Henry Abramovitch

A new approach to developing cross-cultural communication skills

The need for cross-cultural training (CCT) increases as physicians encounter more culturally diverse patients. However, most medical schools relegate this topic to non-clinical years, hindering skills development. Some residency programs have successfully addressed this deficit by teaching cross-cultural communication skills in a teaching objective structured clinical examination (tOSCE) context. The authors developed and evaluated a CCT workshop designed to teach cross-cultural communication skills to third-year medical students using a tOSCE approach. A 1½-day workshop incorporating didactic, group discussion and tOSCE components taught medical students cross-cultural awareness, interviewing skills, working with an interpreter, attention to complementary treatments, and consideration of culture in treatment and prevention. Six standardized patient cases introduced various clinical scenarios and the practical and ethical aspects of cross-cultural care. Student evaluation of the workshop was positive concerning educational value, skills advancement and pertinence to their clinical activities. Survey of students before and after the workshop demonstrated improvement in students’ abilities to assess the culture and health beliefs of patients and negotiate issues regarding treatment. CCT in the context of medical student clinical training can be carried out effectively and efficiently using a dedicated multi-modal workshop including standardized patients.

A European consensus on learning objectives for a core communication curriculum in health care professions

OBJECTIVE To develop learning objectives for a core communication curriculum for all health care professions and to survey the acceptability and suitability of the curriculum for undergraduate European health care education. METHODS Learning objectives for a Health Professions Core Communication Curriculum (HPCCC) in undergraduate education were developed based on international literature and expert knowledge by an international group of communication experts representing different health care professions. A Delphi process technique was used to gather feedback and to provide a consensus from various health care disciplines within Europe. RESULTS 121 communication experts from 15 professional fields and 16 European countries participated in the consensus process. The overall acceptance of the core communication curriculum was high. 61 core communication objectives were rated on a five-point scale and found to be relevant for undergraduate education in health care professions. A thematic analysis revealed the benefits of the HPCCC. CONCLUSIONS AND PRACTICE IMPLICATIONS Based on a broad European expert consensus, the Health Professions Core Communication Curriculum can be used as a guide for teaching communication inter- and multi-professionally in undergraduate education in health care. It can serve for curriculum development and support the goals of the Bologna process.

American medical students in Israel: stress and coping – a follow-up study

Medical students studying abroad face the double stress of adjusting to a new cultural environment while at the same time, coping with the usual stresses of medical school. In a previous article, we examined the perceived stress and coping of American medical students studying in Israel.

American medical students in Israel: stress and coping

Medical students studying abroad have to adapt to a new cultural environment in addition to the usual stresses of medical school. This study explored the perceived stress and coping ability of students of the New York State/American Programme, Sackler School of Medicine, Tel Aviv University, who study medicine in Israel but are expected to return to America to practice. Students were surveyed using the Ways of Coping Checklist (WCCL), Appraisal Dimension Scale (ADS) and two instruments specifically designed for the study. The results supported the view that students having difficulty adapting to their new cultural environment also have difficulty at medical school. This pattern is a negative spiral in which anxiety and depression impair cognitive performance, which leads to academic difficulties and emotional distress. Improvements in student social support and primary prevention were implemented as a result of the study. Limitations of the study are discussed.

An Israeli account of a near-death experience: A case study of cultural dissonance

The text of an Israeli near-death experience (NDE) is presented in translation from the Hebrew. This account is contrasted with the traditional Hebrew sources on NDEs or their equivalents, which formed part of the NDErs native subculture. In the present case, the lack of congruence between the reported NDE and the expected cultural form led to intense confusion described by the NDEr. Further study is needed of folk traditions of NDEs.

Pregnant dreaming: Search for a typology of a proposed dream genre

Dreams during pregnancy were collected from post-partum women on the maternity ward of an Israeli hospital. Our data indicate that primipara women and women with complicated obstetrical histories were more likely to report increased dreaming during pregnancy. The collected dream corpus suggests that dreams during pregnancy can be viewed as a distinct dream genre. This paper develops a tentative typology of that genre. In addition, the authors argue that the context of disclosure was highly relevant to the sorts of manifest contents that were reported.

Enuresis in Cross-Cultural Perspective: A Comparison of Training for Elimination Control in Three Israeli Ethnic Groups

Enuresis was investigated in the context of different styles of training for bladder control among three Israeli ethnic groups (Jews of Moroccan, Kurdish or Eastern European descent). Semistructured interviews were conducted in ethnically homogeneous agricultural villages with 46 mothers of 248 children between the ages of 3 and 18 years. In contrast to previous British and American studies, no sex differences were found, but there were higher rates of primary enuresis and lower rates of secondary (regressive) enuresis. Enuresis was correlated among siblings in the Kurdish group only and with disorderly sleeping arrangements in the Moroccan group. The Moroccan and Kurdish groups had higher rates of enuresis than the Ashkenazi group. The higher rates appear to be related to differences in the age of onset of training and a lack of age-appropriate changes in the parent-child interaction, which led to chronic enuresis and the inability to seek effective assistance. These results are discussed in terms of a proposed typology for training: an early symbiotic style, a strict toddler style, and a communicative partnership.

Death, Anthropology of

The anthropology of death examines the diversity and commonalties in how human societies respond to the demise of its members. Anthropologists have documented the enormous cultural variation in the methods for disposing of the corpse, the expected behavior of the bereaved, and the ongoing relations between the living and their dead. Most cultures, however, do conceptualize death as a transition, or rite of passage, in which the fate of the corpse is linked to the ritual status of the mourners. The social impact of the death is related directly to the social status of the deceased and the type of death. The sudden, violent death of an important leader may paralyze a society, while the lingering death of a marginal stranger may pass unnoticed. Death rituals provide an opportunity to reassert core cultural values at a time of potential demoralization, and as such have important economic, political, and ideological aspects. Contemporary Western attitudes toward death, seen from a cross-cultural perspective, appear decidedly ‘deviant.’ Future research will focus on rituals and institutions, as well as on the impact of new technologies (medical, computer, space, etc.) on the changing conception of death.