چکیده (انگلیسی):

Background:Cultural competence is a broad concept with multiple theoretical underpinnings and conflicting
opinions on how it should be materialized. While it is recognized that cultural competence should be an integral
part of General Practice, literature in the context of General Practice is limited.
The aim of this article is to provide a comprehensive summary of the current literature with respect to the
following: the elements of cultural competency that need to be fostered and developed in GPs and GP registrars;
how is cultural competence being developed in General Practice currently; and who facilitates the development of
cultural competence in General Practice.
Methods:We conducted an integrative review comprising a systematic literature search followed by a synthesis of
the results using a narrative synthesis technique.
Results:Fifty articles were included in the final analysis. Cultural competence was conceptualized as requiring
elements of knowledge, awareness/attitudes and skills/behaviours by most articles. The ways in which elements of
cultural competence were developed in General Practice appeared to be highly varied and rigorous evaluation was
generally lacking, particularly with respect to improvement in patient outcomes. Formal cultural competence
training in General Practice appeared to be underdeveloped despite GP registrars generally desiring more training.
The development of most aspects of cultural competence relied on informal learning and in-practice exposure but
this required proper guidance and facilitation by supervisors and educators. Levels of critical and cultural selfreflection amongst General Practitioners and GP registrars varied and were potentially underdeveloped. Most
standalone training workshops were led by trained medical educators however the value of cultural mentors was
recognised by patients, educators and GP registrars across many studies.
Conclusions:Cultural competency development of GP registrars should receive more focus, particularly training in
non-conscious bias, anti-racism training and critical self-reflectiveness. There is a need for further exploration of how
cultural competence training is delivered within the GP training model, including clarifying the supervisor’s role.
It is hoped this discussion will inform future research and training practices in order to achieve quality and
respectful care to patients across cultures, and to remove health inequities that exist between cultural groups.