Worlds apart facilitator guide

These unique trigger films follow patients and families faced with critical medical decisions, as they navigate their way through the health care system. Filmed in patients' homes, neighborhoods and places of worship, as well as hospital wards and community clinics, Worlds Apart provides a balanced yet penetrating look at both the patients' cultures and the culture of medicine. This series is an invaluable tool for raising awareness about the role sociocultural barriers play in patient-provider communication and in the provision of healthcare services for culturally and ethnically diverse patients.

• Alicia Mercado, a Puerto Rican immigrant, has strong beliefs about using natural home remedies rather than prescription medications. Her diabetes, hypertension, asthma and depression have been aggravated by her recent eviction from her apartment of eighteen years, which has also disrupted the continuity of her care. Her son worries about the "assembly line" care he feels she is receiving. 13 minutes

• Justine Chitsena needs surgery for a congenital heart defect, but her mother and grandmother, refugees from Laos, worry that the scar left by the operation will damage her in her next reincarnation. They want to seek advice from the local Buddhist temple. 11 minutes

• Mohammad Kochi, a devout Muslim from Afghanistan, had surgery for stomach cancer, but is now refusing the chemotherapy recommended by his physician. His daughter thinks he may fear that the kind of chemotherapy offered will prevent him from observing daily prayer, and wonders if a professional translator might have avoided misunderstandings. 14 minutes

• Robert Phillips, a health policy analyst who is African-American, believes he's likely to wait twice as long as a white patient for the kidney transplant he needs. He's looking for a new nephrologist — someone who will be more sensitive to his concerns. 10 minutes

The interactions between these patients and their healthcare providers reveal a great deal about both problems and opportunities in cross-cultural healthcare. The study guide for this documentary series was designed by cross-cultural medicine educators Drs. Alexander Green, Joseph Betancourt, and Emilio Carrillo. The series consists of four programs, ranging from 10 to 14 minutes each; total combined running time is 47 minutes.

"One of the best examples of introducing cultural competency I have seen." —Carol Spector, MS, MHPE, Department of Family Medicine, Midwestern University

"Moves beyond data to put a human face on disparities in health care, and allows us to create solutions to facilitate cultural competency among health care workers, policy makers and educators." —Elizabeth A. Williams, National Conference for Community and Justice

"WORLDS APART offers compelling insights into the lives of patients as they navigate the medical system, making sense of their problems and decisions about their care. The modules will contribute considerably to our students' efforts to become the deeply knowledgeable and effective medical practitioners our diverse society needs." —Dorothy Porter, PhD, UCSF School of Medicine

"The four films focus not only on different ethnicities, but also on different gender and developmental stages, allowing the audience to realize the importance of taking multiple variables into consideration in comprehending patients' behaviors in healthcare. An excellent resource for cross-cultural healthcare education." —International Journal of Intercultural Relations