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Institute for International Medicine
Online International Medicine Course |
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Module Three: Cross-Cultural Skills
Introduction to Cross-Cultural Skills
International medicine by definition involves the health of those in developing nations. Because physical health is closely connected with cultural context, the ability to understand and interact with other cultures is an essential component of the international medicine skill set. It is also an increasingly recognized competency for medical training in North America (Dolhun, Munoz, & Grumback, 2003).
These skills are important because most health professionals involved with international medicine will journey to a developing nation with excellent intentions. However, cultures are not easily understood, nor are they easily entered. For example, consider findings published in the International Herald Tribune: "More than one-third of Americans who take up residence in foreign countries return prematurely because they are unable to adapt to day-to-day life" (1984). Those Americans who nevertheless stay on in foreign lands do not necessarily adapt to the local culture. Robert Kohls, author of Survival Kit for Overseas Living, observed, "The success rate of overseas adjustment among Americans is not nearly as high as it might be. If left to luck, your chances of having a satisfying experience living abroad would be about one in seven" (1984, p. 1).
As disappointing as a premature return can be to an individual, the costs of cross-cultural failure can be more far-reaching:
- Financial costs: The financial expenditure for recruitment, training, travel, and replacement incurred by companies, governments, and institutions can run into the hundreds of thousands of dollars per returning person.
- Political costs: Lack of cultural understanding accounts for much of the standoff in the Middle East, North Korea, and Northern Africa, where the beliefs and values of national leaders stand in marked contrast with their counterparts in industrialized countries.
- Business costs: Of all the business blunders engendered by cultural blindness, few can surpass that of the General Motors' introduction of the Chevy Nova to Central America in the 1980s. Apparently, no one at General Motors considered the fact that, in Spanish, "no va" means "it doesn't go."
| Much of your effectiveness on the job and satisfaction in the overseas living experience will depend on how well you build working and social relationships with host nationals. Skillful intercultural communication is a medium for finding out what expectations your hosts have of you and of getting across your expectations of them. It is a means of creating trust and communicating your sincerity and good will. It is a method of anticipating problems and solving those which arise. It is a channel for reaching out and establishing links with people (1984, p. 62). |
The growing influx of internationals moving to industrialized nations-and bringing with them enormous cultural diversity-also begs for greater understanding and cross-cultural skills on the part of health leaders who remain in their home countries. But most of them have never been instructed and hardly know where to begin.
This module will explore the most basic principles of cross-cultural adaptation, with an emphasis on the personal experience of expatriates-people entering new cultures.
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