01 30 shaffer feng from classrooms to clinic header
Jen Rosio, University of Utah Health
impact
Cultural Wealth: From Classroom to Clinic to Community
We often overlook the wealth of diverse cultural experiences and perspectives that profoundly influence the well-being of our students and patients. Educators Kerri Shaffer and Nina Feng leverage community cultural wealth to transform healthcare education for a more inclusive future.
E

ven with significant efforts to integrate culturally inclusive care into our health organizations, marginalized communities across the nation continue to face overwhelming barriers to quality care.

When we’re talking about overturning centuries-old systemic health disparities, our efforts must begin long before a patient sets foot into our clinics. We realized that the first steps to embracing culturally inclusive care must begin where most of our foundational learning starts – in both clinical and traditional classroom environments.

To breach these barriers, we sought to operationalize and implement anti-discriminatory practices well before prospective medical students entered their fields. Our path to incorporating community cultural wealth into the continuum of learning began with our educators.

To help our educators learn more about culturally inclusive care, we hosted an interdisciplinary faculty development retreat. With the help of a diverse selection of panelists, we created a retreat that focused on three essential domains: public health, medicine, and humanities education.

Consisting of various workshops, immersive activities, and discussions, our event aimed to share the importance of community cultural wealth within the learning cycle.

Understanding Community Cultural Wealth 

The concept of community cultural wealth was introduced by professor Tara Yosso. It reflects the collection of various qualities and experiences that students from different cultural backgrounds bring to the classroom. Yosso argues that we should acknowledge the diverse strengths of our students, including their linguistic, social, familial, and aspirational skills, rather than turning to conventional academic strengths to define intelligence or success.

Our retreat focused on transforming narratives when it comes to teaching the next generation of health care workers. Instead of, “Students aren’t trying hard enough,” we encouraged participants to try: “Let’s consider the inequities students face that contribute to learning differences.”

Shifting Pedagogical Perspectives 

To tackle systemic racism and inequities within education, it’s essential to transition from a deficit mindset to a pedagogical approach that recognizes and builds upon the inherent strengths and assets of students.

We knew we needed to flip the script from the deficit thinking of, “We help them because they need us,” to recognizing that our medical students struggle to care for diverse populations because we haven’t taught them about different cultures. Our first step was to bring that community knowledge and wealth to help students learn how to provide culturally humble care for different populations.

Application of Cultural Wealth in Clinical Settings  

We implemented several activities to help our students learn more about different cultural assets and promote community engagement.

Cultural Asset Activities

  • Exercises like the “ice cream cone cultural activity” encouraged students to reflect on their background and share the strengths of their cultures with their peers.
  • We also arranged for students to explore different communities with our local community health workers. They met other populations and discussed the strengths of that community and the unique challenges they faced.
  • We created a new initiative where students working in our student-led clinic collaborated with community health workers as part of the interprofessional team.

Linguistic Diversity and Knowledge Exchange 

Through these experiences, students learned about the importance of community knowledge. Understanding the linguistic diversity across cultures, or the differences in languages and how people communicate with each other, also benefited our clinical workers and learners.

Panelist Contributions 

We brought in four outstanding panelists with multidimensional experiences to lead our retreat discussions on anti-racism and inclusive teaching.

  • Dr. Jessica Jones addressed problems with traditional definitions of professionalism. She demonstrated that certain assumptions like “your hair looks unprofessional” or “your speech is improper” can be weaponized against marginalized DEI student populations.
  • Health equity advocate Dr. Ivette Lopez pushed for continued community engagement with the support of community health workers as a primary way of learning about the needs of marginalized populations.
  • Dr. Claudia Geist, a gender studies specialist, discussed her insights on social constructions of gender and the inequities  associated with gender stereotypes.
  • Finally, Huntsman Mental Health Institute’s chief executive administrator Dr. William Smith spoke on the impact of racial battle fatigue and the stress responses triggered by ongoing racial discrimination and hostility.

Audience and Impact 

Our retreat hosted a wonderfully diverse audience, including clinicians, professors, graduate students, postdocs, community health workers, and staff. Many of our panelists and audience members shared personal stories, which genuinely highlighted lived experience as knowledge.

We encouraged our community health workers and staff to facilitate group discussions and share their personal experiences. This distinctive opportunity had never been available to many of our faculty members before.

Anti-Racist Techniques and Leveraging Community Wealth 

From our retreat, we’ve compiled some simple tips for providers and educators to implement anti-racist techniques and utilize community wealth in clinics and classrooms: 

  1. Listen: Whether you’re engaged in a conversation with a student or a patient, try to sit back and listen. Appreciate the cultural wealth that they bring to the table.  

  2. Recognize expertise: Realizing that you may not be the expert on a particular subject can be humbling, but other people’s perspectives can teach us so much more than any textbook. We are not the expert on other people’s lived experiences.

  3. Be other-oriented: When meeting with students or patients, avoid preconceived notions about their needs. Consider opening conversations by asking them about themselves and partnering with them to find solutions that meet their unique goals.

    • Simple actions, such as learning someone’s name or taking time to understand their interests or long-term goals, can create a sense of inclusion for patients and students from underrepresented backgrounds, whose needs are often overlooked

  4. Be a mentor: Providing mentorship opportunities can profoundly impact the overall success of underrepresented students. We can foster healthy relationships between faculty and students by advocating for informal sessions like coffee meetings or more structured guidance like research partnerships. Mentorships foster a sense of belonging and promote academic growth for students from diverse backgrounds.  

The Cultural Humility Rubric 

One of the other tools for growth we introduced after the retreat was our Cultural Humility Rubric. This formative assessment was created as a way for faculty to evaluate and design curriculum.

Our standardized assessment includes shared definitions and understandings of cultural humility and common language for students and faculty to use during their discussions. We hope this will encourage our faculty and students to learn more about the importance of cultural diversity in the classroom. 

Future Events 

We hope to continue collaborating with different institutions, disciplines and perspectives for events and workshops in the future. We’re striving to integrate a more holistic approach to care by exposing our practitioners and students to a wide range of ideas. Some of the initiatives and sessions on the horizon include:

  • Sessions on gender-affirming care 

  • Workshops on LGBTQ+ health 

  • Discussions with community activists  

  • More frequent faculty retreats  

We often overlook a wealth of diverse cultural experiences and perspectives that profoundly influence the well-being of our students and patients. This early exposure to a variety of cultural perspectives helps break down stereotypes, biases, and misconceptions and promotes a more open-minded society.

Through our retreat, we hope our leaders and learners were inspired to apply the principles of community cultural wealth to clinical settings to create a more inclusive, welcoming environment for every patient who walks through our doors.

Special Thanks

  • Tashelle Wright, Director of the Office of Health Equity, Diversity, and Inclusion, University of Utah's School of Medicine
  • Jessica L. Jones, MD, MSPH, Associate Professor, Division of Public Health, University of Utah Health
  • Ivette Amelia López, PhD, MPH, Professor of Public Health, Director of the Utah Area Health Education Centers, University of Utah Health
  • Claudia Geist, Interim Chair, Division of Gender Studies, University of Utah
  • William A. Smith, PhD, Chief Executive Administrator, Huntsman Mental Health Institute (HMHI), University of Utah School of Medicine and the Department of Psychiatry.
Contributors

Kerri Shaffer

Director of Curriculum and Faculty Support, University of Utah School of Medicine

Nina Feng

Coordinator of Inclusive Pedagogy, Martha Bradley Evans Center for Teaching Excellence

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