Effectiveness of Cultural Competence Educational Intervention on Patient and Health Professional Outcomes: A Systematic Review

Saturday, 29 July 2017

Duckhee Chae, PhD, RN1
Jin-Hee Kim, PhD2
Jin-A Lee, MSN, RN3
Seo-Jin Park, MSN2
(1)College of Nursing, Chonnam National University, Gwangju, Korea, Republic of (South)
(2)Department of Nursing, Chosun University, Gwangju, Korea, Republic of (South)
(3)Department of Nursing College of Medicine, Chosun University, Gwangju, Korea, Republic of (South)


The primary aim of this systematic review was to assess the effectiveness of cultural competence educational interventions for health professionals working in health settings on patient outcomes and health professional outcomes. Also it was conducted to identify an effective way to educate health professionals.


We performed electronic searches in three international databases (Ovid-Medline, Ovid-Embase, Cochrane Library) and six Korean databases (KoreaMed, KMbase, KISS, RISS, NDSL, and KisTi) for original articles published in either English or Korean in July 2016. We included randomized controlled trials (RCTs) and quasi-experimental design studies. Studies that had reported cultural competence educational intervention for health professionals and measured impact on patient or health professional outcomes were included. Cochrane Risk of Bias (RoB) was utilized to evaluate the quality of the studies. Two groups (two authors in each group) independently screened all articles and extracted the data. The qualitative analysis was conducted due to the heterogeneity of the study caused by the diversity of participants (doctor, nurse, nursing assistant, social worker, patients, etc.), training programs, and training periods.


Initial search identified 1,792 potentially relevant studies and only nine (health professional = 778, patient = 7,991) met the inclusion criteria. Six out of nine studies were RCTs and three were quasi-experimental design studies. And seven were from USA and two were Korea. All reported health professional outcomes and two reported patient and health professional outcomes. Seven studies reported the effectiveness of education on health professional outcomes. It also proved to have benefits on patient outcomes. However, teaching methods and the duration of training included in these studies were diverse. The risk of bias was high.


Cultural competence training of health professionals has been proven as beneficial to improve both health professional and patient outcomes. However, it is undeniable that there is a considerable lack of research assessing whether increased health professionals’ cultural competence improved patient outcomes. Also, since previous studies used differentiating teaching methods, it is seemed as difficult to determine the most effective way of training. Therefore further research in this field is considered necessary.