Table 2.

Cultural competence training approaches

Publication	Training approach
Cross-cultural approaches
Brathwaite (2006) [40]	The cultural competency training components of cultural awareness; cultural knowledge; cultural skill; cultural encounter and; cultural desire were addressed by teaching basic process of providing culturally competent care such as a) acknowledging intracultural diversity and the breadth and complexity of culture as something possessed by all; b) conducting cultural assessments of service users; c) learning from patients about their culture d) recognizing the processes of acculturation and cultural diversity within individuals; e) developing agreed upon treatment plans; and f) accommodating non-harmful health beliefs and practices which may differ from practitioners personal and professional culture.
Khanna (2009) [46]	The training program covered broad cultural competency topics such: as defining cultural and linguistic competency; understanding racial and ethnic health disparities; exploring the relationship between culture and health beliefs; and the importance of cultural competency in effective patient/provider communication. Following training, participants were expected to be able to: define culture and describe the spectrum of diversity; understand the differences between ethnicity, race and culture; recognize and define the concepts of intercultural and intracultural diversity; understand the difference between cultural generalizations and stereotypes; define and understand cultural competency; explain the concept of the cultural competency continuum, and; describe the use of explanatory models and their importance in the patient-practitioner interaction.
Kutob (2009) [47]	Learning objectives included things such as: distinguishing between the terms culture, ethnicity and race; utilizing the Ask, Share, Compare, Negotiate (ASCN) model with patients; describing evidence based information on health disparities as well as health beliefs and behaviours of Mexican American patients; managing potential barriers to blood sugar control for people with type 2 diabetes, and; the appropriate ordering of routine prevention services for diabetes patients. Participants were assessed for things such as their cultural self-awareness, their ability to be open and nonjudgmental, their avoidance of stereotyping, and ability to elicit patients’ explanatory model among others.
Salman (2007) [48]	Cultural workshop focused on understanding the components of cultural competence and its relevance to healthcare delivery.
Thom (2006) [49]	The competencies addressed were knowledge (such as knowledge of cultural identification and levels of agreement with respect to mainstream health beliefs), “communication skills (including listening, explaining, acknowledging, providing recommendations, and working effectively with interpreters); and cultural brokering (including negotiating a treatment plan with patient and family, understanding community resources available to patients, and working with then healthcare system to meet the needs of culturally diverse patients)”.
Categorical/Multicultural approaches
Aboriginal Workforce (2015) [50]	Included an eLearning component providing knowledge on Aboriginal history, culture and people, and exploring key challenges to providing culturally appropriate care to Aboriginal people and communities and a face-to-face workshop component including both generic content (aimed at bridging what is learnt in the eLearning component) and local content (exploring the local communities being served).
Chapman (2014) [38]	Aimed to provide health practitioners with a comprehensive understanding of aspects of Aboriginal culture and ideology.
McElmurry (2009) [45]	Cultural workshops addressed Latino patients’ expectations of care and experiences with health services, the impacts of cultural beliefs and language barriers on issues in diagnosis, treatment, and popular herbal remedies frequently utilised in Latino cultures. In addition to cultural workshops, this intervention offered an intensive Spanish language course, or an integrated immersion program including Spanish language classes, cultural workshops, community-based clinical experiences and home-stays.
McGuire (2012) [44]	A training program focused on factors which may affect patient-practitioner communication and care such as: barriers in accessing health care in the U.S.; differences in health care systems in Latin America and the U.S.; expectations of Latino patients seeking care; social and cultural constructs of health and illness in Latino cultures, and; common health beliefs and practices such as the use of complementary medicine.
McRae (2008) [51]	Cultural awareness training workshop regarding working with Aboriginal Australians.
Wu (2006) [43]	Brief training introduced Latino cultural values and home remedies important to history taking, taught residents a few Spanish expressions to help establish rapport with Spanish-speaking patients, and discussed techniques for optimizing the use of interpreters in improving communication.