Effectiveness of a developmental curricular design to graduate culturally competent health practitioners

With the goal to facilitate cultural competency development of students enrolled in graduate-level health professional education, this study examined the effectiveness of a curricular program guided by the Intercultural Developmental Continuum (IDC) as measured by the Intercultural Developmental Inventory (IDI). The IDI was administered to 17 occupational therapy (OT) students and a control group of 25 non-OT health professional students upon matriculation into their respective programs of graduate study and again upon completion of 3 years of study. OT students participated in a cultural curricular design guided by the IDC, while the control group participated in cultural study not guided by the IDC. Though OT students did not show a significant change in overall developmental orientation mean scores from pre-test to post-test (t = 0.847, p = 0.41), the results indicate that the designed intercultural curriculum increased intercultural competence among those OT students who began their program with the monocultural mindset of polarization (an "us vs. them" evaluative viewpoint) and moved to the interculturally transitional mindset of minimization (recognizing cultural commonalities and elimination of the "us vs. them" mindset). The control group showed a significant decrease in developmental orientation mean scores at post-test (t = 6.1, p < 0.001). No significant group or group by baseline interaction effects were found when comparing overall post-developmental scores adjusting for baseline (F = 2.4, p = 0.131). The curriculum design as guided by the IDC, though it did not significantly increase overall cultural competency of OT students, appears to have mitigated a decrease in competence. Results suggest that the cultural challenges that students face appear to be considerable and, without targeted, integrated intercultural preparation, can overwhelm new health professionals' intercultural capability.