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Acceptance of cultural diversity and the recognition and appreciation of facets of "otherness" such as gender, age, occupational or disease-related group, religion, sociocultural background, and migration history are basic requirements for adequate communication and interaction in healthcare. The term intercultural competence is multidimensional and includes a range of qualities and skills with emotional and cognitive elements with influence on the behavioral level. In the present paper, we discuss the importance of intercultural competence for the healthcare system and which aspects of the intercultural communication are particularly relevant for culturally sensitive medical care. Additionally, we report on the implementation of an interprofessional program and continuing education concept for clinical practice: Interprofessional and Intercultural Work in Medicine, Nursing and Social Services (IPIKA).The basis of the specific approaches to improving intercultural competence should be the systematic education and training of basic communication skills. This concerns almost all curricula for the medical professions. It is important to emphasize that intercultural competence is a core and cross-sectional topic for all healthcare providers., (© 2023. The Author(s).)

Introduction: In many European countries, intercultural treatment situations are an integral part of everyday medical practice. In this context, the appearance of different interest and decision-making conflicts, which result from communication barriers, cultural practice or moral diversity, are not uncommon. In this paper, the characteristics of intercultural treatment situations with their ethical relevance are presented. Some skills and abilities of intercultural competence are also described and their function is demonstrated by a clinical ethical case. The opportunities and limitations of intercultural competence for an ethical orientation are subject of reflection., (© 2023 Aerzteverlag medinfo AG.)

The concept of transcultural competence is increasingly discussed in Germany as a requirement for providing adequate psychiatric-psychotherapeutic care for persons with a migration background. To this day, understanding of this concept is heterogeneous. This overview aims at systemizing existing definitions of transcultural competence in psychology, medicine and related fields to improve understanding of the term in practice. 130 German and English language scientific papers were analyzed and were evaluated qualitatively with grounded theory method. The analysis produced 3 approaches: a technological approach, a component approach and a positioning-and-attitude approach. The suggested categorization of the understandings of the term transcultural competence allows for a detailed overview of the current definitions of this term and thus provides criteria for a better evaluation of implemented transcultural competence in fields of psychiatric-psychotherapeutic care., (© Georg Thieme Verlag KG Stuttgart · New York.)

Advances in medical science and technology offer new medical interventions at the end of life. These new medical measures create new ethical issues, which increase in complexity in a multicultural society. This paper discusses three cases, in which cultural value systems play a decisive role. Change in the goals of therapy, truth telling of diagnosis and prognosis and presumed will of the patient are the key ethical points in these cases. Because of growth in minority populations in Germany, it is foreseeable that the number of these issues will increase in the near future. The author of this paper argues that concepts and measurements must be urgently developed in health care systems to help the medical staff in their daily practises. According to him, cultural competence and cultural sensitive advanced directives can be helpful for solving complex ethical problems at the end of life. Other interventions and measurements were also described for improved end-of-life care in multicultural setting.

[english] One of the main challenges for teaching programs on immigration, ethnic diversity and health is to transform the commonplace notion of “culture” into a helpful tool for medical training and practice. This paper presents the teaching approach of an interdisciplinary course on “migrants’ health” established at the University of Giessen since 2004, which has recently been complemented by a thematically related collaboration with two universities in Latin America (Ecuador, Peru). The overall goal is to translate the abstract philosophy of into medical practice, and to provide students with the insights, attitudes and skills needed for a fruitful use of concepts like “culture”, “ethnicity” and “migration background”. A key feature of the course is the strong commitment to ethnography as an important means for looking under the surface of superficial attributions to culture, and for grasping the interplay of medicine and health with cultural, social, religious, economic and legal aspects in its particular local and/or individual shape. Three elements of the course are presented to illustrate this approach: First, a unit on Islam and Medicine, as important parts of the local immigrant community are Muslims. The second one deals with psychosomatic aspects, because in case of immigrants, complex symptoms and disease representations like somatisation are easily misinterpreted as “cultural”. The third element consists of a unit with specialized social workers form outside the university, who provide direct insights into the living conditions and health problems of local immigrant communities. [german] Eine der zentralen Herausforderungen für Lehrprojekte zum Thema Medizin und ethnisch-kulturelle Vielfalt besteht in der Vermittlung eines angemessenen Konzepts von „Kultur“. Vor allem gilt es, den exklusiven Fokus auf als „fremd“ wahrgenommene Bevölkerungsgruppen und die Gefahr oberflächlicher kulturelle Zuschreibungen zu überwinden. Der vorliegende Beitrag stellt den Ansatz eines interdisziplinären Kurses zur „Migrantenmedizin“ an der Justus-Liebig-Universität Gießen vor, der jüngst durch ein Kooperationsprojekt zur Stärkung interkultureller Aspekte in der medizinischen Ausbildung mit zwei lateinamerikanischen Universitäten ergänzt wurde (in Ecuador und Peru). Durch den internationalen Vergleich soll das abstrakte Prinzip „think global and teach local“ für den medizinischen Bereich nutzbar gemacht werden. Gleichzeitig wird die Bedeutung der Ethnographie für eine sinnvolle Verwendung von Begriffen wie „Kultur“, „Ethnizität“ oder „Migrationshintergrund“ auch in der Medizin betont. Als wichtigste Forschungsmethode der Kultur- und Sozialanthropologie vermittelt die Ethnographie differenzierte Einblicke in die jeweils konkrete Ausprägung der komplexen Zusammenhänge zwischen Krankheit, Medizin und „Kultur“ – jenseits von Stereotypien und unter explizitem Einschluss der im Einzelfall relevanten sozialen, religiösen, ökonomischen und rechtlichen, aber auch medizinischen Aspekte. Der Artikel verdeutlicht die Umsetzung dieser Perspektive in der medizinischen Ausbildung exemplarisch anhand von drei Lehreinheiten des Kurses an der JLU Gießen: Ein Modul zum Thema „Islam und Medizin“, eines zu psychosomatischen Aspekten und eine dritte Einheit, in der Sozialarbeiterinnen eines lokalen Migrationsdienstes unmittelbare Einblicke in die reale Lebenswirklichkeit von Migrant/innen vermitteln.