Beyond cultural competence: online training for healthcare professionals in refugee healthcare; a quasi-experimental...

Refugees and asylum seekers face persistent inequities in healthcare access and quality, while healthcare professionals often report feeling underprepared to address the cultural and structural complexity of refugee care. This study protocol describes the development and evaluation of an online training program that integrates cultural competence, cultural humility, and structural competency. A quasi-experimental mixed-methods pretest-posttest design will be used with 40-60 healthcare professionals. Data will be collected at baseline and immediately post-intervention. Cultural competence will be assessed using the Cross-Cultural Competence instrument for Healthcare Professionals (CCCHP-27). Structural competency will be assessed using four open-ended written-response questions, examining identification of health determinants, analysis of a cross-cultural vignette, and attribution of health disparities among refugee populations, alongside a retrospective post-then-pre questionnaire. Although cultural humility is embedded in the reflective components of the curriculum, it is not assessed as a standalone outcome; the evaluation focuses on cultural competence and structural competency. A post-training qualitative survey will assess perceived effectiveness, relevance, and applicability. Findings will be integrated through side-by-side comparison to generate meta-inferences on intervention effectiveness and learning processes. The protocol aims to contribute to the evidence base on educational strategies that prepare healthcare professionals to deliver care to refugee populations that is both culturally responsive and structurally informed.