Yazar
Aslı DAVAS
Doç. Dr., Ege Üniversitesi Tıp Fakültesi Halk Sağlığı AD(ORCID No:0000-0003-0957-4927)

Özet

  •  Tıp eğitimi, kültürel duyarlılık ve göçmen sağlığı, sağlık hizmetlerinin kapsayıcılığı açısından önemli bir konudur. Göçmenler, sağlık sistemlerine erişimde dil engelleri, hukuki statü belirsizlikleri, kültürel farklılıklar ve ayrımcılık gibi çeşitli zorluklarla karşılaşmaktadır. Bu nedenle, tıp fakültelerinde göçmen sağlığının müfredata entegrasyonu, hekim adaylarının kültürel yetkinlik kazanmasını sağlayarak sağlık hizmetlerindeki eşitsizlikleri azaltabilir. Tıp eğitiminde göçmen sağlığı genellikle seçmeli dersler, atölye çalışmaları ve saha deneyimleriyle sunulmaktadır. Ancak bu eğitimlerin müfredata zorunlu dersler olarak dahil edilmesi, sağlık profesyonellerinin bu alandaki bilgi ve becerilerini geliştirmesi açısından önemlidir. Eğitimin temel bileşenleri arasında kültürel farkındalık, etkili iletişim, sağlık hizmetlerine erişimi engelleyen faktörlerin anlaşılması ve travma odaklı bakım yer almaktadır.  Öğretim yöntemleri arasında grup çalışmaları, vaka temelli öğrenme, simülasyonlar, toplum temelli saha çalışmaları ve multidisipliner eğitim modelleri öne çıkmaktadır. Bu yöntemler, öğrencilerin göçmen sağlığı konusunda teorik bilgi edinmelerinin yanı sıra, klinik beceriler kazanarak pratikte daha etkili hizmet sunmalarına olanak tanımaktadır. Sonuç olarak, tıp eğitiminin göçmen sağlığını kapsayacak şekilde yeniden yapılandırılması, geleceğin hekimlerinin kültürel duyarlılık ve sağlık eşitliği konusunda bilinçlenmesini sağlayacaktır. Daha bütüncül ve sistematik bir yaklaşım, göçmenlerin sağlık hizmetlerine erişimini artırarak toplum sağlığını olumlu yönde etkileyecektir.  

Summary

  • Medical education, cultural sensitivity, and migrant health are crucial for ensuring inclusive healthcare services. Migrants face numerous challenges in accessing healthcare systems, including language barriers, legal status uncertainties, cultural differences, and discrimination. Integrating migrant health into medical curricula can enhance the cultural competence of future physicians and help reduce health disparities. Migrant health education in medical schools is often provided through elective courses, workshops, and field experiences. However, incorporating these topics into mandatory courses is essential for equipping healthcare professionals with the necessary knowledge and skills. Key components of this education include cultural awareness, effective communication, understanding barriers to healthcare access, and trauma-informed care. Teaching methods such as group discussions, case-based learning, simulations, community-based fieldwork, and interdisciplinary education models play a significant role. These approaches not only provide students with theoretical knowledge but also develop their clinical skills, enabling them to offer more effective care in practice. In conclusion, restructuring medical education to include migrant health will enhance future physicians’ awareness of cultural sensitivity and health equity. A more comprehensive and systematic approach will improve healthcare access for migrants and contribute positively to public health outcomes. 

Anahtar Sözcükler / Keywords

  • TR: Tıp eğitimi, Göçmen sağlığı, Kültürel duyarlılık, Kültürel yetkinlik
    EN: Medical education, Migrant health,Cultural sensitivity,Cultural competence

Kaynaklar / References

  • Agudelo-Suárez, A. A., Ronda-Pérez, E., Gil-González, D., Vives-Cases, C., García, A. M., Ruiz-Frutos, C., et al. (2011) The effect of perceived discrimination on the health of immigrant workers in Spain. BMC Public Health, 11:652. Barghadouch, A., Norredam, M. (2022) Psychosocial responses to healthcare: a study on asylum-seeking families’ experiences in Denmark. J Immigr Minor Health, 24(2): 551–5. Başer, D., Mıhcı, Ö., Direk, M., Cankurtaran, M. (2021) Views and experiences of family physicians about Syrian refugee patients in Turkey: a qualitative research. Primary Health Care Research & Development, 22. Bernhardt, L. J., Lin, S., Swegman, C., et al. (2019) The refugee health partnership: a longitudinal experiential medical student curriculum in refugee/asylee health. Acad Med., 94: 544–549. Bradby, H., Humphris, R., Newall, D., et al. (2015) Public Health Aspects of Migrant Health: A Review of the Evidence on Health Status for Refugees and Asylum Seekers in the European Region. WHO Regional Office for Europe. Brottman, M. R., Char, D. M., Hattori, R. A., Heeb, R., & Taff, S. D. (2020) Toward cultural competency in health care: A scoping review of the diversity and inclusion education literature. Academic Medicine, 95(5): 803–813. Gantz, L., Pak-Gorstein, S., Gutierrez, J. R., Noor, Z., Shah, S. (2024) Immigrant and Refugee Health Curricula in US-Based Medical Training: A Scoping Review to Inform Integration Into Pediatric Residency Programs. Acad Pediatr., 24(5S): 103-111. Genç, H., Elitsoy, Z. (2023) Migrants’ access to healthcare services: evidence from fieldwork in Turkey. New Perspectives on Turkey. Gil-Salmerón, A., Katsas, K., Riza, E., Karnaki, P., & Linos, A. (2021) Access to healthcare for migrant patients in Europe: Healthcare discrimination and translation services. International Journal of Environmental Research and Public Health, 18(15): 7901. Grove, N. J., & Zwi, A. B. (2006) Our health and theirs: Forced migration, othering, and public health. Social Science & Medicine, 62(8): 1931–1942. Gruner, D., Feinberg, Y., Venables, M. J., Hashmi, S. S., Saad, A., Archibald, D., Pottie, K. (2022) An undergraduate medical education framework for refugee and migrant health: Curriculum development and conceptual approaches. BMC Med Educ., 22(1): 374. Griswold, K. S. (2003) Refugee health and medical student training. Fam Med., 35: 649–54. Gushulak, B. D., Pottie, K., Roberts, J. H., Torres, S., DesMeules, M. (2011) Migration and health in Canada: Health in the global village. Canadian Medical Association Journal, 183(12): E952–E958. Işik, M., & Özdemir, R. (2024) Cultural Sensitivity of a Group of Nursing Students’ and Attitudes Toward Refugees. Journal of Transcultural Nursing, 35: 244 - 253. Jacob, W., & Pittala, R. (2023) The need for inclusion of integrated teaching on refugee and asylum seeker health in undergraduate medical curriculum. Front Educ., 8: 319. Jones, C. P. (2000) Levels of racism: A theoretic framework and a gardener’s tale. American Journal of Public Health, 90(8): 1212-1215. Joshi, C., Russell, G., Cheng, I. H., Kay, M., Pottie, K., Alston, M., et al. (2013) A narrative synthesis of the impact of primary health care delivery models for refugees in resettlement countries on access, quality and coordination. International Journal for Equity in Health, 12: 1–14. Kalich, A., Heinemann, L., & Ghahari, S. (2016) A scoping review of immigrant experience of health care access barriers in Canada. Journal of Immigrant and Minority Health, 18(3): 697–709. Kalkan, O., Gülay, M., Vatan, İ., Engindeniz, F. T., Bakış, B., Mutlu Özyürek, M., & Özbek, R. (2014). Bursa ili Osmangazi ilçesinde ikamet eden Suriyeli göçmenlerin temel sağlık durumlarının değerlendirmesi. 17. Ulusal Halk Sağlığı Kongresi Özet Kitabı, Edirne, 20-24 Ekim 2014, 457-458. Kwok, M. J. J., & Wright, J. (2024) Framework for implementing asylum seekers and refugees’ health into the undergraduate medical curriculum in the United Kingdom. Health Education Research, 39(2): 170–181. Marzouk, M., Kelley, M., Fadhil, I., Slama, S., Longuere, K. S., Ariana, P., et al. (2019) “If I have a cancer, it is not my fault I am a refugee”: a qualitative study with expert stakeholders on cancer care management for Syrian refugees in Jordan. PLOS One, 14(9): e0222496. McGarry, A., Hannigan, A., De Almeida, M. M., Severoni, S., Puthoopparambil, J., & MacFarlane, A. (2018) What strategies to address communication barriers for refugees and migrants in health care settings have been implemented and evaluated across the WHO European Region? WHO Regional Office for Europe. Mota, L., Mayhew, M., Grant, K. J., Batista, R., Pottie, K. (2015) Rejecting and accepting international migrant patients into primary care practices: A mixed method study. International Journal of Migration, Health and Social Care, 11(3): 208–229. NASW (National Association of Social Workers) (2015) NASW Standards for Cultural Competency. Erişim Tarihi: 1 Ocak 2025, https://www.socialworkers.org/practice/practice-standards-guidelines. Özyürek, D., & Özcebe, H. (2024) Evaluation of self-competency of family physicians and family health workers in providing health services to Syrian children: An example from Ankara, Türkiye. Turkish Journal of Public Health, 22(1): 72–86. Paradies, Y., Ben, J., Denson, N., Elias, A., Priest, N., Pieterse, A., ... & Gee, G. (2015) Racism as a determinant of health: A systematic review and meta-analysis. PLOS One, 10(9): e0138511. Pottie, K., Greenaway, C., Feightner, J., Welch, V., Swinkels, H., Rashid, M., et al. (2011) Evidence-based clinical guidelines for immigrants and refugees. Canadian Medical Association Journal, 183(12): E824-925. Pottie, K., & Hostland, S. (2007) Health advocacy for refugees: Medical student primer for competence in cultural matters and global health. Canadian Family Physician, 53(12): 1923–1926. Suleman, S., Garber, K. D., Rutkow, L. (2018) Xenophobia as a determinant of health: an integrative review. J Public Health Policy, 39(4): 407–23. TC İletişim Bakanlığı. (2024) Türkiye’de bulunan yabancıların sayısı ve vatandaşlık durumları ile ilgili iddialara dair açıklama. İletişim Bakanlığı Web Sayfası. Erişim Tarihi: 24 Ocak 2025, https://www.iletisim.gov.tr/turkce/haberler/detay/turkiyede-bulunan-yabancilarin-sayisi-ve-vatandaslik-durumlari-ile-ilgili-iddialara-dair-aciklama. Těšinová, J. K., Dobiášová, K., Jelínková, M., Tulupova, E., & Koščík, M. (2024). Professionals’ and intercultural mediators’ perspectives on communication with Ukrainian refugees in the Czech healthcare system. Health Expectations, 27, e14171. https://doi.org/10.1111/hex.14171 Tuzcu, A. (2014). Göç alan Antalya ilinde hemşirelik öğrencilerinin kişisel olarak ve uygulama alanında göçle gelen bireylere bakım verirken yaşadığı sorunlar. International Journal of Human Sciences, 11(1), 535-550. World Health Organization. (2022) World report on the health of refugees and migrants. Geneva: WHO. White, J. A., Levin, J., Rispel, L. C. (2020) Migrants’ perceptions of health system responsiveness and satisfaction with health workers in a South African province. Glob Health Action, 13(1): 1850058.

Geliş Tarihi / Received Date

  • 28.09.2024

Kabul Tarihi / Accepted Date

  • 09.10.2024