Cultural competency in healthcare: learning across boundaries.

Abstract

During 2006-2007, 1 was fortunate to study and work as a Fulbright Scholar at the Institute for Professionalism and Ethical Practice, Children's Hospital, Boston. As part of my Fulbright experience in the United States, 1 collaboratively developed a cross-cultural educational experience between the faculty of the Institute of Professionalism and Ethical Practice and of the Chair of Medical Psychology, San Paolo Hospital, Milan to explore how patient-centered care is interpreted and enacted across cultures. Both groups wrote a patient-centered dialogue based on the same clinical scenario. Dialogues were exchanged and each group commented on the other's dialogue during a videoconference. Both groups identified responding to the patient's illness experience and emotions as central to patient-centeredness, while patient autonomy was understood differently. Constructing an ideal patient-centered dialogue and the discussion with a group of another culture enabled participants to become more aware of their implicit assumptions about patient-centeredness. This experience helped both groups to better understand our 'blind spots' and enhance our cultural humility. It was thanks to the 'other' that we ultimately learned more about ourselves.