informs the young people's perspective on diabetes. Being a free adolescent takes priority over managing diabetes, with the results of ill health and possible future complications. The existing dynamics in this care framework change as a third actor enters the scene: the insulin pump, a pager-sized technological device continuously attached to the body. I explore the balancing act between young people and their pumps. As the adolescents actively engage with their pumps not to search for better health but rather to pursue a better quality of life, the guiding question becomes: how can a technological device for insulin injection double as a tool towards a desired identity and a different illness? This work then, can be read as a concrete case study of how a uniform technological device is embedded and used in a specific cultural and social context. It can also be read as an argument for a re-orientation of paediatric diabetes care in the Scottish centre: care centred on collaboration and inclusion rather than focused on merely containing underlying conflict (between adults and adolescents, diabetes and life, health and quality of life). Centres in Brussels, Gothenburg and Boston, and the insulin pump concretely, show how collaboration can lead to good health and quality of life. To leave us to wonder: is 'doing diabetes differently' synonymous with 'doing a different diabetes'?
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