Mechanisms Driving Postgraduate Health and Social Science Students' Cultural Competence: An Integrated Systematic...

Area of Science:

• Health professions education
• Social sciences
• Cultural competence research

Background:

• COVID-19 highlighted healthcare disparities linked to systemic racism.
• Cultural competence (CC) training is recommended by WHO for clinicians.
• Mechanisms influencing CC acquisition in education remain under-explored.

Purpose of the Study:

• To investigate how postgraduate health and social science education approaches cultural competence (CC).
• To identify the mechanisms and social structures that influence the achievement of CC.
• To evaluate the effectiveness of current CC educational approaches.

Main Methods:

• Systematic integrated review using critical realism and Whittemore and Knafl's methods.
• Searched seven databases (2000-2020) for studies on postgraduate CC in health/social sciences.
• Thematic analysis of 32 studies to identify underlying mechanisms and social structures.

Main Results:

• Identified two main approaches to CC: professionalized pedagogy and becoming culturally competent.
• Professionalized pedagogy included subthemes of 'othering' and 'labeling'.
• Becoming culturally competent involved a safe CC teaching environment and social interactions fostering reflexivity.

Conclusions:

• Current CC education often frames cultural differences as problems, focusing on 'othering' rather than self-awareness.
• Developing CC may be enhanced by focusing on insight, cognitive flexibility, and reflexivity.
• Safe teaching environments are crucial for fostering cultural safety, humility, and CC.