December 8, 2011

Bridging the Multicultural Divide

by M. Amjad Zauher, Doctor of Pharmacy Candidate, University of Maryland School of Pharmacy 

I still remember the thoughts running through my mind as I walked into my first class in my undergraduate program. Here I was, in a new country, coming from Colombo, Sri Lanka, a city with a population of over five million, to Clarion County, Pennsylvania, with a population of twelve thousand. I was clearly an outcast – from the color of my skin to my accent, everything was different. Rural Pennsylvania seemed far from welcoming. All I knew was the British educational system. Multiple-choice exams were a foreign concept and I was accustomed to completing all assignments by hand.  Graphing calculators were used in science fiction movies, not in college classrooms. I had to quickly learn how things worked in America.

As the semester rolled on, some professors were exceptional in helping me, explaining what was expected, and how to complete required assignments. More importantly, they brought down that invisible wall in the classroom that made me feel ostracized from everyone who was not like me. I was by no means unique; they were doing this for all the students, whether they were from down the road or from half way around the world.

To bridge the cultural divide that often separate students who come from diverse backgrounds, educators can incorporate techniques such as these:
  • During the first class, have the students say something about themselves.  If its a bigger class, have them write specific information on note cards (city of birth, hometown, hobbies, etc.) for later discussion.
  • Take time, either before or after class, to talk to students about how they are handling the change in academics, atmosphere, and society. Get to know more about each person’s background, ethnicity or culture.
  • Small group projects, in or out of class, promote interaction between students and increase the amount of discussion with classmates with whom they would not ordinarily interact.
  • BaFa BaFa!
Although I can only speak about my own experience as an international student, I believe I represent minorities in many classrooms. Minority enrollment in colleges and schools of pharmacy across the United States have increased from 10.6% to 14.0% between 1988 and 2002.1  And the number of students enrolled at the University of Maryland School of Pharmacy who come from minority backgrounds is greater than 50% (Asian = 45%, African American = 10%, and Hispanic = 2%).2 However, little to no data is available regarding the diversity of pharmacy students in other aspects (e.g. socioeconomic status, sexual orientation, physical ability).

Why is it important that diversity be addressed? It is not simply a matter of making students from various backgrounds feel more comfortable within the classroom, but rather how it shapes us as pharmacists down the road. In 2005, immigrants made up 11.5% of the US population, an increase from 4.7% in 1970 with, approximately 1.5 million immigrants arriving to the United States each year.3 People from different cultures have their own health beliefs and as pharmacists, it is our duty to understand and address the belief systems of our patients. The more experience and practice we get as students through interaction with a diverse group of people, the better prepared we will be at resolving health disparities.1 

Here are a couple of specific classroom-based examples I found to be beneficial to help address students of diverse backgrounds:

Professor Deborah Ball at the University of Michigan pointed out some techniques she employs during her lectures to engage students.4 These include: maintaining eye contact with students throughout the classroom (not just in the front row), initiating “small talk” among the students (by posing questions and having neighboring students discuss), and asking for opinions from different students in every class.

A cultural competence lesson that I hadn't experienced until coming to the University of Maryland was the BaFa’ BaFa’ cultural simulation game.3  The game involves splitting the class into two groups (Alphas and the Betas).  The rules of the game are explained to each group seperately. The Alpha group was a relationship oriented society with strict rules about social behaviors, whereas the Beta group was a trading society that communicated via a complex language. Gradually, members were exchanged between the groups without explanation of how to communicate with the members in the other group. Once everyone had attempted to communicate with the opposite group, the class met as a whole and discussed the experience. Fun as it was to try and figure out what was going on, an incredibly valuable lesson was learned: the feeling of being in a “foreign” culture. We discussed misconceptions that we might have developed through our brief “clash of cultures” and we talked about our past experiences. I was easily able to relate to the exercise but many of my peers had never personally experienced this sensation. 

We live in a world that, with every passing moment, is having its cultures intertwined.  This is resulting in an amalgam of ideologies from all corners of the globe. Teachers will need to implement their own method for breaking down cultural barriers, whether it is through a cultural competence lesson (such as in the BaFa BaFa experience) or creating an “open floor” style of classroom where everyone has an equal say (such as Dr. Ball's small talk exercise). The ability of an educator to communicate with students in a manner that is transcendent is imperative if we want all students to be successful. As an international student being in a classroom where I felt initially separated from the group, a teacher who was able to bridge the gap brought us together. 

1. Nkansah N, Youmans S, Agness C, Assemi M. Fostering and Managing Diversity in Schools of Pharmacy. Am J Pharm Educ. 2009; 73: Article 152
3. Westberg SM, Bumgardner MA, Lind PR. Enhancing cultural competency in a college of pharmacy curriculum. Am J Pharm Educ. 2005; 69: Article 82
4. Arthur F. Thurnau Professors/Engaging Students in the Classroom and Beyond [Internet]. Ball D. Engaging Students in Larger Classes. Center for Research on Learning and Teaching: University of Michigan; 2000.

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