SESSION 2, STREAM 3: EQUALITY, DIVERSITY AND INCLUSION

 

Title: Decolonising Medical Education and Medical Sociology

Author and presenter: Dr Brigit McWade

Background: There is rising interest in decolonising higher education, and specifically medical education. Medical Sociologists are well-positioned to support this work.

Summary of Work: The author is currently leading work to instate anti-racist and decolonial practice across the curriculum at Lancaster Medical School. This has included investigation and reporting on students experiences and witnessing of racial harassment during their degree, the introduction of new teaching within and beyond the SBS, and redesigning report and support policy and procedures for all forms of discrimination.

Discussion and Conclusions: Writing from my experiences of leading this work, I outline key areas for action that SBS scholars can contribute to. First, we can provide compulsory teaching for students, and professional development for staff, on the history of race and racism in health and medicine, specifically how ‘race’ as an arbitrary social classification emerged from colonial science.

This work will inevitably give rise to tensions that require careful interdisciplinary collaboration. For example, our students are simultaneously taught about the myth of race and to prescribe different medications according to skin colour, e.g. for hypertension. We can support our students to think more critically of the paucity of good research on the relationship between ‘race’ and health as an example of structural racism. Further, we can support teaching in other disciplines to identify where racialisation is present, and/or where racialised minorities are excluded, especially where colleagues may not have a nuanced understanding race and racialisation, or when clinical guidelines are behind “the science”. In this way, medical sociologists can exploit the unique interdisciplinary opportunity medical education offers to improve healthcare for racially minoritized patients / clinicians through decolonisation and anti-racist practice in teaching and research.

However, this work positions medical sociology as always already decolonised, and so alongside the above, there is impetus for medical sociologists to explore the colonial legacies of their own discipline, following the examples of Bhambra’s (2014) and Meghji’s (2020) work on decolonising Sociology.

Take-home Messages: Sociologists are well-positioned to lead the project of decolonising medical education. However, medical sociology as a discipline is also interconnected with histories and practices of colonialism, and thus also requires decolonising. Thus, sociologists working in medical schools should not only support change to practice in other disciplines (e.g. dermatology / clinical skills / pharmacology), but also decolonise medical sociology.

Title: Teaching and assessing cultural competence in medical curricula: the case of the University of Nicosia Medical School 

Author:  Costas S Constantinou 

Cultural Competence of healthcare professionals has been acknowledged as an important skill for helping reducing health disparities and it is supported by research, showing its relationship with patient satisfaction and adherence to therapy. The foundations of cultural competence are rooted in two fundamental components of social sciences’ practice. First, the importance of indepth understanding of the self and the other. Second, the practice of such understanding. These components capture the essence of qualitative inquiry in the social sciences of health and illness. That is, critical reflection one one’s own cultural values and understanding the patient from the patient’s perspective.

 

There is strong evidence to suggest that integration of cultural competence in healthcare curricular has been underdeveloped. In this presentation, I am discussing how cultural competence has been taught and assessed at the University of Nicosia Medical School based on a stepladder model, how the model was designed and implemented, what has worked well, and what students have appreciated. The model consists of three main steps: (a) teaching on culture, society and health, (b) working with paper-based cases, (c) hands-on working with simulated patients. Lastly, the presentation discusses what the challenges are and how cultural competence can be further enhanced and evaluated at modern medical curricula.

Title: The attitude of Egyptian medical students towards women's empowerment

Authors: Mariam M. Alwerdani, Salma I. Ramadan, Marwa K. Sadik, Dalia Mohsen, Sara Lotf, Abdel-Hady El-Gilany and Doaa Shokry

 

Introduction: Women's empowerment (WE) has been one of the global priorities; it is acknowledged as the 5th goal in 2030 Sustainable Development Goals. Medical students are considered as future leaders with significant influence on society as a trusted source of advice. This study aims to assess the attitudes of Egyptian medical students towards WE and its variations based on sociodemographic variables. 

 

Methods: It is an institutional-based cross-sectional study targeting Egyptian medical students. Data were collected using an anonymous self-administered questionnaire. WE was represented by five domains: Women's mobility, Household affairs, Women's economic security, Sexual relationship, and Domestic violence. After excluding the incomplete response forms, the data were analysed on 550 responders with a response rate of 85%. 

Results: 40.5% of the participants had witnessed domestic violence against women before, and only half of the students believed that women as lecturers are as qualified as men. Nevertheless, the majority of participants reported supporting women's right to choose their partner, use contraceptive methods, and their right to be safe. Notably, there was an overall tendency to reject domestic violence among students, yet more than half of them justified wife beating if she is unfaithful. A significant favourable attitude towards domestic violence was correlated with: older age, being female, living in nuclear families, higher mother education, and being in advanced academic years. Generally, there was a positive correlation between the academic year and the open attitude towards WE.

 

Discussion: This study proposes several potential directions for improving medical education and integration of social science in the medical curriculum. Firstly, medical training seems to have a profound impact on student's attitudes. In our study, students of advanced years of medical school (years of clinical training rather than academic education) showed a more favourable attitude towards WE. Accordingly, our results emphasise the efficacy of gender mainstreaming in medical education. Secondly, Junior doctors should be aware of multiple and intersecting domains of WE so that they can convey the message appropriately to patients from diverse community groups. Also, junior doctors and general practitioners are expected to have suitable skills to identify and support cases of domestic violence. This could be achieved by considering the various sociodemographic factors and cultural variation in designing the social science-related part of the medical curriculum.

 

Conclusion:  Generally, medical students have positive attitudes towards WE. Further research is needed to offer a detailed understanding of the attitude of health practitioners towards WE.