The Association of American Medical Colleges has produced TACCT—the Tool for Assessing Cultural Competence Training. The tool enables medical school faculty and administrators to track, assess, and better integrate cultural competence training in their curricula.
The Issue: In 2000, the Liaison Committee on Medical Education (LCME), the accrediting authority for medical education programs in the United States and Canada, introduced two standards for culturally competent training. The first standard requires that "faculty and students demonstrate an understanding of the manner in which people of diverse cultures and belief systems perceive health and illness and respond to various symptoms, diseases, and treatments," while the second mandates that medical students "learn to recognize and appropriately address gender and cultural biases in themselves and others, and in the process of health care delivery, while considering first the health of the patient." This move inspired many medical schools to introduce the concept of cultural competence into undergraduate curricula. However, little is known about the content and quality of cultural competency training.
Objective: The Association of American Medical Colleges created the Tool for Assessing Cultural Competence Training (TACCT) to help medical schools assess and improve their cultural competency training, making the best use of their opportunities and resources. Using the TACCT tool, medical educators can integrate the tenets of cultural competency into all phases of medical school training.
Organization: Association of American Medical Colleges
Target Populations: Medical school administrators and instructors
The Intervention: The first part of the survey instrument enables users to map what areas of their current medical school curriculum (e.g., what courses and years) are relevant to cultural competency training and what areas are in need of development. The second part provides a framework for cultural competency training, including exploration of cultural competence, epidemiology of population health, and the history and effects of health disparities; communication skills, such as working with interpreters, negotiating and problem-solving; and other topics. This framework was developed with the input of an expert panel from the fields of medicine, anthropology, and education.
As the developers explain in the TACCT backgrounder, "A cultural competence curriculum cannot be an add-on to the present medical school curriculum. If issues such as culture, professionalism, and ethics are presented separately from other content areas, they risk becoming deemphasized as fringe elements or of marginal importance. The intent of a cultural competence curriculum is to enhance the patient-physician interaction and assure that students have the knowledge, skills, and attitudes that allow them to work effectively with patients and their families, as well as with other members of the medical community."
For Further Information: Contact Ella Cleveland, Ph.D., AAMC Division of Diversity Policy and Programs, [email protected] or visit the AAMC Web site. For additional information about cultural competence in medicine, read two New England Journal of Medicine perspective pieces: Becoming a Physician: Cultural Competence and the Culture of Medicine and Becoming a Physician: Compliance, Caricature, and Culturally Aware Care.