LAUSR

Education in cross-cultural care is critical to training medical students to care for patients from all backgrounds, but it is unclear what experience students have in the clinical learning environment. The quality of feedback that students receive in common clinical scenarios demanding cultural competence also is undefined. This study describes the medical student experience in directly observed cross-cultural encounters within two clinical clerkships, internal medicine and pediatrics. The authors also identify areas of need for further resident and faculty training in providing high-quality feedback following these encounters. Abstract Objectives Education in cultural competence is critical to training medical students to care for patients from all backgrounds, but it is unclear what experience students have in the clinical learning environment. We describe the medical student experience in directly observed cross-cultural encounters within two clinical clerkships, and we identify areas of need for further resident and faculty training in providing high-quality feedback following these encounters. Methods We collected direct observation feedback forms from third-year medical students in the Internal Medicine and Pediatrics clerkships. The observed cross-cultural skill was categorized, and the quality of feedback given to students was quantified using a standardized model. Results Students were observed using an interpreter more frequently than any other skill. Positive feedback received the highest quality scores, averaging 3.34 out of 4 coded elements. Corrective feedback quality only averaged 2.3 out of 4 coded elements, and quality correlated with the frequency of cross-cultural skill observation. Conclusions Significant variability exists in the quality of feedback provided to students following the direct observation of cross-cultural clinical skills. Faculty and resident training to improve feedback should focus on corrective feedback in less commonly observed cross-cultural skills.