Preceptors’ Pointers: How to be a Culturally Sensitive Preceptor.

An occasional series of preceptor-related questions with answers from experienced preceptors.

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Q: I’ll soon be precepting a student who is very different from
me culturally. How do I establish a relationship with her that is
culturally sensitive and minimize the potential for conflicts or
misunderstandings?

A: I would meet with her prior to beginning the preceptorship and
ask her if she has any concerns and what cultural influences she has
identified that might impact her learning or practice. Beginning the
precepting relationship on a foundation of open honest communication
and respect will go a long way toward minimizing conflicts or
misunderstandings. You could also suggest a plan for how your student
can handle an issue if it arises and discuss appropriate times to bring
up any concerns.

A: Rule 1: Make No Assumptions. Don’t assume a level of comfort,
familiarity, or knowledge. When the preceptor and student meet,
it should be in a safe place and there should be an open level of
conversation about expectations on both sides.

Rule 2: Think before you speak or act (unless there is an obvious
danger). Remember there are often many adequate ways to accomplish
the goals before you. I sit in front of a birthing woman. My students
often stand. One preceptor might be all about hand maneuvers and
another is about letting the mom do whatever. Is one way more right
than another?

Rule 3: The person is the expert on his or her own culture.
Communicate. Suppose that you have a belief that all members of X
group behave in Y way, and in front of you is a member of X group who
doesn’t behave in Y way. Who is in error here? I have been a preceptor
for years and have had dozens of students and each was a universe
into his or her self.

A: Do it the same way we deal with our patients every single day,
with respect, understanding, and acceptance, enhanced by open and
straightforward communication and questions. Our students should
be coming to us with those qualities too (since they are going to be
midwives). Asking questions and seeking information in a sensitive
manner are critical elements to interview skills and a showing a caring
attitude in everything we do. Sigh …. if only it were actually so easy, yes?

A: What does it mean to be culturally competent? This is an important
question that providers need to be asking themselves in order to not
only provide culturally competent care, but also to be able to have
an effective professional relationship with health care professionals
from different cultures…. We can best support our students in cultural
competence by leaning on the principles of bioethics. We can discuss our
own professional challenges about how certain patients or situations
have challenged our own moral agency. Serving as a preceptor holds
ethical weight just as does caring for a patient. Regardless of who our
students are, the focus must remain on the patient, on the learning,
and on the professional growth.

A: Precepting for years has shown me no two students are alike.
Just as siblings are related, but different, Similarly, students and
preceptors are related by their desire to help women, but different
in many respects. Start on common ground with common goals and
interests. Then, be respectful and curious: “Tell me about…,” “What
are your thoughts about…,” “How do you think women might react or
respond to….” Capitalize on and encourage their honest responses. Try
to remain open and nonjudgmental as a modeling strategy for your
student to model for her patients. Differences are not negatives; they
are opportunity for growth on both parts. Relax.