Making the Grade: A Systematic Review of the Effectiveness of Cultural Competence Training Programs for Social Workers and other Helping Professionals

Purpose: Cultural competence training among social workers and other helping professionals have been the focus of a growing body of literature due to our country's continued diversification. This diversity has not been equally mirrored, however, among helping professionals, with minority populations being more likely to receive care from non-minority professionals (Assemi et al., 2004). Thus there is a great need for trainings that prepare providers to become culturally competent. Although reviews of intervention studies to improve cultural competence exist in the literature, there have been no systematic reviews that determine what types of intervention characteristics are most effective. Therefore, the purpose of this study is 1) to determine and compare the methodological rigor of cultural competence training studies, 2) to evaluate the effectiveness of trainings to improve cultural competence for two intervention characteristics: duration and target population, and 3) to determine which intervention characteristic is most effective by outcome while accounting for the methodological rigor of the study.

Methods: The researcher identified studies through literature searches in electronic databases including CINAHL Plus, MEDLINE via PubMed, PsycINFO and Social Work Abstracts using keywords “cultural competence,” “training or intervention,” and “evaluate.” Studies were included if published between 2003 and 2009, were empirical evaluations of cultural competence trainings, and targeted students or professionals. The effectiveness of the training was determined by examining significant improvement in three major outcomes: knowledge/beliefs, overall competence and skill/behavior. Methodological rigor was evaluated using an adaptation of the Methodological Quality Rating Scale (MQRS; Miller et al., 1995).

Results: Based on the inclusion/exclusion criteria, the literature search resulted in 14 studies. Seven out of 8 studies targeting students reported significant improvement across outcomes; however, none achieved above average MQRS. Five studies out of 6 targeting professionals reported significant improvement across outcomes. Of those 5, four studies also achieved above average MQRS in addition to one with non-significant results. Accounting for methodological rigor, high duration was most effective in improving skill/behavior; while a training with low duration effectively increased overall competence. Studies targeting professionals were equally effective in improving overall competence and skill/behavior compared to those targeting students. However, due to the low rigor of the student studies, it was difficult to draw conclusions about the success of those trainings across outcomes.

Conclusions: The results of this review indicate that cultural competence trainings targeting professionals are more rigorous than those targeting students. While the majority of both student and professional targeted studies reported significant improvement across outcomes, the strength of the student results is dubious due to their decreased methodological rigor. This review emphasizes the need for studies, especially those targeting students, to achieve stronger methodological rigor to ensure that significant results are in fact conclusive when assessing the effectiveness of cultural competence trainings. In an era where the need for future and current professionals to exemplify cultural competence is most pressing, evidence-based and empirically-tested trainings are required and stronger cultural competence evaluative studies are a means to reach this goal.