When Culture Meets Care: Educating for a More Inclusive Healthcare Future

Maria Adele: In healthcare, culture is everywhere even when we don’t see it. It shapes how people describe their pain, how they interpret diagnoses and how they respond to treatment. That’s why health is never just biological: it’s cultural, social and deeply personal. This course made it clear that treating a patient means more than curing a symptom: it’s about understanding their background, beliefs and communication needs. Cultural competence is essential in today’s globalised society, as patients and practitioners come from a variety of linguistic and cultural situations.

As a PhD student working on narrative medicine and linguistic mediation, I’ve seen how easily communication gaps can turn into care gaps. This experience reminded me that small acts – choosing the right words or recognizing a cultural nuance – can make the biggest difference in a patient’s journey.

What innovative learning tools does the course offer?

Julie: From the very beginning, Ana Luiza Pires de Freitas from UFCSPA and I made sure we were both equally involved in shaping the course. We co-designed the teaching activities, which really helped us create a safe and open learning space. The idea was to encourage participants to take an active role in the course and feel comfortable bringing in their own perspectives. That exchange of worldviews was one of the most rewarding parts. Despite being fully online—which can sometimes feel a bit distant—the atmosphere was always warm and relaxed, which made a big difference.

Another important aspect was the topic itself. Subjects like gender, bias, or cultural perceptions in healthcare are rarely given much space in health sciences programmes, even more so in the curricula of medical studies—at least not in a way that invites in-depth discussion. Having a group made up of students from such diverse fields (speech therapy, medicine, physiotherapy, psychology, biomedical sciences, nutrition, and the humanities) was a huge plus. The conversations were incredibly rich, and you could really see people beginning to shift or question the way they looked at healthcare. After all, health is something we all have personal experience with, so it naturally sparks reflection.

What are the main barriers to culturally inclusive healthcare?

Maria Adele: One of the biggest challenges is assuming that care is neutral. Healthcare systems are built around dominant cultural models (often Western, male and monolingual). During the course, we explored how these assumptions create barriers for patients whose identities, values or languages do not conform to the norm. This experience revealed how exclusion can happen even in well-functioning systems: for instance, from gender bias in diagnostic criteria to the lack of linguistic accessibility for deaf or migrant patients.

These topics confirmed issues I’m also exploring in my current research, that is when a patient can’t describe their symptoms in their own words or when those words are dismissed. In that sense, creating culturally inclusive healthcare means rethinking communication, actively listening and being willing to question what we take for granted. The first step is seeing the barrier: only then can we begin to remove it.

Julie: We took an intersectional approach, which means we did not look at gender in isolation. Instead, we explored how gender interacts with other factors—like ethnicity, skin colour, age, and socio-economic status just to name a few—to create complex layers of discrimination in healthcare. These forms of bias can be both conscious and unconscious, and they often go unaddressed in clinical settings.

Gender remains a misunderstood and oversimplified concept in many areas of medicine. Medical research still tends to rely heavily on a binary sex-gender framework, which can obscure more nuanced realities. Through a combination of book excerpts and interviews, we aimed to spark a broader conversation about gender and how it is represented—or misrepresented—in healthcare and medical studies.

You are particularly sensitive to storytelling in healthcare, and you particularly enjoyed the discussion around the use of metaphors during the course. How does storytelling contribute to better practices in your opinion?

Maria Adele: Storytelling plays an essential role in healthcare by increasing the connection between patients and practitioners, creating a space for empathy and understanding. When patients share their stories about their symptoms, struggles or experiences with the healthcare system, they offer more than just medical facts. Indeed, they reveal the emotional and cultural layers that influence their health. This approach allows healthcare providers to see the person behind the condition, fostering trust and facilitating better care.

In addition, storytelling is a powerful tool in person-centered care, which emphasises the individual as a whole rather than focusing on the illness. By listening to patients’ narratives, healthcare providers can align with their approach to meet the specific needs of each patient, establishing a more personalised healthcare experience. It can be useful also using metaphors, which are often employed by patients to make sense of their conditions. For example, “fighting cancer” or “being on a journey” not only help patients communicate their experiences but also serve as powerful tools for framing and understanding their health challenges. These metaphors can suggest insights into how patients perceive their illness and their path to recovery, which in turn guides healthcare providers in offering more empathetic and effective care.