Addressing Gaps in Military Cultural Competence in Medical Education

Research Paper Title

Addressing Military Cultural Competence in Medical Education.

Abstract

Dr. Lypson and colleagues reported that continuing education workshops, aligned with objectives of the Joining Forces Initiative, can increase knowledge and understanding of veterans’ unique health needs among Veterans Health Administration (VHA) and non-VHA employees.

However, based on the US House of Representatives Committee on Veterans’ Affairs hearing, “Shaping the Future: Consolidating and Improving VA Community Care,” held on March 7, 2017, military cultural competence remains a challenge for VHA and non-VHA community providers alike.

Through medical education reform, the authors believe that high-quality veteran-centered care starts by empowering physicians-in-training to be more military culturally competent and responsive to veterans’ visible and invisible war wounds.

Although many physicians-in-training receive short-term training in VHA health facilities, didactic classes on military cultural competence and veterans’ unique combat and reintegration health needs are limited. This lack of understanding may impact how physicians apply clinical knowledge to practice, which negatively impacts delivery of veteran-centered care. To reduce this “knowledge–practice gap,” the authors propose three strategies that reinforce military cultural competence in clinical practice as an integral component to veteran-centered care.

  • First, medical curricula should incorporate didactic coursework about the history of US military wars and conflicts, including occupational and environmental exposures. Accompanying case studies can provide – for providers addressing veterans’ health needs – information about the clinical and social contexts veterans encountered during combat deployment and the six-month or longer reintegration period.
  • Second, required mentorship and clinical rotations of third- and fourth-year medical students with VHA providers in primary care and mental health clinics can offer additional opportunities to learn about specific physical and psychosocial health challenges as well as the effects of war wounds on veterans’ families.
  • Third, by linking customer service principles3 with veterans throughout medical training, medical students can advance interpersonal communication skills and build rapport with veteran “customers,” aiming to enhance veterans’ experiences in service delivery.

As key health care leaders, physicians must address gaps in medical education that do not fully prepare medical students with a toolkit of competencies relevant for veteran-centered care. By expanding this essential training beyond US borders, international physicians can also strengthen their clinical expertise and responsiveness to identify veterans’ visible and invisible war wounds as well as apply customer service principles in delivering health care services to veterans.

Reference

Mathewson-Chapman, M. & Chapman, H.J. (2017) Addressing Military Cultural Competence in Medical Education. Academic Medicine: The Journal of the Association of American Medical Colleges. DOI: 10.1097/ACM.0000000000001977.

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