School of Medicine

Culture Team

The Tufts Culture and Health Curriculum Development Team was founded in 2005 by a group of faculty physicians in the Department of Family Medicine. The team currently consists of physicians in multiple specialties, culturally diverse community leaders, and medical students who share the mission of training culturally competent future physicians who have the attitudes, skills, and knowledge to provide excellent medical care to diverse patient populations.

In 2007, the Culture Team Leader, Dr. Amy L. Lee, was designated by the Dean of Educational Affairs as the leader of one of the Key Themes of the Tufts School of Medicine Curriculum–Culture and Diversity. Students learn about culture and health issues in a longitudinal four-year curriculum consisting of over 50 hours of training in culturally competent care. Educational research about the impact of this longitudinal curriculum on student cross-cultural patient care skills is ongoing.

  • Office of Minority Health, U.S. Department of Health and Human Services
    Information about health disparities within the U.S., including programs to reduce disparities among minority populations. Also, cultural competency online CME and resources for clinicians.

    Ethnomed, University of Washington, Seattle
    Extensive information about cultural and ethnic groups in the Seattle area, most likely applicable in other areas of the country as well. Includes cultural profiles, clinical topics, bilingual patient education materials, and issues about social life and etiquette that are fascinating.

    National Council on Interpreting in Healthcare
    This group has published the first national standards for medical interpreters including fidelity, ethics and confidentiality, and advocacy information.

    Project Implicit
    Implicit Association Tests including race, gender, and other personal characteristics that are prone to bias and prejudice. Learn about how these tests are being used in studies about health disparities, and how you can take some of the tests to learn about your own implicit bias.

    SPIRAL (Selected Patient Information Resources in Asian Languages)
    Patient information handouts in English as well as multiple Asian languages about various health conditions.

  • Working Effectively with Medical Interpreters

    Interpreter Choice

    • Unless thoroughly fluent in patient's language including medical terms, always try to work with a trained medical interpreter
    • Consider booking a longer appointment for office visits with an interpreter, let the interpreter know how long they will be needed
    • Avoid using family, friends, or untrained staff members as interpreters whenever possible because of problems with accuracy, confidentiality, and medical terminology
    • Minor children should never act as interpreters because of problems with disruption of social roles, sensitive issues, lack of knowledge and accuracy
    • Ask patient whether the designated interpreter is acceptable (gender, ethnicity, or dialect issues)

    Interpreter Use

    • Clinician, interpreter, and patient should be positioned in a triangle
    • Speak to and maintain eye contact with the patient, not the interpreter. Looking back and forth at the interpreter from time to time is fine.
    • Ask interpreter to directly translate using first and second person ("I would like to..." and "Have you..." instead of "she says...")
    • If misunderstanding is suspected, try different wording, use pictures or diagrams, or ask the interpreter for help. They can help you understand cultural cues from the patient if they are from the same culture or are experienced in caring for this particular patient population.
    • To be sure the patient has understood key information or instructions, ask the patient to repeat back to you what they have understood through the interpreter.

    End of Visit

    • Interpreters can write instructions in native language, if patient or patient's family reads in that language
    • For prescriptions given, indicate to the pharmacist what language prescription information should be given in
    • Interpreter can accompany patient to schedule follow up appointments or tests, and schedule future interpreters as needed

  • Culture Team Physicians

    Amy Lee, MD
    Tufts Culture and Health Curriculum Development Team Leader
    Assistant Professor, Family Medicine
    Culture and Diversity Curriculum Key Themes Leader
    Tufts University School of Medicine

    Miguel Martinez, MD
    Emergency Medicine, Beverly Hospital

    Kiame Mahaniah, MD
    Family Medicine, Salem Family Health Center

    Debra Rothenberg, MD, PhD
    Social and Behavioral Medicine Course Director, Tufts University School of Medicine/MMC
    Assistant Program Director
    Maine Medical Center Family Practice Residency Program

    Kirsten Meisinger, MD
    Cambridge Health Alliance

    Suzanne Mitchell, MD
    Family Medicine/Geriatrics
    Serving the Underserved Program Co-Director
    Tufts University School of Medicine

    Wayne Altman, MD
    Tufts Culture Team Advisor
    FM Director of Medical Student Education, FM Clerkship Director
    Tufts University School of Medicine

    Culture Team Community Consultants

    Vanna Thi Altman, RN
    Nursing Coordinator, Cambodian Patient Advocate
    Lynn Community Health Center