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Queen Mary Academy

Conversations on cultural diversity in the online classroom

Two doctors are looking at a screen in a lab
Dr Esther Murray profile picture

Dr Esther Murray

Reader in Health Psychology

In collaboration with

Teaching online has provided a unique opportunity for students on the Certificate in Clinical Foundation Skills to think about biomedical science, and psychosocial issues in health in a shared space, rather than as separate topics. Combining social and physical sciences has encouraged a holistic understanding of patients, and also of the student as doctor. This case showcases the ways in which online spaces can create a safe space for new students to discuss potentially difficult issues.

The opportunities of using online discussion spaces

While teaching online has presented us with many challenges this year, it has also offered some opportunities. Dr Esther Murray, senior lecturer in Health Psychology and Dr Nandini Hayes, Senior Lecturer in Medical Science were able to teach the Practical Skills for Professionals module together this year, giving students on the Certificate in Clinical Foundation Skills a unique opportunity to think about biomedical science, and psychosocial issues in health in a shared space rather than as separate topics. The advantages we think have been twofold – combining social and physical sciences encourages a holistic understanding of patients, and also of the student as doctor. Using the online space has meant that students have felt more able to speak up, as there has been no ‘cross talk’ in the classroom – we have focused on one speaker at a time.

Responding to a need

The students on Practical Skills for Professionals are all taking the Foundation Certificate with a view to joining either the medical degree or dental degree next academic year. These students have just completed school and most of them have not been educated or lived outside their country of origin and certainly not as adults living alone. An important part of their experiences in this academic year has been to learn about the cultural differences both between them and their peers and their future patients. 

Discussions about many areas of medicine and dentistry can become awkward in the classroom where long held beliefs about health, illness, family, sexuality and social order can clash with the expectations of colleagues and the expectations of the General Medical Council or the General Dental Council. A fundamental aspect of every medical students’ training and part of their very professional identity is to become aware of beliefs and practices which differ from their own and those they’re familiar with. This is a potentially uncomfortable process that requires the creation of safe spaces in classrooms to facilitate discussions in which students can learn about cultural differences and explore their own assumptions without feeling criticised or marginalised. In the few years the Foundation Certificate has been running we have had some difficult dynamics in the classroom where the gender split could result in some heated discussions where our female students were finding a new freedom of their expression and some of the male students found that challenging and difficult, we struggled to keep students speaking English rather than their own language which made it hard for us to facilitate safe discussions.

The approach

As a result of the Covid-19 pandemic, we delivered the module online this year. We also had to combine the Practical Skills for Professionals 2 module with the pathophysiology component of a Physics and Integrated Science module because of the online timetable, though this was really useful for us for pedagogic reasons. This meant that students received a science-based lecture on the Monday, with a psychosocial lecture and discussion on the Tuesday.

We were confident that this would benefit students because they would be able to see the connection between the biomedical explanation for illness and pathology, and the psychosocial impacts of illness and the psychological effects of suffering from particular conditions.

The Impact

What we did not expect, and were thrilled to discover, was that the online format of the classes eradicated a lot of the issues we had encountered in the in-person classes. We found that students of all genders freely expressed their perspectives on issues such as gender, sexuality, family, consent, autonomy and the dynamics of the doctor-patient-family interaction and how all of these were dealt with differently in different countries. Students seemed better able to contradict one another without becoming upset or angry, and to offer potentially controversial opinions in a calm manner. Students also seemed well able to reflect with their fellow students about how things were usually done in their country and how they were changing, and how things might be done better or differently. We have yet to garner student feedback from this module but as teachers we were very encouraged by what we saw. Without any real investigation, it’s hard to know exactly why this worked so well, but we suspect that in part the online format freed up the students, prevented cross-talk in the classroom so that only one person spoke at a time, and also we found everyone speaking English the whole time.

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