Culture should be defined broadly and cross-cultural work occurs whenever the patient and provider differ in race, ethnic, religious or social group, age, sex, sexual orientation, physical or psychiatric ability. Obviously, this includes the vast bulk of patient encounters. When ethnicity is seen as something that every patient has, the clinical relevance of cross-cultural methods becomes immediately apparent." (Neher and Borkan, 1990).

Medical educators such as Marian Stuart, PhD emphasize the importance of clinicians examining their own cultural attitudes, knowledge and skills. As the U.S. population becomes increasingly multicultural, biased attitudes will not only cause hurt feelings but will impair our ability to deliver effective services. Dr. Stuart suggests that the knowledge component should focus primarily on self-knowledge and that we must learn to identify our own biases, assumptions, preferences, beliefs and blank spots (Stuart, 1995).

It is in this spirit that we provide you with a self-assessment tool. We encourage you to complete the Cross Cultural Issues in Medicine: Student Views Questionnaire and share your thoughts with your clerkship site coordinator. (Your site coordinator participated in his or her own self assessment and anticipates discussing these issues with you.) We believe this dialogue will greatly enhance clinical experiences with your patients and your learning about how culture impacts delivery and receipt of health care services.