医疗卫生人员跨文化胜任力理论模型与测量工具综述

doi:10.3760/cma.j.cn115259-20251107-01428

摘要/Abstract

摘要： 随着全球化进程加速,外籍人员来华就医、我国援外医疗外派等国内外双向医疗互动日趋增多,提升医疗卫生人员跨文化胜任力已经成为医学教育的重要议题。当前,我国医学教育体系中对跨文化胜任力的培养与评价仍然缺少本土化测量工具。因此,探究医疗卫生人员跨文化胜任力的理论模型与国际主流测量工具,对开发契合我国多民族、涉外诊疗场景的本土化测评体系有着重要意义。本文梳理2000至2024年中国知网、万方数据知识服务平台和Embase等6个数据库,最终纳入15项研究,重点分析5份国际经典量表,包括跨文化能力行为评估量表(behavioral assessment scale for intercultural competence,BASIC),跨文化敏感性量表(intercultural sensitivity scale,ISS),跨文化能力问卷(intercultural competence questionnaire,ICQ),跨文化发展量表(intercultural development inventory,IDI),医疗卫生人员文化胜任力过程评估量表(inventory for assessing the process of cultural competence,IAPCC),医疗卫生人员跨文化胜任力的理论已经发展为涵盖认知、情感与行为的多维整合体系,其均基于西方文化背景开发,与发展中国家医护群体适配性不足。本文提出应当在借鉴国际量表优势的基础上,构建适用于中国医疗情境的本土化综合测评框架,并进行多语境比较分析,促进医学教育发展与提升医疗服务质量。

关键词: 综述, 跨文化胜任力, 医疗卫生人员, 测量工具, 本土化

Abstract: With the acceleration of globalization and the increasing frequency of China′s international medical exchanges, enhancing the cross-cultural competence of medical and health personnel has become an important issue in medical education and practice. However, there is still a lack of localized measurement tools for the cultivation and evaluation of cross-cultural competence in the current medical education system in China. Therefore, exploring the theoretical model and international mainstream measurement tools of cross-cultural competence of medical and health personnel is of great significance for developing a localized evaluation system that fits the multi-ethnic and foreign-related diagnosis and treatment scenarios in China. This study reviewed six databases, including CNKI, Wanfang Data Knowledge Service Platform, and Embase, from 2000 to 2024, incorporating 15 studies. With an analytic focus on five international classic scales, namely the Behavior Assessment Scale for Intercultural Competence (BASIC), the Intercultural Sensitivity Scale (ISS), Intercultural Competence Questionnaire (ICQ), the Intercultural Development Inventory (IDI), and the Inventory for Assessing the Process of Cultural Competence (IAPCC) for healthcare personnel, this study found that the theory of cross-cultural competence in healthcare has evolved into a multidimensional integrated system encompassing cognitive, affective, and behavioral dimensions. Internationally, mainstream measurement tools such as the Behavioral Assessment Scale for Intercultural Competence (BASIC), the Intercultural Sensitivity Scale (ISS), and the Intercultural Competence Questionnaire (ICQ) have been developed primarily within Western cultural contexts, resulting in limited applicability for healthcare professionals in developing countries. This paper proposes constructing a localized comprehensive evaluation framework tailored to China′s medical context by leveraging the strengths of international scales. while establishing multi-context comparative analyses to advance medical education and improve healthcare service quality.

Key words: Review, Intercultural competence, Healthcare professionals, Measurement instruments, Cultural adaptation

中图分类号:

米珂, 尹慧. 医疗卫生人员跨文化胜任力理论模型与测量工具综述[J]. 中华医学教育杂志, 2026, 46(9): 665-671, DOI: 10.3760/cma.j.cn115259-20251107-01428.

Mi Ke, Yin Hui. A review of theoretical models and measurement tools for intercultural competency of healthcare professionals[J]. Chinese Journal of Medical Education, 2026, 46(9): 665-671, DOI: 10.3760/cma.j.cn115259-20251107-01428.

参考文献

[1] Hernandez F, Kose BW. The developmental model of intercultural sensitivity: a tool for understanding principals′ cultural competence[J]. Education and Urban Society,2011,44(4):512-530. DOI:10.1177/0013124510393336.
[2] Chen GM, Starosta WJ.The development and validation of the intercultural sensitivity scale[J].Communication Research, 2000, 3(6):22.DOI:10.1210/endo-44-6-590.
[3] Purnell L. The Purnell model for cultural competence[J]. J Transcult Nurs, 2002,13(3):193-196. DOI: 10.1177/10459602013003006.
[4] D′Zurilla TJ, Nezu AM, Maydeu-Olivares A. Social problem-solving inventory-revised (SPSI-R)[M]. North Tonawanda, NY: Multi-Health Systems, 2002:35-39.
[5] Paige RM, Jacobs-Cassuto M,Yershova YA, et al. Assessing intercultural sensitivity: an empirical analysis of the hammer and bennett intercultural development inventory[J]. International Journal of Intercultural Relations, 2003, 27(4): 467-486. DOI:10.1016/S0147-1767(03)00034-8.
[6] Fantini AE. Exploring and assessing intercultural competence[M]. St. Louis: Washington University, 2006:184-186.
[7] Campinha-Bacote J. The process of cultural competence in the delivery of healthcare services: The journey continues[M]. 5th ed. Cincinnati, OH: Transcultural C.A.R.E. Associates, 2007:73-76.
[8] Lie D,Boker J, Crandall S, et al. A revised curriculum tool for assessing cultural competency training (TACCT) in health professions education[J]. MedEdPORTAL, 2009, 5: 3185. DOI:10.15766/mep_2374-8265.3185.
[9] 张瑜, 李秀艳, Richard Pescador. 本科实习护生文化胜任力与职业自我概念的相关性研究[J].护理研究,2013,27(16):1558-1560. DOI: 10.3969/j.issn.1009-6493.2013.16.010.
[10] Fleckman JM, Dal Corso M, Ramirez S, et al. Intercultural competency in public health: a call for action to incorporate training into public health education[J]. Front Public Health, 2015,3:210. DOI: 10.3389/fpubh.2015.00210.
[11] Jernigan VB,Hearod JB, Tran K, et al. An examination of cultural competence training in US medical education guided by the tool for assessing cultural competence training[J]. J Health Dispar Res Pract, 2016,9(3):150-167.
[12] Marek E,Németh T. Intercultural competence in healthcare[J]. Orv Hetil, 2020,161(32):1322-1330. DOI: 10.1556/650.2020.31836.
[13] Granel N, Leyva-Moral JM, Morris J, et al. Student′s satisfaction and intercultural competence development from a short study abroad programs: a multiple cross-sectional study[J]. Nurse Educ Pract, 2021,50:102926. DOI: 10.1016/j.nepr.2020.102926.
[14] Martinez-Hernaez A, Bekele D, Sabariego C, et al. The structural and intercultural competence for epidemiological studies (SICES) guidelines: a 22-item checklist[J]. BMJ Glob Health, 2021,6(4):137-141.DOI: 10.1136/bmjgh-2021-005237.
[15] Constantinou CS, Andreou P, Nikitara M,et al. Cultural competence in healthcare and healthcare education[J]. Societies, 2022, 12(6):178-181. DOI:10.3390/soc12060178.
[16] Huish C, Greenhalgh C,Garrow A, et al. Intercultural gaps in knowledge, skills and attitudes of public health professionals: a systematic review[J]. J Public Health (Oxf), 2023,45(Suppl 1):i35-i44. DOI: 10.1093/pubmed/fdac166.
[17] Koester J, Olebe M. The behavioral assessment scale for intercultural communication effectiveness[J]. International Journal of Intercultural Relations, 1988, 12(3): 233-246.DOI: 10.1016/0147-1767(88)90017-X.
[18] Jager M,Leij-Halfwerk S, Akkermans R, et al. Cultural competence training of dieticians: development and preliminary evaluation[J]. Prim Health Care Res Dev, 2024,25:e56. DOI: 10.1017/S1463423624000483.
[19] Hammer MR, Bennett MJ. The intercultural development inventory (IDI) manual[M]. Portland, OR: Intercultural Communication Institute,1998:36-39.
[20] Loftin C,Hartin V, Branson M, et al. Measures of cultural competence in nurses: an integrative review[J]. Scientific World Journal, 2013,13:289101. DOI: 10.1155/2013/289101.
[21] Lai D, Lee V,Ruan YX. Perspectives towards cultural competence and receptivity to cultural competence training: a qualitative study on healthcare professionals[J]. Prim Health Care Res Dev, 2023,24:e40. DOI: 10.1017/S1463423623000245.
[22] Genkova P, Schreiber H. Measuring intercultural competence-a review and introduction of the Cult Euro 1 test for intercultural competence[J]. Frontiers in Psychology, 2025,16: 1621499.DOI: 10.3389/fpsyg.2025.1621499.