Emerging Trends in Cultural Competence in Frontline Healthcare Workers

Sunrit Panda, ‘25, Princeton University

Introduction

Recent events such as the COVID-19 pandemic reveal the extent of healthcare disparities between racial and ethnic groups in the United States. Healthcare workers have a responsibility to recognize and correct their own biases to address these historical disparities. After all, cultural competence is one of the AAMC’s fifteen core-competencies for entering medical students (The Anatomy of, 2020). In particular, ethnic literature offers a personal, unfiltered look into the generational struggles of black, indigenous, and people of color (BIPOC) members of society. Careful study of such literature could be one method for developing cultural competence among future healthcare workers.

Chicano Literature

The House on Mango Street by Sandra Cisneros is a modern classic that explores life in a Spanish-speaking neighborhood of Chicago through a series of poetic, descriptive vignettes. The novel explores the themes of empowerment, poverty, racism, patriarchy, and sexuality through the hard-hitting, emotional language of a child. Cisneros’s relatable tone allows a future healthcare worker to internalize these themes. For example, Mamacita’s heartbreaking anguish at being unable to communicate with her grandson underscores the disempowerment faced by patients who do not speak English (Cisneros, 1989). Scenes like this show a future healthcare worker the delicate web of cultural experiences that influences a patient’s care. Health-related academic literature often misses the humanism inherent in healthcare, a quality especially important for individuals treating patients of diverse backgrounds. Hence, The House on Mango Street gives that deeply personal perspective necessary for developing cultural competence.

Cross-Disciplinary Connections

To effectively engage The House on Mango Street in healthcare education, specific parallels may be drawn between literary details and health-related academic literature. For example, the main character’s aunt’s death at the hand of chronic illness may spur a discussion on financial toxicity (Cisneros, 1989). Or, procedures for helping victims of sexual abuse may supplement the many vignettes involving sexual exploitation. Ultimately, a novel as short and concise as The House on Mango Street adds a personal perspective to any discussion of cultural competence. This novel is a model for the potential for ethnic literature’s connections to pertinent aspects of healthcare education.

Potential Implementations

At the undergraduate level, ethnic literature may be integrated into humanities courses targeted towards pre-medicine students who need to satisfy their literature requirement. For example, Princeton University offers a course called Literature and Medicine. Further integration can be achieved at the medical school level through programs such Georgetown’s Literature and Medicine Longitudinal Academic Track. As part of academic tracks of this nature, there may be an ethnic literature course or independent work requirement. Finally, further research needs to be done on specific course structures and reading lists. In the literature, there are already examples of comprehensive plans for courses that bridge literature and medicine; however, there are limited resources for courses that focus specifically on ethnic literature (Calman et al., 1988). Some examples of potential books that may bolster students’ cultural competence include The Spirit Catches You and You Fall Down by Anne Fadiman and Faces in the Moon by Betty Louise Bell.

References

Cisneros, S. (1989). The House on Mango Street. Houston, TX: Arte Publico Pr.

The Anatomy of Cultural Competence. (2020, April 29). Retrieved February 01, 2021, from https://students-residents.aamc.org/applying-medical-school/article/anatomy-cultural-competence/

Calman, K. C., Downie, R. S., Duthie, M., & Sweeny, B. (1988).

Literature and medicine: A short course for medical students. Medical Education, 22(4), 265–269. https://doi.org/10.1111/j.1365-2923.1988.tb00752.x

Note: Portions of this article was submitted as an abstract (unpublished) for an oral presentation at the 2020 University of Pittsburgh Humanities in Healthcare Conference

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