Curriculum Co-design for Cultural Safety Training of Medical Students in Colombia: Protocol for a Qualitative Study

  • Juan Pimentel
  • Germán Zuluaga
  • Andrés Isaza-Restrepo
  • Adriana Molina
  • Anne Cockcroft
  • Neil Andersson
Keywords: Cultural safety, participatory research, medical education, Colombia, thematic analysis.


Background: Cultural safety in medical training encourages practitioners, in a culturally congruent way, to acknowledge the validity of their patients' worldviews.(Allan & Smylie, 2015) Lack of cultural safety is linked to ethnic health disparities and ineffective health services.(Institute of Medicine (U.S.). Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, 2003)

There is growing agreement about the need to train medical students to provide care that is congruent with the cultural needs of patients.(Liaison Committee on Medical Education, 2017; Vogel, 2018) Colombian medical schools do not currently provide training in cultural safety.

Objective: The aim of this qualitative study is to: (i) document the opinions of stakeholders on what a curriculum in cultural safety should teach to medical students; and (ii) use this understanding to co-design a curriculum for cultural safety training of Colombian medical students.

Methods: Three different groups of stakeholders will co-design the curriculum: (i) 10 traditional medicine users from the “Seed of life” community organization in Cota, Colombia; (ii) 25 senior medical students from La Sabana University, Colombia; and (iii) 20 cultural safety experts from the Center for Intercultural Medical Studies (CEMI) in Colombia and Participatory Research at McGill (PRAM) in Canada.

Individual self-administered structured qualitative questionnaires and focus groups will explore the opinions of the stakeholders on what a co-designed cultural safety curriculum should teach to medical students in order for them to provide culturally safe services in Colombia. Two research assistants will use an inductive thematic analysis to create themes and sub-themes.

Two expert panels comprised of cultural safety experts will use deliberative dialogue to decide on the learning goals of the co-designed curriculum. The panels will be informed by the results of the questionnaires and focus groups exploring opinions of stakeholders. Finally, the traditional medicine users and medical students will review, modify, and approve the final version of the curriculum.

Anticipated results: This participatory research project will produce the first co-designed curriculum on cultural safety in medical education in Colombia. This curriculum will integrate the perspectives of different stakeholders, such as traditional medicine users, medical students, and cultural safety experts. The curriculum will inform future cultural safety training in medical and health sciences education. Ultimately, the results of this project will yield evidence to develop participatory methods to co-design medical training programs.

Long-term potential benefits for stakeholders include enhanced quality of delivery of healthcare services (higher patient satisfaction, improved doctor-patient relationship, increased patient adherence) and reduced health disparities in communities of Colombia. The results of this study will be relevant to Canada and other multicultural settings.