Now that I have presented an idea of what both marianismo and machismo are (or are not) as well as the impact they can have on health and well-being, I would like to offer some possible ways to introduce these topics to Spanish for healthcare professionals students. However, before beginning, I would like to restate the need to remember that in the case of languages for specific purposes the students are experts in their respective fields. The instructor’s area of expertise is language and culture. Therefore, when we present cultural aspects to the students, we should encourage the students discuss their own opinions on the impact on patient health and care, guiding them with previous research if discussion stagnates. In this post, I will not attempt to go into the details of teaching culture but instead assume that most instructors know them or will research them. My intent here is to focus on the general flow of presenting cultural aspects in a Spanish for healthcare professionals course. I recognize that the information in the post will be so general that it will leave the desire for something more concrete and specific. However, this foundation is necessary and in the future I hope to delve deeper in different aspects and offer more examples.
In this post, when I refer to “cultural aspects” I am specifically limiting myself to machismo, marianismo, and other cultural beliefs that students from a United States upbringing may find difficult to understand. Teaching every cultural belief in this manner would require more class time than is available in Spanish for healthcare courses. For that reason, beliefs that are more quickly grasped, such as certain beliefs on sickness and health, do not require as much focus and so should be presented differently.
Thankfully, in recent years there has been a movement to include more cultural aspects in general foreign language courses. The information gained from this can be adapted for use in medical Spanish courses. However, since these courses are often times taught in the professional’s native country rather than in that of the target language, the target culture must be recreated within the classroom. Given the time constraints of most of these courses, this can be a challenging endeavor to undertake. It requires that the professor have a good knowledge of the culture and of the available materials or aids, and it requires that the students have a certain level of cultural awareness.
The cultural awareness of the students is important because one must first be conscious of their own culture before they can fully appreciate and understand another. For this reason, the first thing that should be done when preparing to introduce cultural aspects in the classroom is to help the students become aware of their own beliefs or ideas on the matter. For example, with machismo and marianismo it is important to first understand how gender roles play out in our own culture, if they do so at all. This is a good time to remind the students that cultural beliefs are not held by everyone within a population or they are held to varying degrees.
Next, if the aspect you wish to discuss in class has gathered various stereotypes over the years, it is important to not shy away from them but to present these stereotypes to the students with the purpose of showing the truth and the fiction behind them. This cuts the students´ ties with their previous “knowledge” allowing them to see where their thought-line may have been erroneous and to approach the topic in a fresh, positive manner. For example, this is particularly important with machismo in the United States due to its cultural baggage, while basically unnecessary with marianismo due to its relative ignorance. If you do not know if a stereotype exists, feel free to ask the students what they have heard on the topic.
Once stereotypes have been dealt with, we move into the presentation of the cultural aspect as it truly is. It is important to have a positive, not critical attitude when presenting culture in the classroom. Express yourself with the same open-mindedness that you hope your students will adopt. This is the moment where we want to recreate the culture in the classroom in a way that includes “las condiciones de comunicación con todos sus componentes” (Qarmoudi 25). How do we do this? Some of the best techniques use audio and visual aids as well as literature and texts. Songs, movies, TV series, advertisements, novels, short stories, comics, news articles… they all reflect our cultural beliefs. Which we choose depends on the time available, the level and profile of our students, and the difficulty of the concept.
Once we have presented the cultural aspect in its true form, we should encourage the students to discuss what they have learned and interact with it through various activities such as small group discussions, creative writing or, if time is short, more directed activities such as complete the sentence or true / false. Then, encourage them to compare and contrast what they have learned with their own native culture. How do we see traits of marianismo in the United States? How is United States culture adverse to this cultural aspect?
Then, once the students have a grasp on the cultural belief itself we move one step further: how can this cultural view affect one´s health, one´s communication with medical professionals or the way one accesses the health system? This step is the most important in Spanish for healthcare professionals courses because it brings the topic from a conceptual level to a practical level, from an idea to a tool they can use. I would highly recommend that any instructor planning to teach a cultural aspect in the medical setting takee the time to search for video, audio or texts that specifically relate the cultural theme at hand with health. One would be surprised by how many there are when you take the time to look. For example, Minuto Médico from the Noticias 62 based in southern California has a video on “Machismo en la comunidad hispana” as well as the transcript of the video. Students can watch this video and then discuss as a class or in small groups their views on what the doctor explained. It is important during the discussions on how culture affects health that the instructor encourages the students to not only focus on the impact on the health of the individual but also on the health of the individual´s family. How does machismo and marianismo affect the health of the person´s spouse and child?
At this point, it is tempting to end the class feeling satisfied with what has been covered. However, we would be leaving the students with a large hole in their knowledge: what should they do when they encounter these beliefs in clinic? How do they relate to a patient who holds to machismo and encourage him to change his health behaviors? Also, how can they use the positive aspects of machismo to motivate healthy changes? Understandably, instructors who have not worked in a medical setting will have a greater difficulty in responding to these questions and will have to rely on reference materials to help them encourage classroom discussion. In terms of machismo and marianismo, the book Social Work with Latinos: A Cultural Assets Paradigm by Melvin Delgado is one of many that can be of some help.
Finally, ending the class with a role play that allows the students to practice what they have learned can help build the students’ confidence. For example, each pair of students can receive a card with situations such as:
“Un hombre viene a la clínica con dolor del pecho y sospechas que es por ansiedad. Te explica que está trabajando mucho para apoyar a su familia. Cuando le sugieres que puede pedir ayuda del gobierno, se enfada.”
“Temes que tu paciente tiene cáncer de próstata pero él niega tenerlo y se niega a hacer un examen.”
They would then discuss how they believe machismo is affecting the person / family and what they would do in that situation.
Before closing this post, I would like to expound a bit on the resources we use to presentculture in the classroom. We need to ensure that it is not representing a stereotype but instead a vision of reality. At times, in order to quickly and simply present aspects that I cannot find elsewhere, I create my own comics. However, with the ever growing number of resources online a simple search on Google or YouTube typically yields good results in terms of audiovisual aids. However, even with the ease and fun of these aids, I encourage instructors not to ignore the value of text and literature in teaching culture. Sometimes the use of literature can be more powerful in describing feelings and beliefs than any video. For example, short stories such as those by Mario Vargas Llosa vividly depict machismo. Also, the authors Rosario Castellanos, Julia de Burgos and Alfonsina Storni eloquently describe both machismo and marianismo in their writings.
Corpas Viñals, Jaime (2000): “La utilización del vídeo en el aula de ELE. El componente cultural”. Actas del IX Congreso Internacional de ASELE, Zaragoza, págs. 785-791. <http://cvc.cervantes.es/ensenanza/biblioteca_ele/asele/pdf/11/11_0785.pdf>.
Delgado, Melvin (2006): Social Work with Latinos: A Cultural Assets Paradigm. Oxford University Press: New York.
Hola Doc Daniel (2013 enero 21): “Minuto Médico 01-21-13 Machismo en la Comunidad Hispana”. Recuperado el 15 de mayo 2013 de http://www.youtube.com/watch?v=tmSfmfDiOA0
Qarmoudi, Lahouari (2007): “¿Cómo enseñanr cultura para evitar los malentendidos y fomentar la interculturalidad?” Cuadernos de Rabat 19, pág 23-26. Magdalena Roldán Romero (dir). <http://www.mec.es/sgci/ma/es/publicaciones/cuadernosrabat/19/CuadernosRabat19Completo.pdf>.
Sitman, Rosalie and Ivonnee Lerner (1994): “Literatura hispanoamericana: herramienta de acercamiento cultural en la enseñanza del español como lengua extranjera.” Actas del V Congreso Internacional de ASELE págs. 227-233. <http://cvc.cervantes.es/ensenanza/biblioteca_ele/asele/pdf/05/05_0225.pdf>.
Soler-Espiauba, Dolores (2009): “Los contenidos cultural en la enseñanza del español 2/L”. Investigaciones Lingüísticas en el Siglo XXI, págs. 215-248. <http://220.127.116.11/dspace/bitstream/10045/15288/1/ELUA_monografico_2009_09.pdf>