Medical Students’ Perceptions of Their Teachers’ and Their Own Cultural Competency: Implications for Education

  • Britta M. Thompson
  • Paul Haidet
  • Robert Casanova
  • Rey P. Vivo
  • Arthur G. Gomez
  • Arleen F. Brown
  • Regina A. Richter
  • Sonia J. Crandall
Original Article



Enhancing the cultural competency of students is emerging as a key issue in medical education; however, students may perceive that they are more able to function within cross-cultural situations than their teachers, reducing the effectiveness of cultural competency educational efforts.


The purpose of our study was to compare medical students’ perceptions of their residents, attendings, and their own cultural competency.


Cross-sectional study.


A questionnaire containing previously validated instruments was administered to end-of-third-year medical students at four institutions throughout the US. Repeated measures multivariate analysis was used to determine differences in student ratings.


Three hundred fifty-eight medical students from four schools participated, for an overall response rate of 65%.


Analysis indicated overall statistically significant differences in students’ ratings (p < 0.001, η2 = 0.33). Students rated their own cultural competency as statistically significantly higher than their residents, but similar to their attendings. For reference, students rated the patient care competency of themselves, their residents, and their attendings; they rated their attendings’ skills as statistically significantly higher than residents, and residents as statistically significantly higher than themselves. There were differences between cultural competency and patient care ratings.


Our results indicate that students perceive the cultural competency of their attendings and residents to be the same or lower than themselves. These findings indicate that this is an important area for future research and curricular reform, considering the vital role that attendings and residents play in the education of medical students.


cultural competency medical education medical education-undergraduate 



Supported in part by grants from the Southern Group on Educational Affairs (SGEA-AAMC) and K07 Cultural Competence and Health Disparities Academic Awards from the National Heart, Lung, and Blood Institute. The authors would like to thank Rachel Shada and Dr. Cayla Teal for their contributions to the design of the questionnaire.

The opinions contained herein are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute or the home institutions of the authors.

Conflict of Interest

The authors report no conflicts of interest.


  1. 1.
    Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Washington: The National Academies Press; 2002.Google Scholar
  2. 2.
    Liaison Committee on Medical Education. Accreditation Standards, revised 2007., accessed 12/28/09.
  3. 3.
    Accreditation Council for Graduate Medical Education Outcome Project., accessed 12/28/09.
  4. 4.
    Carrillo JE, Green AR, Betancourt JR. Cross-cultural primary care: a patient-based approach. Ann Intern Med. 1999;130(10):829–34.PubMedGoogle Scholar
  5. 5.
    Hobgood C, Sawning S, Bowen J, Savage K. Teaching culturally appropriate care: a review of educational models and methods. Acad Emerg Med. 2006;13:1288–95.CrossRefPubMedGoogle Scholar
  6. 6.
    Betancourt JR. Cultural competency and medical education: many names, many perspectives, one goal. Acad Med. 2006;81:499–501.CrossRefPubMedGoogle Scholar
  7. 7.
    Gregg J, Saha S. Losing culture on the way to competency: the use and misuse of culture in medical education. Acad Med. 2006;81:542–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Morell VW, Sharp PC, Crandall SJ. Creating student awareness to improve cultural competency: creating the critical incident. Med Teach. 2002;24:532–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Hung R, McClendon J, Henderson A, Evans Y, Colquitt R, Saha S. Student perspectives on diversity and the cultural climate at a US medical school. Acad Med. 2007;82:184–92.CrossRefPubMedGoogle Scholar
  10. 10.
    Murray-Garcia J, Garcia JA. The institutional context of multicultural education: what is your institutional curriculum? Acad Med. 2008;83:646–652.CrossRefPubMedGoogle Scholar
  11. 11.
    Haidet P, Stein H. The role of student-teacher relationships in the formation of physicians: the hidden curriculum as process. J Gen Intern Med. 2006;21:S16–S20.CrossRefPubMedGoogle Scholar
  12. 12.
    Culhane-Pera KA, Reif C, Egli E, Baker NJ, Kassekert R. A curriculum for multicultural education in family medicine. Fam Med. 1997;29:719–723.PubMedGoogle Scholar
  13. 13.
    Crandall SJ, George G, Marion GS, Davis S. Applying theory to the design of cultural competency training for medical students: a case study. Acad Med. 2003;78:588–94.CrossRefPubMedGoogle Scholar
  14. 14.
    Thompson BM, Rogers JC. Exploring the learning curve in medical education: the role of self-assessment. Acad Med. 2008;83(10l):S86–88.CrossRefPubMedGoogle Scholar
  15. 15.
    Kline RB. Beyond Significance Testing: Reforming Data Analysis Methods in Behavioral Research. American Psychological Association: Washington; 2004.CrossRefGoogle Scholar
  16. 16.
    Thompson BM, Crandall SJ, Haidet P. Student perceptions of residents, attendings, and their own cultural competency: How do they compare? AAMC Southern Group on Educational Affairs. Nashville, TN, 2008.Google Scholar
  17. 17.
    Teal CR, Gill A, Shada RE, Thompson BM, Fruge E, Villarreal GB, Patton C, Haidet P. When Best Intentions Aren’t Enough: Helping Medical Students Develop Strategies for Managing Bias About Patients. J Gen Intern Med, In Press.Google Scholar
  18. 18.
    Elam C, Stratton T, Gibson DD. Welcoming a new general to college: The millenial students. J College Admissions. 2007:Spring:20–25.Google Scholar
  19. 19.
    Thompson BM, Teal CR, Rogers JC, Paterniti DA, Haidet P. Ideals, Activities, Dissonance, and Processing: A Conceptual Model to Guide Educators' Efforts to Stimulate Student Reflection. Acad Med. In Press.Google Scholar

Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Britta M. Thompson
    • 1
  • Paul Haidet
    • 2
  • Robert Casanova
    • 3
  • Rey P. Vivo
    • 3
  • Arthur G. Gomez
    • 4
  • Arleen F. Brown
    • 4
  • Regina A. Richter
    • 5
  • Sonia J. Crandall
    • 6
  1. 1.The University of Oklahoma College of MedicineOklahoma CityUSA
  2. 2.The Pennsylvania State University College of MedicineHersheyUSA
  3. 3.Texas Tech University Health Sciences Center School of MedicineLubbockUSA
  4. 4.David Geffen School of Medicine at UCLALos AngelesUSA
  5. 5.UCLA Graduate School of Education and Information StudiesLos AngelesUSA
  6. 6.Wake Forest University School of MedicineWinston-SalemUSA

Personalised recommendations