How cultural competence is conceptualised, developed and delivered in pharmacy education: a systematic review

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Abstract

Background

It is important to have a pharmacy workforce that is culturally competent to recognise a patient’s health beliefs to improve medication adherence and reduce poor treatment outcomes.

Aim

This systematic review aimed to identify, critically appraise and summarise how cultural competency is conceptualised, developed and embedded in pre-qualification pharmacy education.

Method

Medline, Scopus, PsychInfo, Web of Knowledge, CINAHL, and Embase databases were searched for relevant papers published in English between January 2012 and December 2021, following PRISMA guidelines. Data from included papers were thematically analysed. Educational quality of papers was appraised using the GREET criteria. This systematic review was registered on PROSPERO, CRD42021295875.

Results

The review included 47 papers (46 studies) with 18 papers meeting ≥ 9 points on the GREET criteria thus considered of good educational quality. Forty papers focused on educational interventions implemented to pharmacy students only, the remaining included students from different health disciplines. Half of the educational interventions focused on cultural competence in general. Most educational interventions lasted over a week and 21 were compulsory. Cultural competence conceptualisation varied; a focus on knowledge about different cultures or on culturally competent behaviours or a continuum with knowledge at one end and behaviour at the other.

Conclusion

There is variation in how cultural competence is embedded in pharmacy programmes, which could be a reflection of the differences in how educators conceptualised cultural competence. Further research is needed to develop a unified understanding of the meaning of cultural competence and how it can be embedded in pharmacy education.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11096-023-01644-3.

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Most cited references 61

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Methods for the thematic synthesis of qualitative research in systematic reviews

James Thomas, Angela Harden (2008)

Background There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies. Methods We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research. Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of 'descriptive themes'; and the generation of 'analytical themes'. While the development of descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage of interpretation whereby the reviewers 'go beyond' the primary studies and generate new interpretive constructs, explanations or hypotheses. The use of computer software can facilitate this method of synthesis; detailed guidance is given on how this can be achieved. Results We used thematic synthesis to combine the studies of children's views and identified key themes to explore in the intervention studies. Most interventions were based in school and often combined learning about health benefits with 'hands-on' experience. The studies of children's views suggested that fruit and vegetables should be treated in different ways, and that messages should not focus on health warnings. Interventions that were in line with these suggestions tended to be more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies, synthesising them in a transparent way, and facilitating the explicit production of new concepts and hypotheses. Conclusion We compare thematic synthesis to other methods for the synthesis of qualitative research, discussing issues of context and rigour. Thematic synthesis is presented as a tried and tested method that preserves an explicit and transparent link between conclusions and the text of primary studies; as such it preserves principles that have traditionally been important to systematic reviewing.

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The assessment of clinical skills/competence/performance

G E Miller (1990)

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The Process of Cultural Competence in the Delivery of Healthcare Services: a model of care.

Josepha Campinha-Bacote (2002)

Several models of service care delivery have emerged to meet the challenges of providing health care to our growing multi-ethnic world. This article will present Campinha-Bacote's model of cultural competence in health care delivery: The Process of Cultural Competence in the Delivery of Healthcare Services. This model views cultural competence as the ongoing process in which the health care provider continuously strives to achieve the ability to effectively work within the cultural context of the client (individual, family, community). This ongoing process involves the integration of cultural awareness, cultural knowledge, cultural skill, cultural encounters, and cultural desire.

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Author and article information

Contributors

Wing Man Lau:

ORCID: http://orcid.org/0000-0002-2998-6470

wing.lau@newcastle.ac.uk

Journal

Journal ID (nlm-ta): Int J Clin Pharm

Journal ID (iso-abbrev): Int J Clin Pharm

Title: International Journal of Clinical Pharmacy

Publisher: Springer International Publishing (Cham )

ISSN (Print): 2210-7703

ISSN (Electronic): 2210-7711

Publication date (Electronic): 27 September 2023

Publication date PMC-release: 27 September 2023

Publication date (Print): 2024

Volume: 46

Issue: 1

Pages: 40-55

Affiliations

[1 ]School of Pharmacy, Faculty of Medical Sciences, Newcastle University, ( https://ror.org/01kj2bm70) King George VI Building, Newcastle upon Tyne, NE1 7RU UK

[2 ]Reading School of Pharmacy, University of Reading, ( https://ror.org/05v62cm79) Whiteknights, Reading, RG6 6AP UK

Author information

Wing Man Lau http://orcid.org/0000-0002-2998-6470

Article

Publisher ID: 1644

DOI: 10.1007/s11096-023-01644-3

PMC ID: 10830822

PubMed ID: 37755644

SO-VID: 36ed34b1-3223-402c-8964-976dd1987b23

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.