LEARN_Model - Cross-cultural Medicne A Teaching Framework...

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Cross-cultural Medicne A Teaching Framework for Cross-cultural Health Care Application in Family Practice ELOIS ANN BERLIN, PhD, and WILLIAM C. FOWKES, JR, MD, Stanford, California Significant demographic changes in patient populations have contributed to an increas- ing awareness of the impact of cultural diversity on the provision of health care. For this reason methods are being developed to improve the cultural sensitivity of persons responsible for giving health care to patients whose health beliefs may be at variance with biomedical models. Building on methods of elicitation suggested in the literature, we have developed a set of guidelines within a framework called the LEARN model. Health care providers who have been exposed to this educational framework and have incorporated this model into the normal structure of the therapeutic encounter have been able to improve com- munication, heighten awareness of cultural issues in medical care and obtain better pa- tient acceptance of treatment plans. The emphasis of this teaching model is not on the dissemination of particular cul- tural information, though this too is helpful. The primary focus is rather on a suggested process for improved communication, which we see as the fundamental need in cross- cultural patient-physician interactions. Health care providers are finding themselves deal- ing with increasingly diverse patient populations. Fueled by armed conflict, political unrest and economic instability, the influx of immigrants into the United States is prompting a structural shift in the demo- graphic representation of minorities. The impact is especially acute in states like California, which are subject to secondary migration or relocation after pre- liminary resettlement. These migration patterns, in combination with reproductive patterns, set a trend that is predictive of what has been termed minoritiza- tion. In addition to language and socioeconomic barriers recognized to stand between minority populations and the health care system,'-3 there is an increasing aware- ness of the impact of diverse health and disease belief systems on the interaction of health care providers and patients of a different cultural heritage.4-'0 Overcoming these obstacles is aided by the incor- poration of new tools. for cross-cultural communica- tion.* At the Family Practice Residency at San Jose Health Center, we have begun to develop a set of guidelines for health care providers in a practice that serves a multicultural patient population. We have structured these guidelines around the following mne- monic: Guidelines for Health Practitioners: LEARN L Listen with sympathy and understanding to the patient's perception of the problem E Explain your perceptions of the problem A Acknowledge and discuss the differences and similarities R Recommend treatment N Negotiate agreement *Cross-cultural curriculum development was supported in part by the South Bay Area Health Education Center, San Jose, California.
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This note was uploaded on 09/08/2010 for the course HPRF 135 at San Jose State University .

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LEARN_Model - Cross-cultural Medicne A Teaching Framework...

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