Date of Award

Spring 2011

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Educational Policy and Leadership

First Advisor

Pink, William

Second Advisor

Lowe, Robert

Third Advisor

Whipp, Joan

Abstract

Background: Even though the need for culturally accessible, acceptable, and appropriate medical care for diverse populations is well established, there is a lack of research on how cultural competencies are developed in physician assistant education. There are no studies that address the intersections among cultural, clinical, and psychosocial competencies from the viewpoint of the physician assistant student. Although accreditation standards for physician assistant educational programs provide general guidelines for inclusion of cultural competency in the curriculum, core competencies in physician assistant education focus primarily on biomedical content rather than address cultural competencies. Because experiential education, such as service learning, offers physician assistant students and opportunity to interact with the "other," this study explores students' perspectives on cultural competence as reflected in their service learning experiences.

Methods: The development of four case studies is based on a series of in-depth interviews with four recent graduates from a physician assistant program. This phenomenological study takes a naturalistic, exploratory, and descriptive approach to understanding the informants' behavior by using inductive methods that provide the researcher access to the underlying meanings that guide those behaviors. Using content analysis, five themes emerge from the data: (a) clinical service learning is less influential than pre-matriculation experiences; (b) the clinical setting matters; (c) language serves as a proxy for culture; (d) labeling patients as "other" is problematic; and, (e) clinical, cultural, and psychosocial competencies overlap.

Conclusion: The results of this study indicate that there is a need to infuse the physician assistant biomedical curricula with content and strategies for developing cultural competencies to better prepare students for clinical practice with the diverse populations they will encounter during their clinical service learning experiences, clinical rotations, and careers. The implications for physician assistant programs and educators are discussed, including suggestions for future research.

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