Student reflections on learning cross-cultural skills through a 'cultural competence' OSCE

Background: Medical schools use OSCEs (objective structured clinical examinations) to assess students' clinical knowledge and skills, but the use of OSCEs in the teaching and assessment of cross-cultural care has not been well described. Objectives: To examine medical students' reflections on a cultural competence OSCE station as an educational experience. Design and Setting: Students at Harvard Medical School in Boston completed a 'cultural competence' OSCE station (about a patient with uncontrolled hypertension and medication non-adherence). Individual semi-structured interviews were conducted with a convenience sample of twenty-two second year medical students, which were recorded, transcribed, and analysed. Measurements and Results: Students' reflections on what they learned as the essence of the case encompassed three categories: (1) eliciting the patient's perspective on their illness; (2) examining how and why patients take their medications and inquiring about alternative therapies; and (3) exploring the range of social and cultural factors associated with medication non-adherence. Conclusions: A cultural competence OSCE station that focuses on eliciting patients' perspectives and exploring medication non-adherence can serve as a unique and valuable teaching tool. The cultural competence OSCE station may be one pedagogic method for incorporating cross-cultural care into medical school curricula.