First-year medical students' attitudes toward diversity and its teaching: an investigation at one U.S. Medical School.

PURPOSE: To investigate whether medical students conceptualize culture and cultural diversity best within "categorical" or "cultural sensibility" teaching models.
METHOD: In spring 2002, first-year medical students at the University of Illinois Colleges of Medicine at Chicago and Urbana-Champaign completed a previously developed questionnaire. A self-selected subset participated in focus groups. The questionnaire collected data on attitudes toward race, culture, and diversity education and how these concepts relate to medical practice; responses to a case scenario; attitudes toward cultural tolerance; definitions of key terms and sense of cultural belonging; and feedback on the questionnaire. The focus groups discussed the two models for teaching diversity.
RESULTS: Questionnaires were returned by 111 of 153 students (72.5%). Generally, the students displayed open attitudes about the balance between cultures of origin and the culture of the wider community in which immigrants may live. However, with very personal issues there was a tendency to stay with the familiar. These students had an impression of ethnic groups as very discrete and well defined. Skin color and issues of race remained a significant barrier to dialogue regarding diversity. Students were overwhelmingly in favor of the cultural sensibility teaching model that emphasizes the fluidity and malleability of culture.
CONCLUSIONS: The students in this study were not familiar with key terms on culture and race, and struggled with the issues that diversity raises in medical practice. Although students held open attitudes toward equal opportunities and multiculturalism, differences among and within groups indicated that all students would benefit from a curriculum that emphasizes self-reflection and diversity teaching.