Defiance, compliance, or alliance? How we developed a medical professionalism curriculum that deliberately connects to cultural context

Background: In the age of globalization, non-Western medical educators seem too eager to conform to Western educational approaches and may, thereby, undermine the pursuit of local curricular needs. Aims: To develop a medical professionalism curriculum that explicitly considered local cultural needs and social expectations. Method: We used a systematic six-step approach to develop the curriculum. Results: We engaged local stakeholders (physicians, allied health professionals, and members of the public) in a nominal group process to identify professionalism competencies. Students and faculty participated in a survey and/or focus groups to determine learner/faculty needs. Teachers drafted goals and objectives related to locally valued competencies. We designed and implemented educational strategies to develop students' competencies that meet local societal expectations, such as involving family members in decision making. We plan to use multi-source feedback and a portfolio to assess students, which reinforces a definition of integrity that encompasses not only congruence between individual values and behaviors, but also achieving harmony among all stakeholders. We plan to reinforce the formal curriculum with faculty development and attention to the hidden curriculum. Conclusions: Based upon our experience and reflection, we offer some practical methods for integrating local cultural values and societal needs in professionalism education.