A New Global Fellowship Cultivates Cultural Humility
In any medical practice, it’s likely that many patients will differ from their doctors in culture, race, ethnicity, gender, sexuality or some other social descriptor. Patients also tend to enter consultation rooms with their own beliefs about illness and their own preferences in healthcare. Because of these factors, the teaching of medicine now includes cultural humility, striving to move away from the paternalistic past when doctors applied one-size-fits-all medicine to address their patients’ needs.
Jill Raufman, associate director of Einstein’s Global Health Center
“Cultural humility involves being aware of differences, respecting them, and shifting treatments to patients’ specific needs,” said Jill Raufman, director of Einstein’s medical student global health programs and associate director of the Global Health Center. “The physician must be ready to correct power imbalances with the patient and to develop mutually beneficial partnerships with communities.”
Doctors today are also encouraged to cast a critical eye on any biases they may have. Studies have shown that cultural humility can lead directly to better health outcomes, since patients who feel understood and validated become partners in their own care and are more likely to adhere to medical advice.
Bridging Communities and Cultures
To cultivate cultural humility at Einstein, a new global fellowship is offering rising second-year medical students the chance to work with people from diverse backgrounds using art as a learning tool and a means of communication. The pilot last spring proved popular and successful.
A student works on his mask
The nine-week program sent nine medical students into the community—two communities, actually; one in the Bronx and one in Kenya. To begin, last March, the Einstein students mentored 20 junior- and senior-high students in the Global Health class at Pelham Lab High School in Westchester Square. As is typical in the Bronx, students in that class came from around the globe, including the Caribbean, Bangladesh, and Guyana. The mentors led weekly discussions exploring cultural issues, including concepts of health.
The conversation got under way not with words but with shapes, colors and design. “It’s about people telling their stories through art,” said Jill, who has done similar projects with high school students for 15 years with a New-York based non- profit, Kiboko Projects.
Exploring Cultural Identity
The Bronx students had the option to express themselves using mask-making and photo diaries.
“We’d put plaster on their faces, let it dry, then lift it off, and there would be masks,” explained Jill. “Then they’d design the masks to say something about themselves.”
She added, “It’s a powerful vehicle through which to tell a story. Our faces are our most-social selves; they tell who we are in relation to our communities, cultures, and times and places in history.”
Mask-making is often used in art therapy to help individuals understand themselves and their relationships with others. “People express things on their masks that they might not say verbally,” noted Jill.
And, in guiding the Pelham Lab students in the creation of their photo diaries, the Einstein medical students had conversations with the Bronx teens that allowed them to bond with and come to understand them in ways they had not anticipated.
“The students responded to a prompt asking them what issues are important to them growing up in the Bronx. Their diaries share their concerns and personal experiences around a variety of topics, including racism, violence, peer pressure, and effects of pollution,” said Jill.
Under One Moon
The Pelham Lab students also Skyped every week with students at a rural secondary school in Kalamba, Kenya, to make friends and learn about the culture there. A Pelham Lab student suggested they call the project “Mwezi One.”
“Mwezi means ‘moon’ in Swahili,” explained Jill, “and the idea behind the name was that we all live under one moon.” Swahili is the common language spoken among nations in eastern and south-eastern Africa, which includes Kenya.
Einstein students with Kenyan students
Thanks to Jill’s extensive travel background and contacts in Africa, in June, the Einstein students then journeyed to an underserved area in rural Kenya to undertake the same project with a group of students there, bringing the Bronx students’ art along.
“Cultural immersion changes how you see everything and is essential to developing cultural humility,” said Jill.
Tara Herrera, Class of 2021, agreed. “The Kenyan students gave me a chance to be more open-minded, to listen to unfamiliar stories without judgment and to question whether the surrounding community looks at something I find unusual in a similar or dissimilar way. If individuals can see that I respect their values and customs, even though they differ from my own, they are likely to reveal more about themselves and their way of life, all of which are intricately related to their health.”
“Seeing how other people live and the struggles and nuances of other cultures will allow us to be more sensitive and open as physicians,” said fellow student Emilee Tu.
Another project participant, Ushna Khan, summed up the experience, noting, “It’s important to know about the issues that each patient faces. This experience will stay with me as a physician.”
The masks will be on view in the glass display case at Einstein’s D. Samuel Gottesman Library from March 21, 2019 through the end of April. For more information about the Mwezi One fellowship, e-mail Jill at firstname.lastname@example.org
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Posted on: Thursday, March 21, 2019