Knowledge, Awareness, and Intercultural Communication Effectiveness Among US and Egyptian Student Physical Therapists

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18 Comments on “Knowledge, Awareness, and Intercultural Communication Effectiveness Among US and Egyptian Student Physical Therapists

  1. JORDYN BROEK (19 hours ago): Nice job with this poster! It is interesting to learn about cross-cultural communication as this is something I have not been exposed to much in the past. I am especially interested as my group is conducting a similar study currently, but with PT students from Taiwan.
    What barriers do you believe caused the U.S. to have much fewer participants than the Egyptian students? Do you think having more U.S. students would have changed your results in any way?

    JORDYN BERNSTEIN reply (14 hours ago): Hey Jordyn, thanks for the question! I can’t wait to read about your study with Taiwanese students. The big barrier that inhibited U.S. students from participating in this research study was timing. We conducted our study over a two-week span in the month of February This ended up being a very busy couple of weeks for both first and second-year USD PT students. In order to account for this, extra efforts were made to recruit participants. Researchers made many announcements, emails were sent, extra credit was offered to first year students, and other incentives were given. We even reached out to other PT schools in the midwest without any luck. I personally feel that if we could re-do this study I would have liked to choose a less busy week for U.S. students because I feel our participation would have improved tremendously. I can not say for sure if the data would have changed. I know that because of the skewed participation we had to change the type of statistical analysis we did. When looking at the data you can see that we did not do any comparisons between U.S. and Egyptian students and instead looked at all PT students as a whole. Additionally, I hypothesize that the distribution of conversation during the group breakout portion of each session would have been more evenly distributed if we had more U.S students. This in turn has potential to affect data, but I cannot say with certainty how the data would change. Hope this answers your question!

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  2. JORDYN BROEK (19 hours ago): Great job with this research study and poster! I enjoyed learning about cross-cultural communication as this is something I have not bet exposed to much. It is also interesting to see similarities and differences between your research study, and my group’s study this year on the same topic, except with Taiwanese physical therapy students. I can support the results to this study as also having improved cultural awareness and feeling more comfortable with interacting with those from a different culture, as I have also experienced this.

    Do you believe there were any barriers in this study that would limit participants (U.S. in particular)? In Tables 3 and 4, it is interesting to note that in all results, the cross-cultural participants had lower ratings and correct answers to knowledge questions pre and post- session as compared to U.S. students. Why do you think this is? Thanks!

    JESSICA SCHMIDT reply (13 hours ago): Thank you for your interest in our topic and your questions! I’m so glad that you were able to benefit from our project! To answer your first question: I do know there were some specific barriers that limited our U.S. participants. Due to the time change and the academic schedules of the participants’ universities, we were limited to when we could schedule the research sessions. Then during the week of our study, our class had three exams plus a day-long seminar to attend and so recruiting among USD students became more difficult. We struggled recruiting any participants from other schools likely for similar reasons.

    For your second question, I think the lower knowledge question ratings of the cross- cultural participants were a reflection of the language barrier. Our Egyptian participants could all speak English but most of them were still learning the language. All of the sessions were held in English, and subtitles in Arabic were the only additional tool we had available to help mitigate the language barrier. So on top of learning about new topics, the Egyptian participants had to learn them using a language that was not their native language. This is incredibly challenging to do, and I believe this challenge was reflected in the scores.

    I hope I was able to answer your questions!

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  3. ANDREW GUENTHER (2 days ago): Great job with this research poster! I think the topics of cross-culture awareness and understanding are not getting the attention they deserve. I think we can help each other and especially our patients in the future by working together and interacting with many cultures and viewpoints to gain the best knowledge of treatment. Did your group ever think about adding some of the questions that were in those surveys to the poster? I know the topics were perceived awareness, knowledge, and intercultural communication effectiveness, but what were the questions like? I think this poster is very well made.

    ALYSA GREGG response (a day ago): Hi Andrew!
    Thank you for acknowledging the importance of cross-cultural communication in todays society. We found this information extremely useful regarding diversity in physical therapy practice.

    We did consider including these questions, however we were a bit limited on space. The questions assessing knowledge were created by each content expert that presented the information at each of the sessions. They insured validation of these questions by reviewing the questions with colleagues in their field as well as a professional who has experience creating board-level exam questions. The awareness questions on the other hand consisted of a Likert rating scale of how “aware” the participants were of the particular topics- ie “I find it easy to talk with people from different cultures” with answers ranging from strongly disagree, disagree, uncertain, agree and strongly agree.

    The questions regarding Intercultural Communication Effectiveness for the pre/post series survey were gathered from the Intercultural Communication Effectiveness Scale (published by Portella and Chen in 2010). This scale consisted of 20 questions regarding the following topics. Behavioral flexibility involves picking up on social cues and adapting during a conversation (4 questions). Interaction relaxation … [remaining cut off from RED]

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    • Interaction relaxation looks at how comfortably people communicate with individuals from another question (5 questions). Interactant respect looks at ones ability to associate with members of another culture including (eye contact, respect (3 questions). Message skills include being able to use a different language and understand verbal and nonverbal cues (3 questions). Identity maintenance is the idea that one’s personality is highly dependent on reflection of their experiences (3 questions). Interaction management includes taking turns initiating, ending, and participating in discussions based on others in the conversation (2 questions).
      Sorry for the long winded response, it took a bit of research to come up with our questions and I wanted to make sure that I provided you a proper response. Thank you for your interest, please let us know if you have any further questions!

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  4. ABBY RIPPERDA (2 days ago): Great job! Your research is very interesting. I think it really highlights the importance of cultural awareness. In table 2, interactant respect did not change from pre to post series. Why do you think that is and going forward what would you recommend adding or changing in order to see an improvement in this area? Thank you!

    JESSICA SCHMIDT reply (14 hours ago): Hey, thanks for the question Abby! We think that Interactant Respect didn’t change from pre to post series because that domain started out very high. In fact, it was our highest value in both our pre series and post series numbers. We were actually pretty happy to see that our groups had high respect for each other from the very beginning and this remained throughout the sessions. I think that having larger groups of participants would’ve likely helped us see more of an improvement in the area. By having more participants, we would likely have a greater variety of cultural experience and opinions than what we had in our study and this may or may not lower our starting value. Hope this was helpful!

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  5. MEGAN WILSON (3 days ago): This is very interesting and clinically relevant research! I think research like this can help advise educational programs. Maybe I missed this in one of your figures, but did you guys look at whether the Egyptian PT students or the US PT students improved their cross cultural awareness more? Also, why do you think 1 of the 6 IES domains did not significantly change? Thanks!

    JORDYN BERNSTEIN reply (2 days ago): Thanks for the questions Megan! We also think that this experience is beneficial for educational programs. You are correct, we did not look at which group improved more. Instead we assessed knowledge and awareness of all PT students as a whole. This was done at the beginning and end of each session. Not over the course of the entire series. Table 3 represents the awareness data and you can see that for all three sessions students showed an increase in awareness of their own culture as well as the opposite culture. As for the IES domains I want to direct your attention to Table 2. You can see that Interactant Respect is the one IES domain that did not have a significant change. When digging deeper into this, you can see that the pre-series value started relatively high (4.67) and stayed high during the post-series assessment (4.67). Therefore, there is not a statistically significant change. This means that participants came into the series with a lot of respect for their cultural counterpart and that did not change over the course of the series. Hope this answers your questions!

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  6. MAIA GABRIELSON (5 days ago): Awesome presentation of your group’s research! It’s very interesting that with only a few sessions, students from both cultures demonstrated improved cultural awareness and cross-cultural knowledge. Does your group have any suggestions on how physical therapy programs can improve cross-cultural awareness and knowledge for their students?
    Thanks!

    ALYSA GREGG reply (5 days ago): Hi Maia! Thanks for your question!
    We have discussed how to make this change more prominent for future studies so that more students can gain insight from a similar study. We mentioned that it would probably be best to have larger, more evenly distributed sample size. If there were more people, we could have made the groups smaller so there could be more intimate discussions with more opportunities for others to interact with students from the other culture. The way it worked out for this study made it so that a few students dominated many of the conversations which left less room for growth of understandings from the overall group. It would also be beneficial to have different forms of the educational sessions vs the pre-recorded sessions that were implemented; live speakers would be helpful to encourage questions in real-time to aid in understanding of the audience. I hope this answers your question!

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  7. Great poster! I think it is really interesting to see the results of this study, as I was a participant myself. Cross-cultural communication is so important, not only in practice, but in every day life. I think having these opportunities to communicate with people from such a different culture has improved my ability to communicate with people who may live close by, but still have a different culture than I do. Do you think there was a ceiling effect on the items that didn’t see a significant change, such as interactant respect and same-culture knowledge? If so, is there a way that you could have limited this ceiling effect to see significant results?

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    • Hi Robyn!
      Thank you for participating in and showing interest in our research!
      Yes, in a sense there was a form of a ceiling effect in some of these categories, but I don’t necessarily view that as a bad thing. When you think of the the personalities of most of the people who go into PT, we are all here because we want to help people, it is good to have respect for those we are treating. With that being said, it is great that all the participants demonstrated such high levels of interactant respect (being able to associate and respect people from a culture differing from ones own), it signifies that the US PT students and Egyptian PT students in the study can mutually care for an individual respectfully. I am glad it is so high, however to adjust for the ceiling effect, it would be interesting to have participants take some of the validated quizzes regarding implicit bias we all took first year to ask these questions undercover… nobody is going to admit to being low in this area, even on an anonymous survey. I think this would be an interesting adjustment to the study to see how participants really played out and make them aware of it too!
      Same cultural knowledge is another difficult one to really alter the ceiling effect for. Most of us have lived in similar cultures our entire lives… we should be fairly familiar with it. However, it could be considered to add in specific questions about different types of prominent cultural topics. For example, I love sports, anatomy and science… however, I do not keep up with current events, politics or celebrities very well. If I ranked my level of knowledge of the first three, it would be pretty high, but the last three would be low. If we incorporated different aspects of “culture” into the assessments, it would be a more all-encompassing survey regarding the culture as a whole versus just ranking one’s self-reported knowledge of it.
      So in short, I think the best way to eliminate these ceiling effects would be to ask different/more detailed questions!
      I hope this all makes sense! Please let me know if you have any more questions!

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  8. Good job on the poster! This topic is much more relevant to me as I’m at my clinical at South Bend, IN compared to Tea, SD. I’m experiencing a greater fluctuation of cultural varieties in co-workers and patients, and while showing everyone respect is a great first step in understanding differences in culture it would be nice to have a better awareness of what differences present across all cultures. My question is with the curriculum load we have in school would it be reasonable to have a course or portion of a course dedicated to cultural awareness or would it be more beneficial to learn from someone of that culture as done in your group’s research? Thanks.

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    • Hey Zach, hope you are enjoying your clinical! I could not agree more, a better awareness of differences between cultures would be very helpful information. In terms of fostering an opportunity for students to acquire that awareness I am unsure if a course dedicated to improving cultural awareness would provide similar results simply because our study did not take that approach. Based on our study, we know that all the sessions that occurred throughout the course of the series were successful in improving awareness (on the presented topics) of both ones own culture and the opposing culture. Based on this information, I would say with what we know currently, sessions structured similarly to this study would likely be the most effective approach in increasing awareness. However, this does not mean that an official course would not be effective. I just have not encountered any research regarding this. In the future I think it would be awesome to integrate these four sessions that were performed in our research study into the PT curriculum in some way. This could potentially be a class or even during orientation week. Hope this answers your question!

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  9. Great job on the poster! Being in the Upper Midwest we definitely don’t have a whole lot of cultural differences so any exposure to different lifestyles and viewpoints are very important. I would interested to see how the results would look for other schools across the nation, especially in the bigger cities that get more exposure to different cultures. With that in mind how do you think the results would look if we looked at countries closer to the US say Canada or Mexico, or even countries in Europe? I know if I was quizzed on things about Egyptian culture I would fail big time. Pretty much the only things I know is the general area the country is and the pyramids are there. Also, how much of an effect do you think the language barrier played in the results?

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    • Hey Jason, thank you for the question! Starting with your second question, I think the language barrier played a large role for the Egyptian students when it came to learning the material which was being taught in their second language. We hypothesized that the language barrier could be why the Egyptian students tended to have lower scores on their knowledge questions. However, I don’t think the language barrier had a detrimental impact on our small group discussions because the groups were still able to converse without any major issue beyond occasional misunderstandings. To answer your first question, I think our results would likely be similar to this study even if we worked with students from other countries. The one place I think we might see a change, though, is in the knowledge questions if we’re working with a country that also speaks English or is more familiar with American culture. Some other countries tend to be fairly familiar with American culture due to movies and media but we as Americans are not often as familiar with other countries. In short, I don’t think the American scores would change much but I think the knowledge questions for the opposite country has more potential to change.
      Thanks again, I hope that answered your question!

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  10. Great work on the poster! I think cross-cultural communication is an important skill to have. I am in the research group that is doing a similar study with students from Taiwan. I’m curious to see how our results from this year will compare to what you found in your study!

    Do you think there would be a difference in results if we were located in a more diverse part of the country? Going off that, do you think there would still be significant improvements if this was the case? I know many people in the midwest do not get a lot of interaction with diverse populations which goes to show how important these cross-cultural activities can be. How about if you changed the country to one with a very different culture than our own but where most people speak English as their primary language (think Australia, New Zealand, Singapore, Belize, Jamaica, etc.)?

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    • Hi Allie!
      I hope your study is going well! I am also excited to see how our results will compare… our initial cohort was supposed to include students from the National University of Taiwan, but due to schedule challenges, we were unable to really make it work with them. I am glad it worked out with your group!!
      This is a very interesting question. I personally think knowledge and awareness in other areas with a more diverse population (say San Diego, CA or New York City, NY) would rank higher initially. However, if their initial response is high, this leads to less room for improvement, thus less of a significance. I think that our sessions for knowledge really did help students learn a little more about the other culture, even if it was a lot of information to absorb in a short amount of time. Our sessions of interaction helped others get a chance to talk and grow as well.
      If the counterparts were to change to a primarily English speaking country, I think that the results would actually be about the same. Our cultures are still different and there is a lot of things we have different than just the language we speak. However, I do think this would make the study more appealing for the opposing culture… when we were setting up this study, I remember thinking to myself that if I were an Egyptian student learning English, I would be too shy to want to try and practice my English with a bunch of American students who speak English primarily! That’s just my personality however!
      Jess answered a similar question up above with a little different perspective.
      I hope this answers your question! Please let me know if I can clear anything else up for you!! Good luck with your study!

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  11. Great project! I really enjoyed learning about this! Being in the clinical environment for rotations this semester, I have had the opportunity to work with many different cultures. It has taught me the importance of being culturally competent that is another reason I think your research is so cool because you guys have so much to share with your experience! What would be the biggest take away you were able to get from this research project that you think will help you be a better practicing physical therapist in the future?

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    • Hey Madi thanks for the comment! Hope you are enjoying your clinical. While I cannot speak for my other group members, I feel personally that through my involvement with this research study I have been able to increase my comfort level in interacting with individuals from another culture as well as my awareness and knowledge of the Egyptian culture. Being raised in rural Minnesota and attending universities in rural South Dakota, cultural diversity was not very common in my school or social life. Therefore, when I previously encountered a situation where I had to interact or work with an individual from another culture I assumed the best thing to do was to act like the differences didn’t exist. I never asked questions because I assumed that was not the appropriate thing to do. Participation in this research study has shown me the benefit of having an inquisitive mind, being curious, and asking questions. Egyptian students loved to talk about their culture and I think most people are proud of their heritage and enjoy sharing with others. As a future physical therapist, this is exactly what I do in practice. If the situation arises, I respectfully ask questions regarding their cultural background and perceived differences. This helps me to make more patient centered decisions and allows for more comfortable interactions between the patient and I. Additionally, it allows me to learn and gives me the knowledge I need for future patient encounters. Hope this answers your question!

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  12. This is a wonderful poster! I enjoyed the charts you used to help communicate your findings. It is so interesting to learn more about different cultures and ways we can work on improving our communication. This is something that is important not only in research but also in everyday life. This was great to learn about as someone who does not have much experience with diverse cultures. Did you find the results of this study surprising in any way? Did this go as you had predicted?

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