Original Publication
Open Access

A Small-Group Reflection Exercise for Increasing the Awareness of Cultural Stereotypes: A Facilitator's Guide

Published: February 25, 2009 | 10.15766/mep_2374-8265.668

Included in this publication:

  • Cultural Competence Self Reflection Exercise Facilitator's Manual.pdf

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Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: Due to the findings that conscious and unconscious stereotypes play a contributing role in racial and ethnic disparities in health and healthcare, several authorities recommend cultural competence training for healthcare providers. The first step in effective cultural competence training is increasing learners’ awareness of racial and ethnic disparities; the presence of unconscious personal stereotypes, biases, and assumptions; and the impact of such stereotypes on healthcare delivery. Methods: In order to address this we created this 150-minute small-group reflection exercise to increase participant's awareness of their biases. Through self- and group-reflection, participants additionally become aware of the potential influence of unconscious stereotypes on healthcare delivery. Results: This exercise was used with 114 second-year medical students in groups of 10-15 with one facilitator. After completing the exercise, 49% of students agreed and 44.7% strongly agreed (93.7% combined) that they were more aware of the influence of unconscious stereotypes and assumptions on providing effective patient care. Additionally, after completing this exercise 41.7% agreed and 49% strongly agreed (90.7% combined) that they were more aware of their own personal stereotypes and assumptions regarding groups different from themselves. Discussion: This exercise is an effective first step in any cultural competence curriculum to improve participants' awareness of unconscious stereotypes they might have about different cultural groups.

Educational Objectives

By the end of this session, learners will be able to:

  1. Understand unconscious cultural stereotypes.
  2. Identify potential impact of unconscious stereotypes on patient care.
  3. Increase awareness of the influence of unconscious stereotypes on medical decision-making.

Author Information

  • Christopher DeGannes, MD, FACP: Howard University College of Medicine
  • Kamilah Woodson Coke, PhD: Howard University School of Education
  • Tanya Bender Henderson, PhD: Howard University School of Business
  • Kathy Sanders-Phillips, PhD: Howard University College of Medicine

None to report.

None to report. 

Prior Presentations
DeGannes CN, Woodson-Coke K, Henderson TB, Sanders-Phillips K. Development of a cultural competence small group reflection exercise to increase the awareness of unconscious assumptions and stereotypes amongst healthcare providers. Poster presented at: 30th Annual Society of General Internal Medicine (SGIM) Meeting, Innovations in Medical Education; 2007; Toronto, Ontario, Canada.


DeGannes C, Woodson Coke K, Bender Henderson T, Sanders-Phillips K. A small-group reflection exercise for increasing the awareness of cultural stereotypes: a facilitator's guide. MedEdPORTAL. 2009;5:668. https://doi.org/10.15766/mep_2374-8265.668