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The Continuum Model of Cultural Competence: Development and Implementation of a New Training Approach for Clinicians at a Hospital in Regional Queensland, Australia

Gabriella Berger,Anita Peerson

Background and Rationale: In the 21st century, cultural competence training of the clinical health workforce has become a key approach in English-speaking countries to improve the health outcomes of its culturally and linguistically diverse (CALD) populations. Increasingly researchers from around the world have proposed and implemented training options and models which incorporate perspectives from various professional disciplines such as public health, nursing, allied health, medicine and medical sub-specialities such as psychology and psychiatry.

Method and Findings: A new cultural competence model has been developed due to other models: i) using numerous definitions; ii) describing different segments of the cross-cultural interaction between patients and health professionals; iii) lacking description, content and depth; and iv) conflating culture with race and ethnicity. The innovative Continuum Model addresses these shortcomings and advocates a 3-step approach to training clinicians. Firstly the dynamics of health and ethnicity in the local CALD context are explored, then the mediating influences within and outside culture are examined, and finally strategies to achieving cultural competencies in the clinic are provided. The Continuum Model has been developed in mid-2010 and implemented for junior doctor training since January 2011 onwards at our regional health service in Queensland, Australia. So far well over 255 doctors, mainly junior doctors and international medical graduates have participated in training and provided feedback. Written and verbal evaluation data has been collected which illustrates its effectiveness and success.

Summary: Precepting with the Continuum Model promotes a supportive learning environment and describes a practical, concrete and integrated approach for atrisk patients and improves key outcomes.