Intercultural competence in medical education - essential to acquire, difficult to assess.

Determining student acquisition of intercultural competence (awareness, skills, knowledge and attitudes) is necessary in medical courses. However, addressing students' learning needs and developing effective tools to measure development of intercultural competence is challenging. Where this is done inadequately, skills may be overlooked or simplistic, one dimensional notions of culture be reinforced. This article examines aspects of the OSCE station development process, raising questions about how and when to assess acquisition of IC in undergraduate medical courses. It cautions against development of assessment tools which may lack authenticity and require students to engage in interactions which are unnatural. It argues for skills consistent with IC to be viewed as part of, and not separate from, the broad spectrum of skills which are a feature of any sensitive and appropriate doctor-patient interaction. Finally it advocates careful consideration of the optimum time to assess students' capacity to demonstrate IC in their interactions with patients, peers and staff, suggesting that this should come in later rather than earlier years, following theoretical, experiential and reflective learning.