Building the Diversity Bridge Abroad: The Journey to Implement Cultural Competent Health Care in Lausanne, Switzerland

Abstract

Introduction

Although the United States has been central in bringing cultural competency into the discussion of high-quality care, health systems all over the world are faced with the effects of global immigration and the widening disparities gap between socioeconomic classes. Lausanne University Hospital is one of five Swiss academic medical centers chosen to develop programs addressing cultural competency. Here we focus on our medical training as a model for other international settings looking to build curricula based on best practices, but tailored to their local context.

Setting and Participants

At Lausanne University Hospital, diversity is part of clinical practice. Just over a third of the patient population is non-Swiss, and include undocumented and recently arrived refugees. The center serves other high-risk and vulnerable populations. The strategies presented here focus on medical learners at the Lausanne center.

Program results and historical overview

Primary cultural competency topics are social determinants of health, cultural groups in the local community, stereotypes, and unintended biases. Early sessions begin with medical anthropology material which raise consciousness of the learner’s own potential biases. Medical education evolves to a more case-based medical training- focusing on the social determinants of health through clinical vignettes linked to disparities (mental health, HIV). Our narrative describes the inception of such teaching topics and its evolution over time given national health mandates and Switzerland’s environmental context.

Discussion

We describe one of the few official cultural competency medical curricula in Europe. We present the theoretical framework and pedagogical models that have been most applicable to our endeavor since its inception in 2005, educational content, developmental approach, and assessments. In summary, we provide a “roadmap” for international health-education systems developing cultural competency medical training, at various learner levels, in the context of their local setting.