In Morocco, religion plays a significant role in the structure of people’s daily lives, and the call to prayer rings out over cities and towns five times a day, recalls Addie Irvin, '25, of her recent trip to western North Africa with ̽̽'s new occupational therapy (OT) program. The Birmingham, Alabama native and her 15 classmates began each morning with a breakfast of Msemmen, a warm, fried flatbread, and then embraced the opportunity to explore another way of life.
Priganc worked with Global Clinical Education founder Said Nafai to arrange the travel experience, which included visits to orphanages, a center for children with physical and intellectual disabilities, a shelter for women with cancer, and a nursing home - a rarity in a culture where many live in multigenerational households their whole lives. The students toured historical and cultural sites to view art and architecture in the 172,000 square mile country with a population of 37 million, where the official languages are Arabic and Berber. They participated in a henna ceremony, a cultural tradition of applying intricate designs to the hands, arms, and feet with a dye made from the dried leaves of the henna plant. They wandered through street markets, or souks, where colorful vegetables and fruits, fragrant spices, and various housewares were displayed for sale. They also visited Morocco’s new occupational therapy school.
Together, the students from the two inaugural programs were about to experience another novelty, thanks to the inspiration of program director Victoria Priganc, who developed the cultural immersion component of the occupational therapy curriculum as a way for future healthcare professionals to learn firsthand the impacts of cultural humility and cultural competence on patient care.
“I wanted these students to experience what it’s like when you are truly among people who speak a different language, dress differently, and have different beliefs,” said Priganc, who had a similar opportunity to practice healthcare in a culture unlike her own early in her career. “It was completely eye-opening - about how certain people live, their experiences, and how I have to change how I'm doing things to think about what makes sense in their particular environment,” Priganc recalls.
A commitment to understanding and respecting individuals of different cultural backgrounds and their beliefs, values, and histories is vital to effective healthcare. The practice improves patient-provider interactions, reduces biases, and increases the chance that patients will comply with recommendations given by their healthcare professionals. It's an essential learned skill for quality healthcare practice, but for many students, it can be challenging to find opportunities to develop it.
As a complement to the tour, Priganc created a one-of-a-kind case study for students from both programs to explore. The case study was a married woman in her 60s with grandchildren who had a stroke. Priganc omitted specific details about the woman so the students from the two countries could witness the case through each other’s cultural interpretation. “In Vermont, it could be that this woman is a very active skier,” explained Priganc. “In Morocco, it could be that she's one of the primary caregivers of the grandchildren.”
With Nafai's help, Priganc had the case study translated into Arabic and French (also widely spoken in the country), reviewed it with the Moroccan OT program faculty, and shared it with students from both programs before the trip. In Morocco, with the help of translators, the students discussed their treatment recommendations for the case study. The U.S. students learned the importance of ensuring the patient’s ability to participate in daily prayer. The Moroccan students wondered why driving rehabilitation was recommended for the patient’s recovery. The two cohorts also discussed the idea of aging in place, a common practice in the U.S. where people without extended family in the home continue to lead independent lives as they age, often hiring supportive services to help with personal care, chores, and meals as needed. “In Morocco, they didn't understand the idea of home health," said Priganc, "because once somebody goes home, they're under the care of their family.”
As a result of the trip, Sarah James, ‘25, now considers culture an essential part of an occupational therapy patient's profile that informs evaluation, treatment, and care. "The travel experience was a rich opportunity to develop compassionate communication and interpersonal skills," said James, a mother of two from Bar Harbor, Maine, who plans to practice in pediatrics, mental health, and advocacy.
For Irvin, interacting with many different people around the country was the highlight of the experience. "While we won’t always speak the same language as other people, there is still so much room for connection and relationship building,” she said.
The lessons the students learned in the mountainous country bordered by the Atlantic Ocean and the Mediterranean Sea will serve them well as they continue to work with families, communities, clients and patients from backgrounds that differ from their own.
“In healthcare, it’s so very important to understand the cultural contexts and the cultural backgrounds of the individuals with whom you will work,” said College of Nursing and Health Sciences Dean Noma Anderson. “You've got to work at feeling comfortable talking to, interacting with, and treating individuals who are different from you - the idea of cultural comfort means that you can work effectively in that space. And if you are culturally humble and become more culturally comfortable, you will build trust with individuals, their families, and their communities.”
The cultural immersion experience is offered locally and internationally in Burlington, Vermont and Morocco.