Introduction to the Communication and Cultural Competence program
A self-education program for physicians to learn about communication and cultural competencies required in Canada
About this program
The Communication and Cultural Competence program was originally designed and created by Drs. Lynn Russell, Leila Lax, Laura Jayne Nelles, Cathy Smith and many others within the Faculty of Medicine, University of Toronto. The revisions and relaunch of this content was enabled by the funding of Health Canada through the Internationally Educated Health Professionals Initiative.
A Canadian physician’s role includes much more than diagnosis, treatment and medical procedures. A physician requires the ability to manage ethical, legal, organizational, cultural and communication matters that arise.
However, these topics are not necessarily found in standard textbooks or other information sources about the practice of medicine. They are topics that international medical graduates (IMGs) have found to be the most different and difficult to understand.
This orientation content consists of a self-education program intended to help you learn about the cultural expectations and standards of communication between physicians and patients, and between health professionals in Canada. It will provide you with essential information regarding the CanMEDS’ physician roles of: communicator, collaborator, health advocate, manager, scholar and professional.
This program has been created to help IMGs achieve the following objectives:
- Improve one’s knowledge of how the Canadian health-care system functions and is organized
- Recognize and discuss common bioethical issues and conflicts
- Demonstrate an ability to communicate with patients in a patient-centred and culturally sensitive manner, including the Aboriginal peoples of Canada
- Demonstrate an understanding of the professional attitudes and behaviours expected of physicians practicing in Canada
- Explore the CanMEDS’ roles, other than medical expert, including: communicator, collaborator, health advocate, manager, scholar and professional
This program is based on case studies that give examples of everyday medical practice in Canada. Unlike other medical cases that you have probably studied, the cases in this program do not focus on diagnosis and treatment. Instead, they focus on communication between physicians, patients and health professionals.
You can work through this orientation material at your own pace and review it as many times as you like. The training includes interactive exercises, commentary and further readings. The cases are not intended to show “the right way” to deal with a situation. Instead, they are intended to make you think more deeply about the issues.
Preparing for the program
Before you begin the program, we recommend that you review this information:
- The Canadian Medical Association Code of Ethics
- The CanMEDS’ roles
- If you plan to practice family medicine, read this document about how the “Four principles of family medicine” are related to the CanMEDS’ roles.
Most cases contains a self-assessment quiz related to the specific case content. First, take the self-assessment quiz to determine if you need to study a particular topic or objective prior to completing the case.
The CanMEDS’ roles were developed by the Royal College of Physicians and Surgeons of Canada.
The central role of a physician in Canada is that of medical expert, which includes all necessary biomedical expertise. This, however, is just one component of a Canadian physician’s practice. The roles of communicator, collaborator, health advocate, manager, scholar and professional are equally important functions needed to be a competent medical practitioner in Canada.
These additional roles are the focus of this program. Cases are used to show how these roles integrate with the medical expert role in daily practice.
Copyright © 2005 The Royal College of Physicians and Surgeons of Canada. http://rcpsc.medical.org/canmeds. Reproduced and adapted with permission.
Purpose of CanMEDS’ roles
It is expected that any physician practicing in Canada will be familiar with these roles and will be competent in the practice of all of them. All of these roles are important because a physician serves individual patients as well as society. Therefore, a physician’s job will change over time, as the culture and society change and evolve.
Biomedical expertise must be applied to a variety of problems and situations that involve multiple health-care providers, and complex ethical and organizational considerations. One reason that many IMGs find it difficult to understand how the Canadian medical culture works is because each culture consists of a set of values and principles learned from birth. When we interact with another society, differences in culture can make it difficult to function effectively.
The CanMEDS’ roles ensure that physicians in Canada can work successfully in complex environments for the benefit of society.
The CanMEDS’ roles are intended to:
- Change the focus of physician training in Canada away from the interests and abilities of the individual physician and toward the needs of society
- Train physicians in Canada to consider the needs of individual patients in the context of the population at large
MCC examinations and role objectives
The Medical Council of Canada (MCC) examinations are based on MCC objectives for the qualifying examination.
- The objectives are classified by CanMEDS physician roles
- The objectives related to the central role of medical expert are organized by a detailed list of clinical presentations
- Some of the objectives are also classified under “other” (i.e., non-medical expert) physician roles
These “other” non-medical expert objectives are referred to throughout this program as MCC role objectives. They are provided to show the connections between the topics covered in this program and the MCC examinations. The MCC exams are a requirement for physicians seeking to practice medicine in Canada.
Physician roles and family medicine
For physicians who practice family medicine, it is important to understand the CanMEDS physician roles in the context of family medicine. Each of the cases used in this program are mapped against MCC role objectives and the sentinel habits required of practicing family physicians. You will see how the roles and sentinel habits apply in daily medical practice.
If you will be entering a Canadian practice in family medicine, it is important to become familiar with the expectations that are specific to that specialty: the “Four principles of family medicine” and the “Eight sentinel habits.”
The four principles of family medicine:
- The family physician is a skilled clinician.
- The patient-physician relationship is central to the family physician role.
- The family physician is a resource to a defined population.
- Family medicine is community based.
To learn how these four principles relate to the CanMEDS roles, please read this document from the College of Family Physicians of Canada.
The eight sentinel habits
In addition to the principles above, the College defines the following eight sentinel habits for family physicians.
- Incorporates the patient’s experience and context into problem identification and management
- Generates relevant hypotheses resulting in a safe and prioritized differential diagnosis
- Selects and attends to the appropriate focus and priority in a situation
- Manages patients using available best practices
- Demonstrates respect and/or responsibility
- Uses clear and timely verbal or written communication
- Uses generic key features when performing a procedure
- Seeks out and responds appropriately to feedback
Each of the cases used in this program are mapped against MCC role objectives and the sentinel habits required of practicing family physicians. You will see how the roles and sentinel habits apply in daily medical practice.
Begin the program
You can study the modules and cases that comprise this program in any order that you choose. Each case contains a self-assessment quiz related to the specific case content. First, take the self-assessment to determine if you need to study a particular topic or objective prior to completing the case.
Before you begin to study the cases, we also recommend that you review this information:
- The Canadian Medical Association Code of Ethics
- The CanMEDS’ roles
- If you plan to practice family medicine in Canada, read this document about how the “Four principles of family medicine” are related to the CanMEDS’ roles
This content is intended for the information and education of those who access it. The creators of the program, and any and all other parties involved in the creation and delivery of the program, assume no liability for the accuracy of the information therein, nor for any errors or omissions contained therein. The creators assume no liability for any use to which the program is put by those using it. Users of the portal should further understand that feedback provided from quizzes and similar exercises are for the personal use of the person undertaking the task, and does not imply any recognition of or attainment of a standard of competence. The creators and others involved with this program assume no liability for any consequences that may accrue to users.
This program will not prepare you for any particular course, assessment or examination.Start the program