Exercise #32
BINGO — Professional Behaviors in the Context of Cultural Diversity
Authors: Małgorzata Zimny
25–35 minutes
Description
A card-matching activity that builds the four cultural competencies clinicians need when caring for patients from diverse backgrounds.
Methodological Guide
Objectives
Identify key cultural competencies related to cultural diversity: self-reflection, flexibility, empathy, and protection of patient rights. Match appropriate professional behaviors to specific challenges arising from cultural differences (language barriers, religious norms, patient concerns). Strengthen communication competencies, ethical attitudes, and self-reflection.
Expected Outcomes
After completing the exercise, the student should be able to:
Identify appropriate professional behaviors
Students can indicate specific actions related to empathy, flexibility, self-reflection, and the protection of patient rights in intercultural situations.
Make conscious clinical decisions
Participants can choose an appropriate response to realistic scenarios, taking into account the needs and values of patients from diverse cultural backgrounds.
Develop intercultural communication competence
Students demonstrate the ability to conduct conversations with patients in an empathetic, understandable, and professional manner.
Increase self-awareness and professional reflection
Students can recognize their own biases, evaluate their behaviors, and identify areas requiring further development.
Collaborate effectively in a team
Students exchange perspectives and justify their decisions, strengthening teamwork and intercultural dialogue.
Identify appropriate professional behaviors
Students can indicate specific actions related to empathy, flexibility, self-reflection, and the protection of patient rights in intercultural situations.
Make conscious clinical decisions
Participants can choose an appropriate response to realistic scenarios, taking into account the needs and values of patients from diverse cultural backgrounds.
Develop intercultural communication competence
Students demonstrate the ability to conduct conversations with patients in an empathetic, understandable, and professional manner.
Increase self-awareness and professional reflection
Students can recognize their own biases, evaluate their behaviors, and identify areas requiring further development.
Collaborate effectively in a team
Students exchange perspectives and justify their decisions, strengthening teamwork and intercultural dialogue.
Exercise Procedure
Stage 1 — Review the 16 professional behaviors. Stage 2 — Drag each behavior into the competency category it best represents. Stage 3 — Click Check Answers; incorrectly placed behaviors turn red. Stage 4 — Move any misplaced behaviors and re-check. When every behavior is in its correct category, the attempt completes and you may reflect on which behaviors were most obvious and which required a shift in perspective.
Mode of Implementation
Introduction – Students receive a link to an individually generated Bingo card.
Stage 1 – Individual work – Interactive selection of situations and marking squares.
Stage 2 – Real-time discussion of results.
Stage 3 – Creating a shared competencies map.
Summary – Joint discussion with all students / moderated by the teacher.
Stage 1 – Individual work – Interactive selection of situations and marking squares.
Stage 2 – Real-time discussion of results.
Stage 3 – Creating a shared competencies map.
Summary – Joint discussion with all students / moderated by the teacher.
Role of the Teacher
The teacher introduces the objective of the exercise, explains the rules of Bingo, and presents the competencies emphasized in the game: empathy, flexibility, self-reflection, and protection of patient rights.
The facilitator draws scenarios, oversees the progress of the game, and encourages active student participation, ensuring clear instructions and appropriate pacing.
After achieving Bingo, the teacher asks brief reflective questions (“Why did you choose this behavior?”, “What could be an alternative response?”) to stimulate analysis and the development of cultural competencies.
The teacher monitors student engagement, provides guidance, helps interpret challenging scenarios, and supports less active participants.
The teacher assists students in creating a shared competencies map, highlights key conclusions, and connects them to professional practice.
The teacher encourages self-reflection (e.g., short final questions), demonstrating how the acquired knowledge can be applied to real patient interactions.
The teacher creates a safe and engaging environment for developing cultural competencies in an interactive and practical manner.
The facilitator draws scenarios, oversees the progress of the game, and encourages active student participation, ensuring clear instructions and appropriate pacing.
After achieving Bingo, the teacher asks brief reflective questions (“Why did you choose this behavior?”, “What could be an alternative response?”) to stimulate analysis and the development of cultural competencies.
The teacher monitors student engagement, provides guidance, helps interpret challenging scenarios, and supports less active participants.
The teacher assists students in creating a shared competencies map, highlights key conclusions, and connects them to professional practice.
The teacher encourages self-reflection (e.g., short final questions), demonstrating how the acquired knowledge can be applied to real patient interactions.
The teacher creates a safe and engaging environment for developing cultural competencies in an interactive and practical manner.
Theoretical Basis
Experiential learning:
Students analyze realistic clinical situations and make decisions that reflect their own cultural competencies. Active participation in the game (choosing responses, justifying decisions, engaging in discussion) supports movement through the cycle of reflection, conceptualization, and practical application.
Social constructivism:
Knowledge is created through interaction — students compare their choices, discuss strategies, and build shared meanings related to empathy, flexibility, and the protection of patient rights. The team-based format of the game supports peer learning.
Transformative learning:
The exercise encourages critical reflection on personal beliefs, potential biases, and automatic reactions. Confronting one’s assumptions with culturally different scenarios can lead to a shift in perspective and to more conscious professional practice.
Pedagogy of intercultural competence:
The Bingo activity serves as a tool for identifying and practically applying key elements of cultural competence: self-reflection, empathy, behavioral adaptation, and respect for patient rights. In this way, the exercise mirrors the real demands of contemporary healthcare.
As a result, the game integrates cognitive, emotional, and practical learning, supporting the holistic development of cultural competencies among medical students.
Students analyze realistic clinical situations and make decisions that reflect their own cultural competencies. Active participation in the game (choosing responses, justifying decisions, engaging in discussion) supports movement through the cycle of reflection, conceptualization, and practical application.
Social constructivism:
Knowledge is created through interaction — students compare their choices, discuss strategies, and build shared meanings related to empathy, flexibility, and the protection of patient rights. The team-based format of the game supports peer learning.
Transformative learning:
The exercise encourages critical reflection on personal beliefs, potential biases, and automatic reactions. Confronting one’s assumptions with culturally different scenarios can lead to a shift in perspective and to more conscious professional practice.
Pedagogy of intercultural competence:
The Bingo activity serves as a tool for identifying and practically applying key elements of cultural competence: self-reflection, empathy, behavioral adaptation, and respect for patient rights. In this way, the exercise mirrors the real demands of contemporary healthcare.
As a result, the game integrates cognitive, emotional, and practical learning, supporting the holistic development of cultural competencies among medical students.
Practical Application
The exercise prepares students for work in real medical settings, where they regularly encounter patients with diverse cultural, linguistic, and religious needs. Participants learn to quickly identify appropriate professional behaviors in changing clinical situations and practice making decisions consistent with the principles of empathy, flexibility, self-reflection, and the protection of patient rights. The game also strengthens the ability to respond in stressful situations and to work effectively as part of a team — both essential competencies in healthcare.
Knowledge Transfer
The exercise enables students to transfer knowledge from a theoretical level to clinical practice through the analysis of realistic, multicultural scenarios. Identifying appropriate behaviors (empathy, flexibility, self-reflection, protection of patient rights) supports the development of competencies that can be directly applied when interacting with patients in hospitals, clinics, or long-term care settings.
Through reflection and the exchange of perspectives, students can transform their prior thinking patterns and develop lasting, conscious professional attitudes that positively impact the quality of care in real intercultural situations.
Through reflection and the exchange of perspectives, students can transform their prior thinking patterns and develop lasting, conscious professional attitudes that positively impact the quality of care in real intercultural situations.
Reinforcement & Reflection
To reinforce acquired skills and encourage students’ critical self-reflection, short reflective tasks or discussion questions can be used after the exercise.
Proposed self-reflection questions:
Which professional behaviors felt most intuitive to me, and which required conscious effort?
What did this exercise make me most aware of regarding my reactions to cultural diversity?
What one specific action would I like to implement in my next interaction with a patient from a different cultural background?
Proposed peer discussion prompts:
Which BINGO squares appeared most frequently — what does this say about our group?
In any situation, did we differ in our interpretation of the appropriate response? What might have caused these differences?
How can this exercise help us deal with real communication challenges in clinical practice?
Reinforcement/strengthening activities:
Students can create a shared “good practices” list based on the marked squares.
Short analysis of one square that was particularly important to them, explaining why it matters for patient care.
Mini-quiz or a quick Mentimeter survey to check which behaviors students remembered and considered most important.
Proposed self-reflection questions:
Which professional behaviors felt most intuitive to me, and which required conscious effort?
What did this exercise make me most aware of regarding my reactions to cultural diversity?
What one specific action would I like to implement in my next interaction with a patient from a different cultural background?
Proposed peer discussion prompts:
Which BINGO squares appeared most frequently — what does this say about our group?
In any situation, did we differ in our interpretation of the appropriate response? What might have caused these differences?
How can this exercise help us deal with real communication challenges in clinical practice?
Reinforcement/strengthening activities:
Students can create a shared “good practices” list based on the marked squares.
Short analysis of one square that was particularly important to them, explaining why it matters for patient care.
Mini-quiz or a quick Mentimeter survey to check which behaviors students remembered and considered most important.
Required Resources
Electronic devices: tablet, smartphone, or laptop enabling access to the MultiCultiMed Platform
Internet access to reach the exercise platform
PDF files or images with scenario descriptions
Interactive Bingo platform
BingoBaker / Wordwall (for generating cards)
Mentimeter (for reactions and voting)
Wheel of Names (for randomly selecting scenarios)
Board on the MultiCultiMed Platform for creating the competencies map
Internet access to reach the exercise platform
PDF files or images with scenario descriptions
Interactive Bingo platform
BingoBaker / Wordwall (for generating cards)
Mentimeter (for reactions and voting)
Wheel of Names (for randomly selecting scenarios)
Board on the MultiCultiMed Platform for creating the competencies map
Assessment / Evaluation
Self-assessment:
Students complete a short reflective card after the exercise (e.g., “Which behavior in Bingo was the most challenging for me and why?”).
Participants identify 1–2 Bingo squares they plan to implement in future clinical practice and justify their choice.
Peer assessment:
Brief exchanges in pairs or small groups: students discuss which behaviors were key for them and how they can apply them.
The group provides each other with feedback regarding the relevance and justification of the selected Bingo squares.
Teacher observation:
The teacher observes activity during the game: engagement, reasoning behind chosen squares, and the ability to justify decisions.
During the final discussion, the teacher assesses the depth of reflection, the ability to recognize relationships between competency categories, and the ethical maturity of the responses.
Students complete a short reflective card after the exercise (e.g., “Which behavior in Bingo was the most challenging for me and why?”).
Participants identify 1–2 Bingo squares they plan to implement in future clinical practice and justify their choice.
Peer assessment:
Brief exchanges in pairs or small groups: students discuss which behaviors were key for them and how they can apply them.
The group provides each other with feedback regarding the relevance and justification of the selected Bingo squares.
Teacher observation:
The teacher observes activity during the game: engagement, reasoning behind chosen squares, and the ability to justify decisions.
During the final discussion, the teacher assesses the depth of reflection, the ability to recognize relationships between competency categories, and the ethical maturity of the responses.
Practical Tips
Set a clear time limit for each part of the exercise: rules explanation, gameplay, discussion, summary.
For larger groups, reduce the number of scenarios discussed or conduct Bingo in smaller subgroups.
Randomly draw scenarios in a dynamic way (e.g., online spinner, number generator, QR cards).
Encourage students to give brief reactions during the game (“Why did you mark this square?”, “Who has Bingo and why?”).
Vary the types of Bingo squares (behaviors, short clinical decisions, reflective statements) to maintain engagement.
Use ready-made online Bingo templates.
In online versions, students can mark squares on their own cards or use a shared version displayed on screen.
Add a short reflective form (e.g., Google Forms) to be completed after the exercise.
Use built-in chat or online whiteboard functions to record observations.
Suggest that students create a “Mini Cultural Competency Journal” to accompany future sessions.
Remind students that the exercise does not assess the patient’s culture, but focuses on analyzing their own reactions and choices.
Emphasize that diverse answers are welcome — not all scenarios have a single “correct” solution.
Prepare Bingo cards in advance as PDF files or links to digital versions.
Ensure that all participants have access to audio/video (for online sessions) or printed materials (for in-person sessions).
Keep a list of scenarios and short behavior descriptions handy for the teacher.
For larger groups, reduce the number of scenarios discussed or conduct Bingo in smaller subgroups.
Randomly draw scenarios in a dynamic way (e.g., online spinner, number generator, QR cards).
Encourage students to give brief reactions during the game (“Why did you mark this square?”, “Who has Bingo and why?”).
Vary the types of Bingo squares (behaviors, short clinical decisions, reflective statements) to maintain engagement.
Use ready-made online Bingo templates.
In online versions, students can mark squares on their own cards or use a shared version displayed on screen.
Add a short reflective form (e.g., Google Forms) to be completed after the exercise.
Use built-in chat or online whiteboard functions to record observations.
Suggest that students create a “Mini Cultural Competency Journal” to accompany future sessions.
Remind students that the exercise does not assess the patient’s culture, but focuses on analyzing their own reactions and choices.
Emphasize that diverse answers are welcome — not all scenarios have a single “correct” solution.
Prepare Bingo cards in advance as PDF files or links to digital versions.
Ensure that all participants have access to audio/video (for online sessions) or printed materials (for in-person sessions).
Keep a list of scenarios and short behavior descriptions handy for the teacher.
Discussion Topics
Which behaviors on the BINGO cards were the most intuitive for you, and which required the greatest shift in perspective? Why?
In which real clinical situations is it most difficult to apply empathy, flexibility, or protection of patient rights? How can these barriers be overcome?
During the game, were there moments that prompted you to reflect on your own biases or cultural assumptions? What conclusions can be drawn from this?
What system-level solutions (e.g., organizational, educational, technological) could enhance the cultural safety of patients in your healthcare setting?
In which real clinical situations is it most difficult to apply empathy, flexibility, or protection of patient rights? How can these barriers be overcome?
During the game, were there moments that prompted you to reflect on your own biases or cultural assumptions? What conclusions can be drawn from this?
What system-level solutions (e.g., organizational, educational, technological) could enhance the cultural safety of patients in your healthcare setting?
Further Resources
https://pmc.ncbi.nlm.nih.gov/articles/PMC7011228/?utm_source=chatgpt.com
https://www.termedia.pl/Cultural-competencies-of-selected-health-care-r-nworkers-in-the-West-Pomeranian-Voivodeship%2C134%2C54032%2C1%2C1.html?utm_source=chatgpt.com
https://minorityhealth.hhs.gov/think-cultural-health?utm_source=chatgpt.com
https://link.springer.com/article/10.1186/s12909-025-08008-7
https://link.springer.com/article/10.1186/s12939-024-02290-5
https://mdpi-res.com/bookfiles/book/6475/Cultural_Competence_in_Healthcare_and_Healthcare_Education.pdf?utm_source=chatgpt.com
https://www.termedia.pl/Cultural-competencies-of-selected-health-care-r-nworkers-in-the-West-Pomeranian-Voivodeship%2C134%2C54032%2C1%2C1.html?utm_source=chatgpt.com
https://minorityhealth.hhs.gov/think-cultural-health?utm_source=chatgpt.com
https://link.springer.com/article/10.1186/s12909-025-08008-7
https://link.springer.com/article/10.1186/s12939-024-02290-5
https://mdpi-res.com/bookfiles/book/6475/Cultural_Competence_in_Healthcare_and_Healthcare_Education.pdf?utm_source=chatgpt.com
Additional Remarks
Ensure diversity of examples – if the group has clinical experience, participants can be invited to introduce their own scenarios into the game, increasing the authenticity of the exercise.
Avoid rushing – give students time to reflect on each behavior, especially those related to self-reflection, which requires calm and consideration.
Pay attention to a safe and supportive atmosphere – discussions about biases can be sensitive; the teacher should clearly emphasize that the exercise is developmental, not evaluative.
Prepare an alternative for online work – if the platform fails or the connection is unstable, have a PDF version of the Bingo board ready to share.
Watch for dominance in the group – during discussions, some participants may take over; the teacher should moderate to ensure everyone has the opportunity to speak.
Encourage students to note “Aha moments” – brief, personal insights or discoveries that emerge during the game; this reinforces learning.
The Bingo board can be revisited later – after a few weeks, the group can play again or discuss selected squares to see how their understanding of professional behaviors has evolved.
Avoid rushing – give students time to reflect on each behavior, especially those related to self-reflection, which requires calm and consideration.
Pay attention to a safe and supportive atmosphere – discussions about biases can be sensitive; the teacher should clearly emphasize that the exercise is developmental, not evaluative.
Prepare an alternative for online work – if the platform fails or the connection is unstable, have a PDF version of the Bingo board ready to share.
Watch for dominance in the group – during discussions, some participants may take over; the teacher should moderate to ensure everyone has the opportunity to speak.
Encourage students to note “Aha moments” – brief, personal insights or discoveries that emerge during the game; this reinforces learning.
The Bingo board can be revisited later – after a few weeks, the group can play again or discuss selected squares to see how their understanding of professional behaviors has evolved.