The Value of Qualitative Methods in Cross Cultural Education

A Case Study from a First Person Perspective

Abstract

This paper presents a first-person account of using qualitative research methods to address medical residency education. The results of this project have been published. However, the study's process and its educational impact on the participants have not been well-described. The purpose of this article is to describe the background and conduct of the study itself. A family medicine residency program, the setting for this project, had recently begun accepting international medical graduates (IMGs) who had lived and received medical school education outside of the United States. The author, a faculty member in the residency and a clinical psychologist, and the physician faculty observed residents as they saw patients in the family medicine residency clinic. Concern was expressed about some of the IMG resident physicians’ knowledge base and their ability to develop rapport with patients. In providing instruction in behavioral science, the author and a psychologist colleague noted that some of the IMG residents were confused by aspects of U.S. family life and the educational system. The relationship with clinical instructors and expectations of faculty also differed from the pedagogical norms in U.S. medical education. As a result, a qualitative interview project was undertaken to understand better how these IMG residents were experiencing and interpreting faculty-learner and resident physician-patient interactions. The results were beneficial in multiple ways. First, recognizing that faculty members were interested in their experiences helped develop rapport and trust between the faculty and residents. Providing the project results to the residents helped open discussion about cultural differences in medical education and patient care. For educators who may have difficulty understanding the perspective that learners bring to their education, the process described could be of potential benefit.