Abstract:
PURPOSE : The global mobility of medical student and trainee populations has drawn
researchers’ attention to consider internationalization in medical education. Recently,
researchers have focused on cultural diversity, predominately drawing on Hofstede’s
cross-cultural analysis of cultural dimensions from general population data to explain
their findings. However, to date no research has been specifically undertaken to examine
cultural dimensions within a medical student or trainee population. This is problematic as
within-country differences between gender and professional groups have been identified
within these dimensions. We address this gap by drawing on the theoretical concept
of national context effects: specifically Hofstede’s six-dimensional perspective. In doing
so we examine medical students’ and trainees’ country profiles across dimensions,
country-by-gender clustering, and differences between our data and Hofstede’s general
population data.
METHODS : We undertook a cross-cultural online questionnaire study (eight languages)
containing Hofstede’s 2013 Values Survey. Our questionnaire was live between 1st
March to 19th Aug 2018, and December 2018 to mitigate country holiday periods. We recruited undergraduate medical students and trainees with at least 6-months’
clinical training using school-specific methods including emails, announcements,
and snowballing.
RESULTS : We received 2,529 responses. Sixteen countries were retained for analyses
(n = 2,307, 91%): Australia, Chile, China, Hong Kong, India, Indonesia, Ireland,
Israel, Japan, Malaysia, New Zealand, Pakistan, South Africa, South Korea, Sri-Lanka,
Taiwan. Power distance and masculinity are homogenous across countries. Uncertainty
avoidance shows the greatest diversity. We identified four country clusters. Masculinity
and uncertainty are uncorrelated with Hofstede’s general population data.
CONCLUSIONS : Our medical student and trainee data provides medical education
researchers with more appropriate cultural dimension profiles than those from general
population data. Country cluster profiles stimulate useful hypotheses for further research,
especially as patterning between clusters cuts across traditional Eastern-Western
divides with national culture being stronger than gendered influences. The Uncertainty
dimension with its complex pattern across clusters is a particularly fruitful avenue for
further investigation.