Cultural Issues in Medical Learner Evaluation

To benefit from the broad range of perspectives and approaches brought by our increasingly diverse medical learner population, medical educators need to ensure that their efforts are designed to address the predictable complexities that diversity brings. This article considers the role that cultural factors might play in medical learner evaluation by describing how cultural differences can affect evaluation accuracy and by illustrating some of specific ways such differences might play an underlying role in performance problems. Cultural factors that might affect evaluation accuracy include issues related to language comprehension, evaluator bias, and learner anxiety. To mitigate these effects tests should be written and reviewed carefully, overall evaluation strategies should include multiple methods and tools, and any potential or eventual discomfort with the evaluation process should be openly discussed with learners. Cultural factors might also contribute to unfair judgments, particularly when poor performance that actually stems from a discrepancy between learning expectations and cultural norms is mistakenly attributed to a lack of ability or willingness. To prevent this, medical educators should ensure that learners clearly understand, and are comfortable with, the learning objectives and evaluation methods being used. In addition, evaluation data should be reviewed regularly to look for systematic differences in performance between culturally distinct groups of learners. A more thorough investigation into cultural characteristics that have the most potential for conflict with evaluation methods and learner performance could ultimately lead to more specific and tested recommendations for addressing and correcting these problems.