Table 1. Literature review summary of cultural competence articles published between 1994 and 2023 categorized by article
Authors Year Medical School Structural Components* Attendance Requirement Local Community Involvement StudyDesign* MethodofEvolution* Constructs of Cultural Competence Evaluated Efficacy
Allen, et al. 2020 University ofLouisville School of Medicine Integration, Interactive Activity, Passive Learning Mandatory Kentucky smokers Quasi Self K, A 3
Alli, et al. 2023 Mayo ClinicAlix School of Medicine Experiential Learning,Interactive Activity,Passive Learning Mandatory None Post External, Self K, A 3
Betancourt & Cervantes 2009 Harvard Medical School Integration, Longitudinality, Clinical Training, Interactive Activity,Passive Learning Mandatory None Post External, Reeval K, S, A 3
Bi, et al. 2020 University of Chicago Pritzker School of Medicine Experiential Learning,Interactive Activity,Passive Learning Mandatory LGBT andracial/ethnic minorities Quasi Self K, S, A 3
Blue, et al. 2005 Medical University of South Carolina Integration, Clinical Training, Experiential Learning, Passive Learning Mandatory None Post External, Self K, A 1
Borowsky,et al. 2021 University of California San Francisco School of Medicine Interactive Activity,Passive Learning Mandatory None Quasi External, Self, Reeval K, A 3
Brainin-Rodriquez 2001 University of Hawaii John A. Burns School of Medicine Integration, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory None Post Self K, S, A 3
Bright & Nokes 2019 Tufts University School of Medicine Interactive Activity,Passive Learning Optional None Quasi Self K, S, A 3
Burson, et al. 2022 Perelman School of Medicine, University of Pennsylvania Interactive Activity,Passive Learning Mandatory None Post External, Self, Reeval K, A 2
Carpenter,et al. 2011 University of Hawai‘i John A. Burns School of Medicine Integration,Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatoryand OptionalElements NativeHawaiians Quasi External, Self K, S, A 3
Carter, et al. 2006 Uniformed Services University of the Health Sciences Integration, Clinical Training, InteractiveActivity, Passive Learning Mandatory None Quasi Self K, A 3
Coria, et al. 2013 Geisel School of Medicine Integration,Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory None Post External K, S, A 3
Crandall, et al. 2003 Wake Forest University School of Medicine Integration,Longitudinality,Experiential Learning,Interactive Activity,Passive Learning Optional None Quasi Self K, S, A 3
Crocker, et al. 2019 University of Alabama School of MedicineBirmingham Interactive Activity,Passive Learning Mandatoryand OptionalElements None Post External, Self K, S, A 2
Crosson, et al. 2004 New Jersey Medical School Integration,Longitudinality,Experiential Learning,Interactive Activity,Passive Learning Mandatory None Quasi Self, Reeval A 3
DallaPiazza, et al. 2020 Rutgers New Jersey Medical School Integration,Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory None Post External, Self K, S, A 3
Dao, et al. 2017 Perelman School of Medicine at the University of Pennsylvania Experiential Learning,Interactive Activity,Passive Learning Mandatory None Post Self K, S, A 3
Denizard- Thompson, et al. 2021 Wake Forest School of Medicine Integration, Clinical Training, InteractiveActivity, Passive Learning Mandatory None Quasi Self, Reeval K, S, A 3
Dhanani, et al. 2022 Stanford Schoolof Medicine Interactive Activity,Passive Learning Optional None Quasi Self K, S, A 3
Dogra &Karnik 2003 University of Illinois Colleges of Medicine atChicago and Urbana- Champaign Interactive Activity,Passive Learning Optional None C/S Pre External, Self K, A 1
Ellison, et al. 2021 LSU Health New Orleans School of Medicine Longitudinality, Interactive Activity, Passive Learning Mandatory New Orleans’ segregation and racism Quasi Self K, A 3
Fracica, et al. 2016 Mayo Medical School Minnesota Experiential Learning,Interactive Activity,Passive Learning Optional Somalipopulation in Minnesota Quasi External, Self K, A 2
Genao, et al. 2011 Emory University School of Medicine Integration, Clinical Training, InteractiveActivity, Passive Learning Mandatory None RCT External K 3
Godkin & Weinreb 2001 University of Massachusetts Medical School Integration,Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Optional Immigrant and refugee groups Post Self K, S, A 3
Godley, et al. 2020 University of North Carolina School of Medicine Experiential Learning,Interactive Activity,Passive Learning Optional Black southerners Post External, Self K, A 3
Gonzalez,et al. 2021 Albert Einstein College of Medicine Interactive Activity,Passive Learning Mandatory None Post External, Self K, S, A 3
Green, et al. 2017 Harvard Medical School Integration,Longitudinality, Clinical Training, PassiveLearning Mandatory None Quasi Self K, S 2
Green, et al. 2007 Harvard Medical School Integration,Longitudinality,Experiential Learning,Interactive Activity,Passive Learning Mandatory None Post External,Patient K, S, A 3
Greene & Scott 2021 Morehouse School of Medicine Integration, Experiential Learning, PassiveLearning Mandatory Deaf/hard of hearing Quasi External K, S, A 3
Griswold, et al. 2007 The State University of New York Experiential Learning,Interactive Activity,Passive Learning Optional International refugees Post External, Self K, S, A 3
Hearn & Hearn 2020 University of Michigan Medical School Interactive Activity,Passive Learning Mandatory None Quasi External, Self K, S, A 3
Hutchins,et al. 2014 University ofWisconsin– Madison’s Global Health Institute Integration, Experiential Learning, InteractiveActivity, Passive Learning Optional None Post Self, Reeval K, S, A 3
Kenison,et al. 2017 Harvard Medical School Integration,Longitudinality, Clinical Training, Experiential Learning Optional None Post External K, S, A 1
Khoury, et al. 2022 SUNY Upstate Medical University Integration, Clinical Training, InteractiveActivity, Passive Learning Mandatory None Quasi External S, A 3
Kitzes, et al. 2007 University of New Mexico School of Medicine Integration,Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory NativeAmerican/rural/Hispanicpopulation Post External, Self K, S 3
Lie, et al. 2006 University of California, Irvine, School of Medicine Integration, Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory None Post Self K, S, A 3
Lie, et al. 2010 University of California,Irvine School of Medicine Integration, Clinical Training, Experiential Learning, InteractiveActivity Mandatory Latino Post External, Self K, S, A 3
Litzelman & Cottingham 2007 IndianaUniversity School of Medicine Integration,Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory None Post External, Self, Patient S, A 3
Lombardero, et al. 2022 University of Nevada, Reno, School of Medicine Longitudinality, Clinical Training, InteractiveActivity, Passive Learning Optional None Quasi External, Self K, S, A 3
Loue, et al. 2015 Case Western Reserve University School of Medicine Longitudinality,Experiential Learning,Interactive Activity,Passive Learning Mandatory None Post Self K, S, A 1
Lubimir& Wen 2011 University of Hawai‘i John A. Burns School of Medicine Clinical Training,Interactive Activity,Passive Learning Mandatory None Post External, Self K, S, A 3
McElfish,et al. 2017 University of Arkansas for Medical Sciences Northwest Clinical Training,Experiential Learning,Interactive Activity,Passive Learning Optional Marshallesemigrants Quasi External, Self K, S, A 3
Miller & Green 2009 Harvard Medical School Integration,Longitudinality,Interactive Activity,Passive Learning Mandatory Bilingual Latina women Post External, Self K, S, A 3
Nora, et al. 1994 Rush Medical College Longitudinality,Experiential Learning,Interactive Activity,Passive Learning Optional Hispanic Health Alliance Quasi External, Self K, S, A 3
Novak, et al. 2022 University of Southern California Keck School of Medicine Interactive Activity,Passive Learning Mandatory None Post External, Self K, A 3
Offei-Dua,et al. 2022 Washington University in St. Louis School of Medicine Experiential Learning,Interactive Activity,Passive Learning Mandatoryand OptionalElements Neighborhood tour, African American/ Latinx/ refugee health Post External, Self, Reeval K, S, A 1
Omoruyi,et al. 2018 University of Texas Health Science Center at Houston Integration, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory None Quasi External, Self K, S, A 3
Ona, et al. 2020 Tufts University School of Medicine Interactive Activity,Passive Learning Optional None Quasi External, Self K, S, A 3
Ortega, et al. 2021 University ofIllinois College of Medicine Clinical Training,Experiential Learning,Interactive Activity,Passive Learning Optional None Quasi External, Self K, S, A 3
Perlman& Stagnaro-Green 2010 New Jersey Medical School Integration,Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory Alternative medicinecommunity Post External K, S, A 2
Railey, et al. 2022 Duke University School of Medicine Clinical Training,Passive Learning Mandatory None Quasi Self, Reeval K, S, A 1
Robins, et al. 1998 University of Michigan Medical School Integration, Interactive Activity, Passive Learning Mandatory None Post External K, S, A 3
Sarmiento,et al. 2016 University of Michigan Medical School Longitudinality,Experiential Learning,Interactive Activity,Passive Learning Mandatory Local disability group Post Self K, A 3
Shapiro, et al. 2006 University of California Irvine, School of Medicine Longitudinality, Clinical Training, Experiential Learning, PassiveLearning Optional None Post External, Self K, S, A 2
Shield, et al. 2011 Alpert Medical School of Brown University Integration, Longitudinality, Clinical Training,Experiential Learning,Interactive Activity,Passive Learning Optional None Quasi External, Self K, A 3
Smothers,et al. 2018 Duke University School ofMedicine Integration, Clinical Training, InteractiveActivity, Passive Learning Mandatory None Quasi Self A 3
Swanberg,et al. 2015 OaklandUniversityWilliamBeaumont School of Medicine Integration,Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory None Post Self K, A 3
Symons, et al. 2009 State Universityof New York (SUNY) at Buffalo Integration,Longitudinality, Clinical Training,Experiential Learning,Interactive Activity,Passive Learning Mandatory Local disability groups Quasi External, Self, Patient K, S, A 3
Thew, et al. 2013 University of Rochester School of Medicine and Dentistry Experiential Learning,Interactive Activity,Passive Learning Optional None Post Self, Reeval K, S, A 3
Turner & Farquhar 2008 College of Human Medicine (CHM) at Michigan State University Integration,Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory None Post External, Self, Reeval S, A 3
Wong & Omori 2016 University ofHawai‘i John A. Burns School of Medicine Integration,Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory HomelessHawaiian island populations Post External K, S, A 3
Woodard,et al. 2012 University of South Florida Health, Morsani College ofMedicine Integration, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory Communitysite visits Quasi External, Self, Reeval, Patient K, S, A 3
Worden & Ait- Daoud Tiouririne 2018 University ofVirginia School of Medicine Integration, Experiential Learning, InteractiveActivity, Passive Learning Mandatory None Post External A 1
Zanetti 2014 University of Massachusetts Medical School Clinical Training,Experiential Learning,Interactive Activity,Passive Learning Mandatory None Quasi External, Self K, S, A 3
Zanetti, et al. 2011 University of Massachusetts Medical School Longitudinality, Clinical Training, Experiential Learning, PassiveLearning Optional Recentimmigrants Quasi External, Self S, A 3
Albritton& Wagner 2002 Medical College of Georgia Integration,Longitudinality,Experiential Learning, Passive Learning Optional Center forlocal migrantworkers N/A N/A N/A N/A
Ambrose,et al. 2014 University ofHawai‘i John A. Burns School of Medicine Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Optional None N/A N/A N/A N/A
Bussey-Jones, et al. 2005 Emory University School ofMedicine Integration, Clinical Training, Experiential Learning, PassiveLearning Mandatory None N/A N/A N/A N/A
Eddey& Robey 2005 Matheny Medical and Educational Center Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory Local disability organizations N/A N/A N/A N/A
Gupta, et al. 2020 Mayo Clinic Alix School ofMedicine Arizona Integration,Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Mandatory and OptionalElements None N/A N/A N/A N/A
Kumagai,et al. 2009 University of Michigan Medical School Integration,Longitudinality,Experiential Learning,Interactive Activity,Passive Learning Mandatory None N/A N/A N/A N/A
Lewis & Prunuske 2017 University of MinnesotaMedical School, Duluth Experiential Learning, Passive Learning Mandatory Indigenous population N/A N/A N/A N/A
Lypson, et al. 2008 University of Michigan Medical School Integration,Longitudinality,Interactive Activity,Passive Learning Mandatory None N/A N/A N/A N/A
Rogers, et al. 2016 Mayo Medical School Experiential Learning,Interactive Activity,Passive Learning Optional Local disability groups N/A N/A N/A N/A
Schiff &Rieth 2012 University ofHawai‘i John A. Burns School of Medicine Longitudinality, Clinical Training, Experiential Learning, InteractiveActivity, Passive Learning Optional None N/A N/A N/A N/A
Solotke, et al. 2017 Yale University School ofMedicine Integration,Longitudinality,Clinical Training,Experiential Learning,Interactive Activity,Passive Learning Mandatory Local organizations N/A N/A N/A N/A
Thande, et al. 2019 Yale University School ofMedicine Integration,Longitudinality,Experiential Learning,Interactive Activity,Passive Learning Mandatory LGBT patients N/A N/A N/A N/A

Key: Year= Year Published. K= Knowledge, S= Skills, A= Attitudes. C/S Pre= Cross-Sectional Pre-Curriculum Evaluation. Quasi= Quasi-Experimental. Post= Post-Curriculum Evaluation. RCT= Randomized Controlled Trial. 1= Low Efficacy. 2= Medium Efficacy. 3= High Efficacy. N/A= Not applicable due to no reported evaluation in paper.

*Operational Definitions: Integration= Program is integrated with existing curricula not already centering cultural competence (clinical skills, basic sciences, OSCEs, etc.). Longitudinality= Program lasts at least 1 school year; only counted by aspects of program mentioned in that article; frequency within total duration is not taken into account. Clinical Training= Program occurs during clinical training; optional preceptorships not included. Experiential Learning= Program has community involvement with projects and/or direct contact with members/institutions of the community; inside or outside the classroom. Interactive Activity= Program incorporates interactive activities inside the classroom (discussions, role-plays, case-studies, project-based learning, etc.). Passive Learning= Program incorporates passive learning methods (lectures, readings, videos, etc.).69 Quasi= quasi-experimental (pre- and post-implementation evaluation); Post= post-implementation evaluation only; C/S Pre= cross-sectional pre-implementation evaluation only; RCT= randomized controlled trial. External evaluation= not from the students’ own perspective (quiz, OSCE, peer evaluation, final project, qualitative analysis of a self-assessment, etc.); Self-Evaluation= students’ self perception of their abilities (survey, reflection assignment, focus group); Reevaluation= any second form of evaluation after any amount of time after conclusion of the program; Patient Evaluation= any consultation of patients or standardized patients coming from the target cultural group(s) in evaluation. Low Efficacy (1)= no/very limited achievement of the article authors’ desired outcomes; Medium Efficacy (2)= some/multiple article authors’ desired outcomes met; High Efficacy (3)= all of the article authors’ desired outcomes met.

 Int J Med Educ. 2026; 17:26-41; doi: 10.5116/ijme.69c3.e171