Assessment of Competences of an Academic Teaching in an Intercultural Classroom

Academics and doctors who train medical students are generally enthusiastic about delivering contents and skills which are directly related to the structure and function of the human body. Students learn from these experts about how to interact with the human body either through some chemical substances or through some invasive procedures which change the tissue composition of the patient in one way or another.

The CLILMED project, however, attempts to develop skills in other kinds of human interactions: communication skills and professional behavioural attitudes. This may sound odd for medical professionals who may seem to be more interested in physical interactions.

We have developed the self-assessment test alongside the Glocal Competence Profile for Medical Educators. As a tool, the Profile is intended to clarify and support lifelong learning and lead educators toward developing their own Itercultural Competence (ICC) and the one of their students’. Click —> the Glocal Competence Profile for Medical Educators for its detailed explaination.

User Guide

  • Click on THIS LINK to access the free self-assessment test;
  • Calculate your result;
  • Assess yourself against the criteria provided below;
  • If you are interested why and how we developed the test, see our background explanations (below).
  • Take action! Use other CLILMED tools to advance your professional development in a medical classroom.

How to understand the test-taking process:

The questionnaire aims to help explore the frequency of specific events in the context of teaching and learning activities along the teacher`s praxis up until the point of taking the self-assessment. Each question is framed as a positive statement, e.g. “I exercise this teaching competency with all of my students”.

Respondents decide the frequency of those events in their teaching praxis where the positive statement in question can reflect truth. Frequency of these events is decided with a unipolar Likert scale using five items: never-rarely-sometimes-often-always. The meaning of these scale items are:

How to understand your result and what to do next:

The majority (over 50%) of your answers was “never” or “rarely”.  

When you teach, you seem to be in the initiation phase of the process to develop intercultural competences. Being in this phase indicates a clear need for a targeted action.  

You might be in this phase because you have not developed your intercultural competences before, or because you chose not to address this issue yet in your teaching career. 

In either case, your current role of teaching medical students in an international medical program comes with a responsibility. It is imperative that you now pause to think about the reasons for the answers that placed you in the initiation phase of intercultural competence development. This self-reflection can be aided in several ways. 

Your first step forward should be to read our GLOSSARY, which may assist in a better understanding of basic concepts about intercultural competence. 

A second step could be to read all categories of intercultural competence levels (INDEPENDENT, IMPACT, INNOVATION). Doing so might provide an insight about the next goals in your professional development in the area of intercultural competence.

The majority of your answers was “sometimes” or undecided.

You are in the independent phase of developing intercultural competence. You are able to identify relevant activities in your teaching. However, uncertainty in your answers suggests that you might not be obliged by your institution to pay attention to pedagogical standards of international higher education.

Reasons for such outcome could be either that you have not explored pedagogical standards in medical education as defined by law, or that these standards have not been adequately represented, or even ignored, in your teaching.

International standards in medical education exist to assist teachers in delivering quality education. This is a good moment to make yourself aware of such standards in your local context and in the international context we are providing through the “Profile”. 

You may also make yourself familiar with our GLOSSARY of relevant terms to put context to intercultural competence as a basic requirement in international medical education. 

Furthermore, explore what the next intercultural competence levels require of you (IMPACT, INNOVATION). It is possible that your university’s continuous professional development officers could offer advice on how to proceed.

The majority of your answers was “often“. 

You are in the impact phase of developing intercultural competencies. You not only understand the value of intercultural competence, but also are continuously developing your teaching in the area. You are humble to realise that there is always room for improvement. You might need some assistance in deciding how your development could be both strategic and systematic. This would be needed to allow your progress into leadership roles in a competitive academic environment where excellence and quality are measurable. 

You are well positioned to further explore why and how excellence and quality in medical education depend on a highly developed intercultural competence. Because your work environment in academia and especially in medicine is highly competitive, it is advisable to better understand what quality means in your local context and how it is measured at your institution. 

To support your efforts and your intentional monitoring of your own development, we suggest reading the GLOSSARY with quality management in higher education in mind. The might offer an insight on how the intercultural competence is an essential quality marker in top level international medical education. 

Furthermore, looking up to the final top phase of intercultural competence development (INNOVATION) may help you gain a deeper awareness into how to remain excellent within your local work context.

The majority of your answers was “always“.

You are in the innovation phase of developing intercultural competencies. You are continuously developing your intercultural competence, both strategically and systematically. You may think your progress into leadership roles is warranted in a competitive academic environment where excellence and quality are measurable. However, our self-assessment tool has a serious limitation: it can indicate a self-perceived level of proficiency only. This means that the proficiency level verbalised here is not absolute. It is open for challenge by unknown situations arising along the progress in your professional development. To sustain excellence, a self-reflection process can be aided in several ways.

First, as part of your existing strategic and systematic professional development, stay humble and step back regularly by re-reading the descriptions of the lower categories of competency levels (INDEPENDENT, IMPACT). 

Second, global requirements of educational standards may develop independently of your own professional development in your local context. To avoid delusion of self-perceptions, you will need to explore any updates on global pedagogical standards regularly by yourself. Humility is essential at any given point of professional development. 

Finally, it seems essential to regularly share professionally problems and solutions you have found in your local context. This means sharing and discussing your educational measurement data with an international expert community at professional conferences about medical education.

Regardless of the phase you find yourself in, consult the CLILMED Tools available for your professional development. These tools were designed specifically to help medical academics who teach in international medical programs to achieve teaching excellence which is measurable and sustainable. 

Want to know more about how we as the CLILMED partnership have developed this test?

Read on below. 

 

Why the need for systematic assessment of intercultural communication competencies?

There are some good reasons why medical professionals in general are less interested in formal training about professional attitudes (such as intercultural communication competence). The rules and art of communication of doctors have always been shaped by existing cultural or societal norms. There was no need for a formal training in these competences within the university for centuries. Communication competences in general are being well developed at those medical schools where the quality of teaching includes regular oral (viva voce) exams or meaningful consultations between academics and small groups of students and between small groups of students and patients. 

Intercultural communication, which is the focus of this project, was historically also part of the informal medical curriculum in antiquity, in medieval and in modern Europe. Knowing foreign languages (beyond the native, the Latin, and the Greek languages), studying medicine abroad, getting clinical training in another country has been more of a rule than an exception in Europe for many centuries. Academics and doctors who themselves have lived in other countries and worked together day by day with colleagues from other cultures have developed their intercultural competence in an informal way which they benefited naturally during their professional career, including their teaching duties. The quality of their intercultural competence was perceived good enough by all stakeholders, therefore there was just no need for systematic measurements. 

From this historical point of view we can surely confirm that skepticism is valid about any benefits of such systematic measurements. Creating unnecessary administrative burdens on medical academics must be avoided at all costs. However, if such measurements can provide a real fix for a systemic problem within contemporary medical education, then the burden of such assessments having been introduced into medical education can be well justified.

Why the need for systematic assessment of intercultural communication competencies?

Societal and global changes in the 20th and 21st centuries have increasingly produced new conditions which have profoundly changed the traditionally universal nature of medical education:

  1. In the 20th century, the increase of medical knowledge, life expectancy, and wealth resulted in the opening of many many more new medical schools globally. It was reasonable to expect that a large number of new institutions will have difficulties to attract the limited number of available academics with sufficient intercultural competences or with sufficient global outlook. Therefore, academics with limited intercultural experience have filled the majority of teaching positions.
  2. In the last two decades, a global trend of internationalisation has introduced multilingual medical programs at both old and new universities. High numbers of international students are admitted with a very heterogeneous background of learning culture, of communication culture, or of beliefs about own virtues needed to cultivate by a medical student.
  3. American sociologists and social psychologists have clearly demonstrated that university students born after around 1995 have very different communication skills (let alone intercultural communication skills) when compared to previous generations. The interpretation of their data contains unprecedented disruption in psychosocial development of teens since 2007 due to the explosion of and access to digital platforms feeding from human interactions. Since 2017 medical schools with international programs experience a decline of students’ communication skills at a global scale. As a consequence, not only international but also their national students show a clear increase in reported mental health issues associated with their curricular progress. The motivation of international students to mingle and work together with each other has decreased according to the perception of their teachers.
  4. Content teachers perceiving these developments (1-3) are facing a key dilemma of their teaching profession if left alone without good leadership support of their institution. On the one hand, teaching efforts must be limited to the absolute truths of relevant natural sciences and social sciences and of contemporary diagnostic and therapeutic procedures. As medicine became one of the fastest evolving disciplines producing large amounts of new knowledge every year, teaching only absolute truths is an overwhelming task for every content teacher as of the quantity of contents to be delivered. Content delivery in its traditional medical context means therefore selection and presentation of only those absolute truths in medicine which are most relevant for medical students. If the selection is not optimal, there remains very little time and space for debate, reflection, or critical analysis of data by students. On the other hand, if such activities are not built into the curriculum in a systematic manner, communication skills cannot be developed. Without a systematic approach directed by the leadership of the university, the dilemma of the course organiser remains how to balance between the amount of content and the amount of such activities within given time limits. Should a teacher break tradition and reduce the amount of content to allow more time for developing communication skills within his or her course? Should a teacher adapt every year to the degrading general communication skills of the enrolled students by reducing the amount of content and increasing the amount of activities? Or should a teacher stick to the traditional path of high contents with high dropout rates to preserve quality education and prestige? Is it possible to preserve both high quality and prestige of content delivery while increasing engagement of students in more activities for skills development? The answer depends on the nature of the course subject in question, and therefore any change in teaching traditions would need very careful planning by the course organiser aided by university leadership. It must be very carefully assessed if an individual course organiser needs to shift focus in his or her traditional course structure and pedagogy in order to align with global (Sustainable Development Goal 4 of United Nations) and institutional goals in quality education. This assessment must not only be driven by university leadership but it also must utilise assessment tools which can reliably inform both teachers and leadership about the process of communication skills’ development.

AUTHORS:

University of Pécs Medical School, Hungary: Andras Nagy, PhD; Tímea Németh, PhD; Zsuzsanna Varga, PhD; Anikó Kőhalmi Hambuchné PhD, Dr Erika Marek; Karolinska Institutet, Sweden: Jennifer Valcke, PhD; Amani Eltayb, PhD; Karin Båge, PhD Candidate; Luminar Foundation, Poland: Justyna Gieżyńska, MA; Semmelweis University: Levente Kiss, PhD; Katalin Monzéger, PhD; Borbála Kozma,  Medical University of Gdańsk, Poland: Damian Szczęsny, PhD; Jacek Kaczmarek, PhD; Katarzyna Rückemann-Dziurdzińska, PhD; Jagiellonian University Medical College, Poland: Anna Żądło, MA; Grzegorz Cebula, PhD; Marta Szeliga, PhD; Ian Bernard Perera, M.D.; Medical University of Warsaw, Poland: Marta Kurzeja, PhD; Emilia Grosicka-Maciąg, PhD; Atlantic Language, Ireland: Katya Radovanova, Peter Scargill.