One hundred and nine third-year medical students at Inje University College of Medicine attended a CD class in March, 2017. The class was offered as part of an intensive mandatory patient safety course completed prior to students entering their core clinical clerkship [6]. Before the class, we obtained informed consent for this study and video recording, as well as an oath of confidentiality from each student.

The aim of the class was to facilitate students to realize the current status of CD in Korean healthcare and reflect on multicultural patients’ experiences of healthcare in Korea.

During the 4-hour class, HR, an experienced surgeon and medical educator, introduced the current statistics from multiculturalism in Korea to draw focus to the need for CD. Then, two Korean doctors and LN, an Australian nurse and medical communications specialist, presented their experiences with CD from the perspective of the healthcare practitioner. Next, multicultural guests shared brief accounts of their experiences as patients in Korean hospitals. We divided students into 12 small groups to discuss what they wanted to know about the multicultural patients’ hospital experiences and list and prioritize questions to ask. Students then submitted their written questions and we verified that they were appropriate, and culturally safe before allowing students to directly ask them to the panel of multicultural guests (Table 1).

Two medical doctors participated in the class as experts. Both were faculty members who also worked at Inje University Paik Hospital. One was a paediatrician and the other was an emergency physician. Both had many clinical experiences with multicultural patients and understood the concept of CD and patient safety.

LN recruited four multicultural guest volunteers from among her acquaintances. We selected a Chinese woman married to a Korean, a Mongolian mother of two children, a Bangladeshi Muslim man, and a white South African woman. Our participants covered the following demographics: Chinese, woman and man from non-English-speaking developing countries (Mongolia and Bangladesh), Westerner, mother, Muslim, and marriage migrant (Table 2). They all had experiences in Korean hospitals. We chose English or Korean speaking participants for interpretation convenience.

Before the class, we held a luncheon meeting with the experts and guests at a restaurant of their choosing and verified the menu with all attendees before the meeting. We explained the objectives and process of the class and the need for confidentiality using supporting documents written in both English and Korean. Experts and guests briefly shared their healthcare experiences in Korea and then we discussed which were most appropriate for the class. We obtained informed consent and an oath of confidentiality from each person before the class.

Before the guests entered the lecture-room, we asked students to respect all participants and consider their nonverbal behaviours and stereotypes in their questions and comments. We also asked students whether they needed English to Korean interpretation and the students requested it. However, as students reported experiencing little difficulty understanding the guests during the class, we tapered interpretation off.

After the class, students wrote feedback including what was good, what needed improving, whether students needed English interpretation, and any other issues they may have encountered. HR classified the contents of the comments in each category qualitatively and then counted the number of comments under each classification.

Students indicated that the class progressed satisfactorily (n=5). They said that the multicultural patients’ stories were ‘moving’ and they felt ‘touched’ (n=8). Students rated the class as new and fresh (n=6), and fun (n=2). Students said that the experts and guests’ vivid descriptions of their experiences made them focus on the class (n=3).

Students greatly appreciated the opportunity to meet people from diverse cultural backgrounds (n=28). They also expressed that it was good to experience direct face-to-face interaction with multicultural patients (n=23) and hear live cases (n=20), frank opinions (n=10), the hidden truth about the Korean healthcare system (n=9) from multicultural patients, and real stories from healthcare professionals (n=8). Students also indicated that the interaction between students and guests, and between students and students was good (n=4) (Table 3).

Students commented that the class was valuable and meaningful (n=7). Students said that the class helped them concrete their understanding of the reality of Korean medical care for foreigners (n=6) and cultural differences (n=4). Students said that the class made them reflect deeply on their prejudices (n=6). They also indicated that the class helped them recognize the importance of cultural safety and understand the need for improvement of the attitudes of health care professionals (including the students themselves) (n=3).

Students indicated that the discussion with the multicultural guests was not detailed enough due to a lack of time (n=6). One student felt unpleasant to observe some students seemed distracted while guests spoke (Table 3).

Students wanted more contact with patients from more diverse backgrounds (n=11) such as low socioeconomicstatus, non-Korean and non-English speaking persons, low-educated people, immigrant workers, North Korean defectors, women who married Korean men, and homosexuals. In addition, students suggested a longer question and answer session with the multicultural guests (n=8) and some requested additional individual sessions with them (n=6). Students suggested that the introduction of Korea’s CD status and lectures from the experts should be shortened (n=4). One student hoped diversity education could be included in other courses during the curriculum. One student suggested a harsher warning about showing respectful attitudes prior to the class.

Many students indicated that interpretation was unnecessary because guests spoke English slowly and used easy words (n=20). However, three students indicated that they needed English interpretation. Two students suggested using a professional interpreter, and three students suggested the use of scripts or presentation slides to accompany the guests’ stories.