The learning and teaching of cultural diversity in undergraduate medical education in the UK.

The aim of this thesis is to identify and analyse the origins, organisation, contents, delivery and outcomes of the learning and teaching of 'cultural diversity' within undergraduate medical education in the UK. Literature reviews of the history of medical education and relevant educational theory were conducted. Two ideal type models of 'cultural diversity' teaching programmes, designated as the 'cultural expertise' model and the 'cultural sensibility' model, were devised. Comparisons were made between the educational philosophy, educational process, educational content and outcomes of the two models. The models were then utilised as benchmarks against which to analyse and compare approaches and programmes to the teaching of 'cultural diversity'. The main research objective was to identify perceptions and evaluations of the teaching and learning of 'cultural diversity' held by a range of stakeholders in medical education including policymakers, school heads, teaching staff, researchers, students and users. Qualitative interviews of 61 respondents and documentary analysis were undertaken. The key findings are that the origins of 'cultural diversity' education have been driven more by political than educational agendas. As a result, the development of 'cultural diversity' teaching has not been systematic and has been inadequately informed by available theory or evidence. Programmes have evolved through the advocacy of individuals, many of who have not been involved in the development of education strategy. Contents and assessment processes are driven largely by ideas that are consistent with the 'cultural expertise' ideal type but the desired outcomes in clinical practice and for students are more in line with the 'cultural sensibility' model. Ambivalence towards assessment in this area, and the management of students who demonstrate inappropriate attitudes needs resolution since the current position undermines the development of the subject. Specific recommendations for each stakeholder group are included and the thesis concludes with ideas for future research.