作为妇产科居民，我在荷兰阿姆斯特丹的多元文化环境中亲身经历了跨文化交流的挑战。诸如习惯，价值观，期望和看法，语言障碍或涉及家庭角色的文化差异之类的问题使我想知道为什么医学教育没有为这些挑战做好充分的准备。我想知道我的主管如何处理与自己的患者进行跨文化交流的问题。

This was the start of a research project about intercultural communication in the medical consultation room. As intercultural communication has many definitions, we defined it as the process of interpersonal interaction between ethnically different doctors and patients. We focused on native Dutch medical specialists communicating with non-native patients. Neither these non-native patients nor their parents were both in the Netherlands. As part of this larger research project, we recently published inBMC Medical Educationthe results of a reflective practice study with medical specialists of various specialties.

In this study medical specialists reflected on their own, videotaped intercultural communication behaviour. The medical specialists mainly focused on generic communication, such as listening and explaining, instead of intercultural communication, for example asking for the language ability of the patient. They mentioned the wish to treat every patient as a person irrespective of their background. Furthermore, they spoke of intercultural communication ‘challenges’ instead of ‘problems’ and consider the presence of a language barrier as the biggest challenge.

…即使医学专家比居民更有经验，但他们经历了与我作为居民相同的挑战。

作为研究人员，与医学专家的反思性实践不仅对我有用。所有参与者都非常有价值地看到自己与患者进行交流。作为一名研究人员，我了解到，即使医学专家比居民更有经验，但他们经历了与居民相同的挑战。研究生医学培训后继续进行沟通培训可能有助于提高人们对自己的沟通行为的认识，这可能会改变通过多年经验而发展的适得其反的沟通习惯。

I found it curious that medical specialists seem to experience difficulties in reflecting on their own communication. This is not something which gets a lot of attention in medical school and asks an open attitude and mind of doctors, which can be trained. Participating in this reflective practice study could create awareness of one’s own communication skills and behaviour.

总体而言，我们得出的结论是，医学专家专注于他们的通用沟通技巧，而不是针对特定的跨文化沟通技巧。因此，访谈导致了更多关于沟通行为的知识，而不是按预期的是跨文化沟通技巧，因为医学专家参与的认为，每个患者都应被视为一个人。这可能表明以患者为中心的沟通和跨文化交流之间存在重叠，因为将患者视为一个人在两种沟通策略中都很重要。目前，这种重叠是许多讨论的重点，我们希望这项反思性实践研究可以通过证明医学专家的观点来为文献做出贡献。此外，我们的结果清楚地表明，反思实践既是研究方法，又是交流培训的开始。

…when it becomes normal to watch how you behave with others, it becomes easier to reflect on how you communicate with them.

Working as a resident myself I learned to reflect more on my communication skills and not being afraid to get feedback on my videotaped consultations. I learnt that when it becomes normal to watch how you behave with others, it becomes easier to reflect on how you communicate with them. I would like to plea for the introduction of life-long communication training for doctors which would ideally include both general communication skills and specific intercultural communication skills.