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Which were you aware of and which ones were you not aware of?

Which were you aware of and which ones were you not aware of?

Which were you aware of and which ones were you not aware of?
TSL 550 Benefits of Cultural Differences Knowledge to Teachers

Guidelines for cultural differences are discussed in your required reading. Which were you aware of and which ones were you not aware of? Why is this knowledge beneficial to teachers?

Cultural competence in healthcare assists in the delivery of culturally sensitive and high-quality services. This scoping review aims to provide an overview of the available evidence and to examine the effectiveness of classroom-based intervention strategies used to enhance the cultural competence of undergraduate health science students.

A comprehensive and systematic literature search was undertaken in databases, including Cochrane Library, Medline, and Emcare. Articles were eligible if they employed an experimental study design to assess classroom-based cultural competency education for university students across the health science disciplines. Two reviewers independently screened and extracted relevant data pertaining to study and participant characteristics using a charting table. The outcomes included knowledge, attitudes, skills, and perceived benefits.

Ten studies were analysed. Diverse approaches to cultural education exist in terms of the mode, frequency, and duration of interventions. For the knowledge outcome, students who experienced cultural education interventions yielded higher post-test scores than their baseline cultural knowledge, but without a significant difference from the scores of students who did not receive interventions. Data relating to the skills domain demonstrated positive effects for students after experiencing interventions. Overall, students were satisfied with their experiences and demonstrated improvements in confidence and attitudes towards culturally competent practice.

Across health science disciplines, cultural competency interventions were shown to be effective in enhancing knowledge acquisition, performance of skills, attitudes, and student satisfaction. Future research is necessary to address the significant absence of control arms in the current literature, and to assess long-term effects and patient-related outcomes.

Keywords: Attitude, Cultural competency, Data management, PubMed, University students
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Cultural competence is a foundational pillar of healthcare that endeavours to reduce current disparities in delivering culturally sensitive and quality services [1]. Fundamentally, it strives to provide equal access to healthcare across diverse groups and to ensure that all patients receive care according to their needs [2]. Culturally competent services can be broadly defined as those that respect diversity amongst the patient population and the socio-cultural factors that may affect their health; this includes their beliefs, behaviours, attitudes, and language [3]. As populations become increasingly diverse due to globalization and migration, health professionals are continually finding themselves servicing patients with differing cultural and linguistic needs [4].

Numerous reviews have analysed the impacts of cultural competence interventions on registered health professionals [5,6] and students in other fields including nursing and medicine [7,8]. Although cultural competence training has varied across disciplines in terms of the frequency, duration, and overall nature of educational interventions, their conclusions indicate that cultural competence education may be effective in positively influencing the capabilities of both professionals and students. These benefits have been proposed to directly mitigate health disparities caused by a variety of factors, including social and economic conditions, access issues, insurance coverage, and genetic factors [9]. Practitioners’ increased competency levels were correlated with increased treatment adherence, patient satisfaction, and information-sharing [10]. Furthermore, when cultural differences between healthcare clinicians and healthcare users are not addressed, considerable miscommunication, mistrust, dissatisfaction, and disempowerment are undesirably fostered [11].

In recent years, many institutions have opted for a cross-cultural approach that focuses on teaching more general knowledge, attitudes, and skills that are applicable to a plethora of cultural situations [11]. The health sciences are distinct from many disciplines in that undergraduates learn theoretical knowledge through conventional didactic courses, whilst partaking in clinical placements where experience with real-world principles is continually evaluated and their professional identities are developed [12]. Education concerning cultural competence prior to these latter environments may play a key role in improving students’ understanding and equipping them with greater competence after graduation. As characterized by the majority of related studies, the dimensions of competence have generally encompassed knowledge (i.e., acquisition of cultural-related information), attitudes (i.e., beliefs and tendencies), skills (i.e., performance of cultural-related activities), satisfaction, and perceived confidence [13]. To the best of our knowledge, however, no previous review has been undertaken with an exclusive focus on undergraduate health science students.

Surveys have suggested that current healthcare workers remain unaware of the actual impact of health disparities nationwide [14]. This may be due to a deficiency in effective cultural competency in their undergraduate education, because facilitating a comprehensive curriculum that includes the entire scope of cultural competency is still a recognized challenge. Examining the approaches used to facilitate cultural competency education may help improve culturally appropriate care.

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TSL 550 Benefits of Cultural Differences Knowledge to Teachers
TSL 550 Benefits of Cultural Differences Knowledge to Teachers

Therefore, this scoping review aimed to examine the intervention strategies utilized by studies and their outcomes in order to determine educational approaches that may enhance the cultural competence of undergraduate health science students. Ultimately, the findings of this study are hoped to build awareness of such education and inform the future implementation of educational research to enhance the cultural competence of graduating health professionals. Specifically, this review may aid in facilitating curricular changes that have the potential to translate into patient-related outcomes, reduce bias, and provide high-quality healthcare for all people.

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Ethics statement
Written informed consent and ethical approval were not required due to the nature of the study.

Reporting guideline
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) statement was utilized to perform this scoping review. The checklist contains 20 required items and 2 optional items for the transparent reporting of essential study aspects [15].

Eligibility criteria
This review encompassed a wide range of both experimental and quasi-experimental study designs, including but not limited to randomized controlled trials, non-randomized controlled trials, pre-post studies, and observational studies such as prospective and retrospective cohort studies, cross-sectional studies, and case-control studies. Clinical trials, previous meta-analyses/reviews, editorial comments, and opinion pieces were excluded. Participants included undergraduate students within the health science discipline. Studies that included primary, secondary, or post-graduate students were excluded, as well as professionals in the field with existing accreditation. There exists no established definition that specifically defines the disciplines under the “health science” banner. We therefore chose to selectively include the fields that constitute the Australian National Registration and Accreditation Scheme [16] and comprise the overwhelming majority of health science and allied health clinical activity [9]. Specifically, we included undergraduate students enrolled in health science, pharmacy, physiotherapy, podiatry, medical radiation, optometry, speech pathology, and occupational therapy.

Information sources
The Cochrane Library, Medline, and Emcare databases were systematically searched for literature published from database inception until June 2020.

The search strategy was defined through the principles of a systematic search, using the PICO (population, intervention, comparison, outcome) scheme. The search terms included the following keywords: [‘cultural competen*’ or ‘cultural awareness*’ or ‘intercultural education’ or ‘cross-cultural education’ or ‘indigenous education’] AND [‘higher education’ or ‘tertiary education’ or ‘universit*’ or ‘colleg*’ or ‘further education’ or ‘undergraduate*’] AND [‘allied health’ or ‘health’ or ‘health science*’ or ‘radiograph*’ or ‘physio*’ or ‘podiat*’ or ‘occupational therap*’ or ‘physical therap*’ or ‘speech patho*’ or ‘optometr*’ or ‘pharm*’ or ‘speech path*’ or ‘medical imag*’ or ‘medical rad*’]. The search was limited to English studies and those with human participants.

Selection of sources of evidence
The reference lists of previous systematic reviews were investigated to find eligible studies not discovered from the systematic search. The concept of interest was classroom-based cultural competency programs administered to health science students. These programs may be elective courses or courses forming part of the compulsory university curriculum. This implies that the included studies may have provided cultural competency education via a range of delivery methods. In terms of setting, the search encompassed initiatives performed at universities, skills laboratories, or virtual classrooms, and included (but was not limited to) didactic lecture formats, tutorials, computer-based training, and simulation methods or virtual reality software. However, clinical placements, immersion experiences, and service-learning courses were excluded. No stipulation was made in regard to the duration or frequency of the educational program, implying that interventions could range from a single sitting to longer-term cultural interventions. No geographical limitation was applied.

Data charting process (data extraction)
Two reviewers (E.S.A. and M.C.) independently extracted relevant data from the included studies. This information encompassed the following aspects: the characteristics of studies (publication year, sample size, country, field of education), participant characteristics (age and gender where possible) and characteristics relating to the intervention, control, and outcome measures (i.e., frequency and duration, measurement tools). Any disagreements that arose between the reviewers were arbitrated by consensus. When required, authors of studies were contacted to request missing or additional data.

Data items (variables)
Articles were included if they featured any independent variable relating to the following: knowledge (i.e., acquisition of theoretical concepts), skills (i.e., practical application), self-perceived benefit (i.e., satisfaction, motivation, confidence, etc.), attitudes (i.e., beliefs and tendencies) and/or costs.

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