Understanding Sociocultural Factors in Clinical Education

1. MA Education for Clinical ContextsModule 2 – Innovative Practices & Theories in Clinical Education Topic 1 Assignment - Factors Affecting Learning...‘The Wider sociocultural context’ Dr. H Grant Peterkin 13.2.18

2. Wider sociocultural context – Key Points • Sociocultural factors are the ‘larger scale forces within cultures and societies that affect thoughts, feelings and behaviours’. • Topics listed under this heading include –religion, custom, tradition, law, language, aesthetics, disability rights, law, politics, technology, racism, gender, power, institutions (basically everything) • Interactions where such factors could be observed • Student - student • Student - teacher • Student/teacher – medical school • Student/teacher – other relevants institutions (governing bodies) • Student/teacher – media/wider public sphere • Student/teacher – patients (& a patient’s friends & family)

3. Imagine studying then

4. Wider sociocultural context – Hugh’s Examples • Student – student – historic (?) sexism • Student – teacher – changes in behaviour i.e. texting on phone during lectures • Student/teacher – medical school – emergence of PBL at same time as shift in theories re psychology • Student/teacher – other institutions - GMC regulation around use of social media • Student/teacher – wider sphere - slides 6 & 7 • Student/teacher – patient – diverse patients - cultural competence vs cultural awareness vs cultural sensitivity. Essentially - patients and diseases change over time and what is expected of a doctor changes over time.

5. Wider sociocultural context – Some theoretical approaches • Complexitiy Theory • ‘a framework which assumes multiple, dynamic connections and relationships between people and systems which cannot be fully understood by an analysis of their parts, as the interactions between these parts and the consequences of these interactions are equally significant’. • Cultural Historical Activity Theory • CHAT - ‘how different activity systems interact with each other, to understand dialogues, multiple perspectives and networks of interacting activity systems’. • Bourdieu – • Social Capital as well as the theory of habitus (embodied disposition) & field (social position)

6. The Media

7. The law Judgment delivered in Rabone ‘On 8 February 2012 the court handed down its unanimous judgment in Rabone v Pennine Care NHS Trust. Determining that the NHS does owe an Article 2 “operational” duty to informally detained patients, the judgment has further expanded the scope of the NHS’ Article 2 responsibilities. This briefing assesses the scope of the duty and what this will mean in practice for trusts’. https://www.mills-reeve.com/files/Publication/470ec247-822c-4608-b77e-e243ac016f89/Presentation/PublicationAttachment/09acbfcd-94fc-4e0c-b2bb-e42f82c3e879/NHS_duty_to_prevent_suicide_Feb2012.pdf

8. Specific examples • Improving access to medical schools – UKCAT to widen participation • The emergence of a national qualifying exam – desire to standardise and measure – the more you have to measure the less you trust? • Pre/post Brexit vilification of the expert & ‘hostile environment for migrants’

9. Wider sociocultural context – how this relates to my own context • It relates to my work in three important ways • I want to understand what parts of me are getting in the way of what I am trying to teach (stale, pale, male etc.) • I want to understand what barriers within the student (related to sociocultural context) I might realistically address in order to improve my teaching • I find this kind of thing fascinating; if I follow what I am interested in I am less likely to burnout.

10. Wider sociocultural context – Key Authors • Prof Alan Bleakley • https://www.plymouth.ac.uk/staff/alan-bleakley • Prof Jennifer Cleland • https://www.abdn.ac.uk/iahs/research/profiles/jen.cleland • Prof NishaDogra– • https://www2.le.ac.uk/departments/npb/people/nishaDogra

11. Wider sociocultural context – References • Bhui, K., Warfa, N., Edonya, P., McKenzie, K. and Bhugra, D., 2007. Cultural competence in mental health care: a review of model evaluations. BMC health services research, 7(1), p.15. • Bleakley A, Cleland JA. Sticking with messy realities: how “thinking with complexity” can inform healthcare education research. In Cleland JA and Durning SJ (Eds), Researching Medical Education. Oxford: Wiley 2015, p.81-92 • Bleakley, A., Brice, J. and Bligh, J., 2008. Thinking the post‐colonial in medical education. Medical education, 42(3), pp.266-270. • Cleland, J., Walker, K.G., Gale, M. and Nicol, L.G., 2016. Simulation‐based education: understanding the socio‐cultural complexity of a surgical training ‘boot camp’. Medical education, 50(8), pp.829-841. • DograN, Bhatti F, Ertubey C, Kelly M, Rowlands A, Singh D and Turner M (2015) Teaching diversity to medical undergraduates: Curriculum development, delivery and assessment. AMEE GUIDE No. 103 • LaPointV., Butty JA.M., Danzy C., Small C. (2010) Sociocultural Factors. In: Clauss-Ehlers C.S. (eds) Encyclopedia of Cross-Cultural School Psychology. Springer, Boston, MA • Sorensen, J., Norredam, M., Dogra, N., Essink-Bot, M.L., Suurmond, J. and Krasnik, A., 2017. Enhancing cultural competence in medical education. International journal of medical education, 8, p.28.