Using DPT Student Intercultural Development Inventory Profiles to Inform Curricular Activities and Track Student Outcomes
Purpose
Using the theoretical framework in Bennett's developmental model of intercultural sensitivity, this session will address efforts to create a culture of responsive teaching that requires knowledge about Physical Therapy students’ individual and collective orientation towards patterns of cultural commonalities and differences at Year 1 and Year 3 of their academic program.
Methods and/or Description of Project
This session will explore how educators’ can connect with the cultural orientation of each student to provide meaningful classroom practices, guided mentorship, and simulated interview, service and clinical experiences. Information about personal intercultural sensitivity included in the Intercultural Development Inventory (IDI) assessment report provides students with key information to successfully develop intercultural goals, create intentional intercultural learning experiences and reflect on quantitative and qualitative personal outcomes. The Intercultural Development Inventory (IDI) is a cross-culturally valid and reliable assessment of intercultural sensitivity on a 6-point scale from ethnocentrism to ethnorelativism. Past research suggests that one semester of intentional instruction is needed to advance a student’s intercultural development one standard deviation along the tools scale.<span style="font-size:11px; line-height:17px">(Bennett, 1993)</span> The IDI was determined, therefore, to be a sensitive measure of change across the planned 5 semesters of pre and post testing in the DPT curricula. Published research also supports the use of the IDI as developmental tool in providing students with an assessment of their intercultural sensitivity and progress through stages of denial, defense, minimization, acceptance and adaptation.The IDI does not assess knowledge but rather how individuals and groups recognize, behave and respond to patterns of cultural commonalities and differences. In practice, this indicates the degree to which cultural differences and commonalities in values, expectations, beliefs, and practices are effectively bridged. The IDI is different from other tools in that it approaches building intercultural sensitivity with training, education & leadership development that focus on the individual’s and group’s underlying developmental orientation. The DPT intercultural curriculum was created to challenge students to re-frame their interpretation of past intercultural encounters and uncover assumptions that may have guided thier interactions in these situations.
The session will present current student outcome research investigating between class (graduating class 2015 & 2016) differences in IDI collective profiles and within class differences between Year 1 and Year 3 of a DPT program for the graduating class of 2015. The DPT class of 2015 (n=68) and the DPT class of 2016 (n=64), had similar (no significant differences, p<.05) IDI group profiles in which the majority of studetns were in an IDI orientation of Minimization. This would indicate that the group’s primary orientation toward cultural differences reflects a tendency to highlight commonalities across cultures that could potentially mask important cultural differences in values, perceptions, and behaviors.
The DPT School provides opportunities for each student to 1) Review their IDI Group and Individual Profile results, 2) Describe their intercultural background in terms of the IDI Profile results, 3)Analyze developmental goals and progress indicators, 4)Identify those intercultural stress points that are barriers to goal attainment, and 5)Create a Intercultural Development Plan (IDP). Other program learning opportunities include personal intercultural coaching, student reflection and artistic expression of their own culture, motivational interviewing with simulated patients from culturally diverse backgrounds, power and privilege learning activities and reflection, service learning with under-represented and marginalized populations, a global health elective course and global clinical immersion experiences.
The results of the within group study analysis showed that the class of 2015 made significant improvements in mean Intercultural Developmental Inventory (IDI) scores indicating that the students moved along the continuum from ethnocentric stages of denial and defense to transitional phases of minimization and were moving toward ethnorelative stages of acceptance and adaptation.The capability to shift cultural perspective and adapt—or bridge--behavior to cultural commonality & difference requires:
1. Deep cultural self-awareness
2. Deep understanding of the experiences of people from different cultural communities—in perceptions, values, beliefs, behavior and practices
3. Behavioral shifting across these various cultural difference.
The School of Physical Therapy recognizes that intercultural skills are an important component of clinical practice and leadership behavior and believes that student development is enhanced when curricular activities are uniquely designed to meet students where they are in their orientation towards cutlural sensitivity.This session will reveal how student outcome research and a purposeful intercultural development curriculum will cultivate physical therapists who are committed to providing culturally sensitive care in a diverse and dynamic health care environment. Practical applications will be shared as to how evidence-based decision making can be integrated into student curriculum, inter-professional learning opportunities and global clinical immersions. The session is intended to be interactive to faciliate sharing of creative and innovative curricula focused on intercultural development.
Results/Outcomes
At the end of the session the learner will be able to:
1. Explain the DPT student experience with the IDI and cultural sensitivity curricular thread.
2. Understand how DPT faculty use the IDI student and group profiles for advising, planning curricula and assessing outcomes
3. Describe the DPT student IDI composite in terms of Bennett’s developmental model of intercultural sensitivity
4. Explore creative and challenging classroom activities, aesthetic expression presentations, interview simulations, interprofessional-cultural immersions and individual inter-cultural coaching aimed and helping students move along the intercultural continuum.
Conclusions/Relevance to the conference theme: Shaping the Future of Physical Therapy Education
Shaping future physical therapists happens when faculty intentionally and dynamically shape curricula in response to evidence based student outcomes. Developing students with intercultural competence is a core capability in today's health care environment and involves "cultural self-awareness, understanding the experiences of people from diverse communities, and the capability to adapt one’s mindset and behavior to bridge across differences."(Bennett, 1993) This session is intended to promote small table and large group dialog around innovative teaching methods that result in the development of a student who can “provide services that are respectful and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients” (NIHCC, 2014)
References
Bennet MJ. Toward a developmental model of intercultural sensitivity. IN R. Michael Paige (Ed.), Education for the intercultural experience. Intercultural Press, Yarmouth, ME. 1993.
Campinha-Bacote J. The process of cultural competence in the delivery of healthcare services.(4th ed.). Transcultural Care Associates. Cincinnati, OH: 2003.
Dupre A, Goodgold S. Development of physical therapy student cultural competency through international community service. J Cult Divers. 2007;14(3):126-134.
Fabregas Janeiro MG, Lopez Fabre R, Nuño de la Parra JP. Building intercultural competence through intercultural competency certification of undergraduate students. JIER. 2013;10 (1):15-22.
Hammer MR, Bennett MJ, Wiseman R. Measuring intercultural sensitivity: The intercultural development inventory. Int J Intercult Relat. 2003;27 (4):421-443.
Hammer MR. Additional cross-cultural validity testing of the Intercultural Development Inventory. Int J Intercult Relat.2011;35 (4):474-487.
Hayward L M, Li Li. Promoting and assessing cultural competence, professional identity, and advocacy in doctor of physical therapy (DPT) degree students within a community of practice. JOPTE. 2014;28 (1):23-36.
Hilliard MJ, Rathsack C, Brannigan P, Sander AP. Exploring the cultural adaptability of doctoral entry-level physical therapist students during clinical education experiences. J Allied Health. 2008; 37(3):e199-e220.
Lazaro R, Umphred D. Improving cultural diversity awareness of physical therapy educators. J Cult Divers. 2007; 14 (3):121-125.
Lewis A, Bethea J, Hurley J. Integrating cultural competency in rehabilitation curricula in the new millennium: keeping it simple. Disabil Rehabil. 2009; 31 (14):1161-1169.
Matteliano MA, Stone JH. Cultural competence education in university rehabilitation programs. J Cult Divers.2014 21(3):112-118.
May S, Potia TA. An evaluation of cultural competency training on perceived patient adherence. European J Physiother. 2013; 15(1):2-10.
Morton J. Transcultural healthcare immersion: a unique interprofessional experience poised to influence collaborative practice in cultural settings. Work (Reading, Mass.) 2012; 41 (3):303-312.
Munoz CC, DoBroka CC, Mohammad S. Development of a multidisciplinary course in cultural competence for nursing and human service professions. J Nurs Educ. 2009; 48 (9):495-503.
O’Shaughnessy D, Tilki M. Cultural competency in physiotherapy: a model for training. Physiother. 2007; 93 (1):69-77.
Pechak C M. Survey of international clinical education in physical therapist education. JOPTE. 2012; 26 (1):69-77.
Portney L, Applebaum D. Integrating objectives for clinical education, research, and service learning into community health promotion projects. JOPTE. 2006; 20 (3):18-24.
Veras M, Pottie K, Cameron D, et al. Assessing and Comparing global health competencies in rehabilitation students. Rehabil Res Pract. 2013; 1-9.
Course Objectives
1, Understand primary principles of an Developmental Model of Intercultural Sensitivity
2. Identify the theoretical framework for the Intercultural Development Inventory and compare to other evidence based frameworks
3. Explore the student experience with the IDI plan and the DPT intercultural curriculum
4. Consider how a continual cultural self-assessment process and intentional intercultural sensitivity curriculum can enhance the student’s ability to provide services that are respectful and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients.
Instructional Methods
1) Presentation of Bennets' Developmental Model of Instercultural Sensitivity: Power Point and Lecture
2) Sharing Intercultural Developmental class composites: Power Point and Lecture
2) Sharing Intercultural Curricular Activities and Experiences: Power Point and Lecture
3) Sharing student presentations related to Intercultural Development: Videos, story telling, poetry
4) Small group discussion regarding curricular design, teaching methods, strategies and experiences to meet students oreintation to intercutlural development.
5) Large group sharing of main points: Facilitated Discussion
Tentative Outline/Schedule
1) Presentation of Student Outcome Research and Bennet's Developmentla Model of Intercultural Sensitivity: 20 minutes
2) Discussion around individual intecultural development coaching, curricular Activities and Experiences Related to Intercultural Development: 15 minutes
3) Sharing Student Presentations Related to Intercultural Development: 10 minutes
4) Small Group Discussion Regarding Curricular Design, Teaching methods, Strategies and Experiences that meet student's where they are in their intercutlural development: 30 minutes
5) Large Group Sharing of Main Points: 10 minutes