practice partner
tions challenges.
Part two includes five case studies (again
with videos) of everyday medical practice in
Canada. The cases revolve around: 1) consent and confidentiality; 2) cross-cultural
communication; 3) communicating with
adolescents; 4) Aboriginal health; and 5)
mental health.
Users encounter “what would you do?”
options and commentaries, knowledge
checks, reflective exercises, role objectives,
and additional readings.
For example, the case about adolescents
concerns a 15-year-old, Kelsey. She has
been moody, her grades are falling, and she
has changed her eating habits and lost a lot
of weight. Kelsey’s mother convinces her to
see her doctor.
When Kelsey comes in, she complains
that her mother is on her back about
everything. The doctor talks about her diet
and nutrition, and discovers that Kelsey is
underweight. He ends up referring her to a
dietician. A month later, Kelsey returns to
the doctor, this time with her mother, and
the two are clearly angry with each other.
This is only the start of a multi-part case. It
raises complex issues. In a population that’s
usually healthy, what are the physician’s
responsibilities to ensure continued health?
What are barriers to providing good care to
adolescents? What special issues should a
physician consider when seeing adolescent
patients? What techniques can help obtain
sufficient and accurate information from
that patient? What role should the parent
play? How do you decide if adolescents are
capable of making their own decisions?
Each case presents scenarios that encourage deep thinking on values, ethical and
professional behaviours, cultural awareness
and a range of communications choices.
“You may be very skilled, but those are
things you may have never seen,” says Mr.
Faulkner. “At the end of the day we want
IMGs to be successful in Canada, and this
is one way to help.”
All doctors can benefit
As the modules note, two major cultural systems are at work in medical communication:
the medical culture in which people trained
and/or practise, and the non-medical society
in which they were raised and/or live.
Dr. Russell, a retired Assistant Professor of
Medicine at University of Toronto, has heard
complaints from IMGs who struggled to be
able to practise in Canada. “They were angry,”
she says. “They said ‘I was a good doctor in my
home country, and can be a good doctor here.’
My answer was ‘Not necessarily’. There are
things important to good patient care that aren’t
just about the expertise of the medical role.”
She says doctors who were raised and
trained in Canada naturally
grasp certain communications
“This project ... has
skills and cultural competenvalue beyond IMGs. We
cies. “They’re embedded in
encourage anyone to
the culture and know the
idioms,” says Dr. Russell.
use the site. I guarantee
That’s a leg up over
you’ll get something out
IMGs, yet it doesn’t mean
of it, no matter where
everything, she says. Every
doctor, whether born and
you are in your career.”
educated in Canada or elsewhere, must be adept at the
interpersonal and sensitive to cultural needs
and wants. That takes experience, training, reminders and reflections. That’s why
Dr. Russell suggests that the MCC online
portal is useful to any doctor.
Mr. Faulkner agrees. “This project was
developed for particular purposes, but it
has value beyond IMGs,” he says. “We
encourage anyone to use the site. I guarantee you’ll get something out of it, no matter
where you are in your career.”
Dr. Villeda sees it that way too. It takes
time for anyone, he says, to really learn and
absorb the best ways to interact with and treat
patients. “If you’re from here, you catch up
faster. But that doesn’t mean you don’t need
training. It’s important for any doctor to
review communications and cultural competencies. Everybody can benefit.”
Issue 1, 2016 Dialogue
25