Southeast Launches New Courses Dedicated to Cultural Competence in the Health Professions


New interdisciplinary coursework at Southeast Missouri State University is focusing on preparing future health care workers to be culturally competent care professionals.

Dr. Debra Lee-DiStefano, professor of foreign languages, Dr. Linda Garner, associate professor of nursing, and Dr. Doc Billingsley, instructor of anthropology, say they are bringing an interdisciplinary approach to healthcare while educating students on the importance of compassion in their work.

“My hope is that these courses make us much more empathetic towards people that are in the most vulnerable situations,” said Lee-DiStefano. “Healthcare is a difficult topic in the United States, and I see other countries have much better answers to this question than what we currently have in the United States.”

Cultural competence is increasingly recognized as an important factor in how well patients are treated and whether they benefit from medical interventions, Billingsley said.

“Basically, cultural competence refers to the healthcare provider’s ability to understand their patient within their social context; after all, we are not just patients on a doctor’s examination table. We are complete individuals with our own families, communities, traditions and challenges that are largely defined by culture and history,” he said.

Doctors’ ability to care for their patients depends on understanding them as a complete person and relating to their needs, he said.

Lee-DiStefano has developed three courses in Spanish within the context of health, all providing a solid base in cultural competence. This semester, she is teaching “Spanish for Health Professions I” and “Spanish for Health Professions III.” “Spanish for Health Professions II” will be offered in spring 2018.

“We talk a lot about working with populations that are different from ourselves as an individual practitioner,” said Lee-DiStefano. “I think that even if students do not get to actually use a lot of Spanish in their future careers, this discussion about how to feel empathy for other humans who are in vulnerable situations will be the part that is most long lasting.”

Southeast students recently visited the Casa de Salud in St. Louis.

With growing demands for bilingual nurses, the courses will benefit future nurses by providing them with the skills to care for patients whose primary language is Spanish, enabling them to offer better care, Garner said. Lee-DiStefano and Garner also plan to co-teach a community health worker course in spring 2018. Community health workers serve as liaisons or navigators for people who interact with healthcare systems, Garner said.

“In short, the community health worker program will attract people who want to make a difference in society, in the lives of those who need it most,” said Lee-DiStefano.

Another new course, “Medical Anthropology and Public Health,” will be piloted at Southeast in the future, bringing together students from the Department of Modern Languages, Anthropology and Geography along with health communication and pre-medical students, Billingsley said.

“We discuss the ways in which health and illness are understood very differently from one society to the next—even between countries that seem to have a lot in common, the ways that people treat sickness can vary dramatically,” said Billingsley. “We also critically analyze the ways in which we understand and treat illness in the United States, and we will end the semester by doing a class ethnographic project to gather information about health-related issues in and around the Southeast community. I do not know how much my students will remember about specific health beliefs or different groups around the world, but I feel confident that they will remember the experience of turning the lens to look at healthcare here, at home, and learning to ask why we believe and do the things we do.”

Hispanic populations include a diverse array of people from many different countries, including about 50 million United States citizens.

“Some health issues or beliefs prevalent in one group may not be applicable to another, so it is impossible to create anything like a checklist that a doctor or nurse could use to treat any and every patient who walks into their clinic based on their language or country of origin,” Billingsley said. “However, it is possible to prepare yourself to offer better services to Spanish-speaking patients by developing some skills and by opening your eyes and paying attention to the wider community around you.”

The new courses dovetail with a new major and minor in health communication, spearheaded by Brooke Hildebrand Clubbs, director of health communication at Southeast, and launched in 2015. She, along with Garner, Lee-DiStefano and Billingsley recently were awarded a Funding for Results (FFR) grant to bring visiting speakers to the campus to discuss culturally and linguistically competent healthcare.

From left are Brooke Hildebrand Clubbs; Dr. Doc Billingsley, Southeast instructor of anthropology; Ruth Terry Vilches, Casa de Salud’s Community Engagement coordinator; Dr. Debra Lee-DiStefano, Southeast professor of foreign languages; and Dr. Linda Garner, Southeast associate professor of nursing.

The first speaker, Jorge Riopedre, executive director of the Casa de Salud, visited Southeast Oct. 3 to discuss the mission and structure of Casa de Salud, an immigrant health clinic located on the campus of Saint Louis University. Casa de Salud is the premier healthcare resource for the foreign-born community of metropolitan St. Louis, and part of the infrastructure that welcomes people of all origins to this region.

“Casa de Salud is an excellent model for students to study on how you work with a population in a culturally competent way that produces better health outcomes,” Clubbs said.
Recently, Southeast’s students visited the Casa de Salud, learning it serves as a resource for anyone that comes for help, primarily uninsured Latinos, helping more than 500 patients each month.

“I learned that St. Louis is currently the second fastest growing immigrant and refugee population in the United States, which amazed me because it is just two hours away from Cape Girardeau,” said Zack Koeller, of Jackson, Missouri, who is pursuing a Bachelor of Science in health communication and a minor in Spanish. “The amount of good work and healthcare that the Casa de Salud provides to the underrepresented and uninsured immigrant community is inspiring.”

Garner said,” Most students indicated that they were unaware of the growing immigrant population in St. Louis. In fact, many of them had never considered how this population accesses health-related services in a system that is confusing and overwhelming. Students were impressed with the comprehensiveness of services provided at Casa de Salud and the effectiveness of a volunteer model.”

To prepare and become more informed about the subject of health professions, both Lee-DiStefano and Garner participated in training in summer 2016 in Mexico to assist them in making the new coursework a reality at Southeast, and Lee-DiStefano took medical courses in Spanish in Ecuador last summer as well.

Creating a more equitable society is the ultimate goal of the new “Spanish for Health Professions” coursework at Southeast. A minor in Spanish for the health professions is currently being created and could be available by fall 2019. To learn more about these classes, contact Lee-DiStefano at