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Summary PDF: What is the impact of cultural competence training among health and mental health providers?

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What is the impact of cultural competence training among health and mental health providers?

Evidence about the impact of cultural competence training on client health and mental health outcomes is generally inconclusive.

  • Five systematic reviews, including one review of reviews, all published within the past ten years, concur that existing studies lack adequate methodological rigor to draw conclusions about the impact of cultural competence training and programming. Additionally, existing studies have produced contradictory results, showing either a positive impact or no impact. These systematic reviews have examined cultural competence training in general, not specifically as it relates to resettled refugees.

 

Virtual and experiential refugee-specific cultural competence training approaches show promising results.

  • Several studies have examined changes in health care provider attitudes, knowledge, and/or skills associated with refugee-specific cultural competence training. These studies have examined virtual and/or experiential learning. The studies have found improvements primarily in providers’ attitudes such as empathy and confidence in providing care. However, these studies all used uncontrolled pretest-posttest or posttest-only designs; thus, their findings are only suggestive and promising for further research.

Post TitleStrength of EvidenceType of StudyDirection of Evidence
The impact of service-learning on students’ cultural competenceInconclusive or mixed impactImpact evaluationInconclusive or mixed impact
“Shattering culture”: Perspectives on cultural competence and evidence-based practice in mental health servicesSuggestiveSuggestive evidenceN/A
Supportive care: Communication strategies to improve cultural competence in shared decision makingSuggestiveSuggestive evidenceN/A
Cultural competence in teaching immigrant-origin youth: The ethic of cariñoSuggestiveSuggestive evidenceN/A
Cultural competence of internationally educated nurses: Assessing problems and finding solutionsSuggestiveSuggestive evidenceN/A
Cultural competence of parenting education programs used by latino families: A reviewPositive impactSystematic reviewPositive impact
Cultural competence of professionals working with unaccompanied minors: Addressing empathy by a shared narrativePositive impactSuggestive evidencePositive impact
Cultural competence and mental health across different immigrant and refugee groupsPositive impactSuggestive evidencePositive impact
Demonstrating cultural competence within health-visiting practice: Working with refugee and asylum-seeking familiesSuggestiveSuggestive evidenceN/A
Developing cultural competency for providing psychological services with immigrant populations: A cross-level training curriculumPositive impactSuggestive evidencePositive impact
Developing measurable cultural competence and cultural humility: An application of the cultural formulationPositive impactSuggestive evidencePositive impact
Development and psychometric evaluation of an instrument to assess cross-cultural competence of healthcare professionals (CCCHP)SuggestiveSuggestive evidenceN/A
Educating nursing students for cultural competence in emergencies: A randomized controlled trialPositive impactImpact evaluationPositive impact
Effects of cultural education and cultural experiences on the cultural competence among undergraduate nursing studentsSuggestiveSuggestive evidenceN/A
Enhancing cultural competence for improved access to quality carePositive impactSuggestive evidencePositive impact
Inter-professional and inter-cultural competence training as a preventative strategy to promote collaboration in encountering new-coming refugees in the reception programme: A case studyPositive impactSuggestive evidencePositive impact
Methods of increasing cultural competence in nurses working in clinical practice: A scoping review of literature 2011-2021Positive impactSystematic reviewPositive impact
Multicultural training experiences as predictors of psychology students’ cultural competenceSuggestiveSuggestive evidenceN/A
Need for ensuring cultural competence in medical programmes of European universitiesSuggestiveSuggestive evidenceN/A
Organizational and staff-related effects on cultural competence in the hospital settings: A cross-sectional online survey of nursing and medical staffSuggestiveSuggestive evidenceN/A
Patient-centered care for cultural competence: Negotiating palliative care at home for Chinese Canadian immigrantsSuggestiveSuggestive evidenceN/A
Practice parameter for cultural competence in child and asolescent psychiatric practiceSuggestiveSuggestive evidenceN/A
Cultural competence among Swedish child health nurses after specific training: A randomized trialPositive impactImpact evaluationPositive impact
A framework for cultural competence, advocacy, and social justice: Applications for global multiculturalism and diversitySuggestiveSuggestive evidenceN/A
Comparison of four cultural competence models in transcultural nursing: A discussion paperPositive impactSuggestive evidencePositive impact
Cultural competence among nurse practitioners working with asylum seekersSuggestiveSuggestive evidenceN/A
Cultural competence and cultural sensitivity education in university nursing courses: A scoping reviewPositive impactSystematic reviewPositive impact
Cultural competence education in university rehabilitation programsSuggestiveSuggestive evidenceN/A
Cultural competence in migrant healthcareSuggestiveSuggestive evidenceN/A
Cultural competence in practice: The example of the community nursing care of asylum applicants in ScotlandSuggestiveSuggestive evidenceN/A
Cultural competence in refugee service settings: A scoping reviewStrongSystematic reviewN/A
Promoting Quality Care for Recently Resettled Populations: Curriculum Development for Internal Medicine ResidentsSuggestiveSuggestive evidencePositive impact
Organisational Systems’ Approaches to Improving Cultural Competence in Healthcare: A Systematic Scoping Review of the LiteratureStrongSystematic reviewInconclusive or mixed impact
Effectiveness of Cross-Cultural Education for Medical Residents Caring for Burmese RefugeesSuggestiveSuggestive evidencePositive impact
Innovative Training with Virtual Patients in Transcultural Psychiatry: The Impact on Resident Psychiatrists’ ConfidenceSuggestiveSuggestive evidencePositive impact
Beginning with the End in Mind: Evaluating Outcomes of Cultural Competence Instruction in a Doctor of Physical Therapy ProgrammeSuggestiveSuggestive evidencePositive impact
Interventions to Improve Cultural Competency in Healthcare: A Systematic Review of ReviewsStrongSystematic reviewInconclusive or mixed impact
Does Cultural Competency Training of Health Professionals Improve Patient Outcomes? A Systematic Review and Proposed Algorithm for Future ResearchStrongSystematic reviewInconclusive or mixed impact
Cultural Competence Dimensions and Outcomes: A Systematic Review of the LiteratureStrongSystematic reviewInconclusive or mixed impact
Reshaping Curricula: Culture and Mental Health in Undergraduate Health DegreesSuggestiveSuggestive evidencePositive impact
Refugees and Medical Student Training: Results of a Programme in Primary CareSuggestiveSuggestive evidencePositive impact
Cultural Awareness Through Medical Student and Refugee Patient EncountersSuggestiveSuggestive evidencePositive impact
Cultural Competence Education for Health ProfessionalsStrongSystematic reviewInconclusive or mixed impact

Studies included in the database focused on high-income or upper middle-income countries, including but not limited to the United States. Studies included must have been published since 2000. To identify evidence related to cultural competence training, we searched the following websites and databases using the following population, methodology, and target problem terms:

Websites and Databases Population Terms Methodology Terms Target Problem Terms
Campbell Collaboration
Cochrane Collaboration
Mathematica Policy Research
Evidence Aid
Urban Institute
Migration Policy Institute
HHS OPRE
ASSIA
Social Services Abstracts
Social Work Abstracts
PsycInfo
CINAHL
PILOTS
refugee
OR
immigrant
OR
“unaccompanied minor”
OR
asylee
OR
“temporary protected status”
OR
“victims of traffick*”
OR
“traffick* victims”
OR
T-Visa
OR
U-Visa
OR
Cuban
OR
Haitian
OR
Amerasian
evaluation
OR
impact
OR
program
OR
intervention
OR
policy
OR
project
OR
train*
OR
therapy
OR
treatment
OR
counseling
OR
workshop
OR
review
OR
meta-analysis
OR
synthesis
“cultural competence”

For databases or websites that permitted only basic searches, free-text terms and limited term combinations were selected out of the lists above, and all resultant studies were reviewed for relevance. Conversely, for databases or websites with advanced search capability, we made use of relevant filters available. All search terms were searched in the title and abstract fields only in order to exclude studies that made only passing mention of the topic under consideration.

After initial screening, Switchboard evidence mapping is prioritized as follows: First priority is given to meta-analyses and systematic reviews, followed by individual impact evaluations when no meta-analyses or systematic reviews are available. Evaluations that are rated as impact evidence are considered before those rated as suggestive, with the latter only being included for outcomes where no evidence is available from the former.