Faculty and Student Challenges in Facing Cultural and Linguistic Diversity.

Clark LW, Waltzman DE, eds. Springfield, IL 62794-9265, Charles C Thomas, Publisher, 1993, hardback, 263 pp, $49.75.

This book is meant to serve as a guide for health care educators on the issues of working with culturally diverse students, becoming culturally competent as faculty, and turning out health professionals able to deal with culturally diverse client populations. This book is intended for allied health care educators, but all health care educators, as well as clinicians, could greatly benefit from it, The authors have covered the issues of minorities in health care and education so clearly and in-depth that anyone even skimming this book would gather a great deal of information to help the reader to teach or treat a culturally diverse population.

This is one of the finest books ever written on this topic, and it covers all of the issues involved. The book is divided into three sections: "Challenges Before Faculty and Students," "Diverse Student Groups: Prerequisite Knowledge for Achieving Effective Recruitment and Retention," and "Successful Learning Strategies and Curriculum Approaches." After introducing the demographics and defining the problems, the authors go on to definitively cover the needs and characteristics of the main diversity groups. They also offer extensive approaches to altering and enhancing curricula so that faculty and students can become cross-culturally competent.

Clark and Waltzman bring up several concepts that are appropriate and need to be addressed. They explain that cross-cultural competency begins with cultural self-awareness and then move on to specific knowledge of other cultures, understanding that all aspects of human life, including health beliefs, are touched by culture. Emphasizing that because of the dramatically changing demographics of the United States, faculty need to address updating their knowledge regarding cultural diversity. This knowledge must then be turned into action.

Nonverbal communication also needs to be understood. Direct eye contact, for example, which is highly valued in American culture, can be viewed as disrespectful to an Asian student. Faculty who view certain behaviors of a student as inappropriate in the classroom may not understand that those behaviors are culturally appropriate for that student. It is suggested that to create a partnership between faculty and students, faculty should not be afraid of possible conflict, use many teaching strategies, and be aware of one's own attitude. To enhance cultural understanding, faculty could encourage ethnic visits within the school's community and use the diversity of the class to inform the class. Also, to avoid feelings of isolation, faculty could admit several students from the same minority into the program at the same time.

The authors believe that faculty need to challenge the more traditional modes of education. Instead of tolerating and compensating for student differences, they should view diversity as a strength instead of a deficit. The book states that ethnic and racial jokes have no place in the classroom. It also explains that bigotry is easy to detect, but the subtle instances of racism are difficult to catch, and must be recognized and stopped.

The book confirms that attention to academic success alone will not be sufficient in retaining students from nondominant cultures. These students must feel welcome and valued, and must not be forced to give up their cultural identity in order to succeed.

After addressing the problems and the history of some of the issues, the book then goes on to extensively define the characteristics and lifestyles of the more prominent minority groups. The book explains, for example, that African-American enrollment and retention in institutes of higher education are low because of the low number of role models and mentors in academia. it also explains that nonverbal issues, such as patting someone on the head, which is a sign of approval in American culture, is looked down on in the Asian culture.

The book then addresses ideas for solving the problem of changing the allied health curriculum to address the issue of cultural diversity. The infusion method, in which diversity themes are woven throughout each course, and the one-course approach are compared. The book emphasizes that allowing the student to celebrate his or her own culture, as well as the culture of others, is a necessary approach.

Extensive references are included in each chapter, and personal experiences of many of the authors, which obviously served as learning experiences, are shared with honesty and insight, making the material all the more relevant and meaningful. The authors have appropriate and relevant credentials, and the fine, clear writing, as well as the listing of options and techniques, is powerful and effective.

This book is must reading for everyone involved in physical therapy and every other health field.