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Quality Enhancement Plan (QEP) Resource Portal

The resource portal is intended to provide resources in support of the educational program development and implementation towards social determinants of health (SDOH).



Cultural competence is the ability to interact effectively with people of different cultures. “Culture” is a term that goes beyond just race or ethnicity. It can also refer to such characteristics as age, gender, sexual orientation, disability, religion, income level, education, geographical location, or profession. Cultural competence means to be respectful and responsive to the health beliefs and practices—and cultural and linguistic needs—of diverse population groups.

The Substance Abuse and Mental Health Services Administration. (2016). Cultural competence. Retrieved from

A “culturally competent” health care system has been defined as one that acknowledges and incorporates—at all levels—the importance of culture, assessment of cross-cultural relations, vigilance toward the dynamics that result from cultural differences, expansion of cultural knowledge, and adaptation of services to meet culturally unique needs. Furthermore, the field of cultural competence has recognized the inherent challenges in attempting to disentangle “social” factors (e.g., socioeconomic status, supports/stressors, environmental hazards) from “cultural” factors vis-à-vis their influence on the individual patient.

Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health carePublic Health Reports, 118(4), 293–302. PMID: 12815076



Marino, R., Ghanim, A., Morgan, M., & Barrow, S. (2017). Cultural competency and communication skills of dental students: Clinical supervisors' perceptions. European Journal of Dental Education, 21(4), e101-e108. doi:10.1111/eje.12227. PMID: 27418424

Forsyth, C. J., Irving, M. J., Tennant, M., Short, S. D., & Gilroy, J. A. (2017). Teaching cultural competence in dental education: A systematic review and exploration of implications for indigenous populations in Australia. Journal of Dental Education, 81(8), 956-968. doi:10.21815/jde.017.049. PMID: 28765440

Feng, X., Mugayar, L., Perez, E., Nagasawa, P. R., Brown, D. G., & Behar-Horenstein, L. S. (2017). Dental students' knowledge of resources for LGBT persons: Findings from three dental schools. Journal of Dental Education, 81(1), 22-28. PMID: 26246536

Behar-Horenstein, L. S., Warren, R. C., Dodd, V. J., & Catalanotto, F. A. (2017). Addressing oral health disparities via educational foci on cultural competence. American Journal of Public Health, 107(S1), S18-s23. doi:10.2105/ajph.2017.303721

Ocegueda, D. R., Van Ness, C. J., Hanson, C. L., & Holt, L. A. (2016). Cultural competency in dental hygiene curricula. Journal of Dental Hygiene, 90 Suppl 1, 5-14.

Nicholson, S. L., Hayes, M. J., & Taylor, J. A. (2016). Cultural competency education in academic dental institutions in Australia and New Zealand: A survey study. Journal of Dental Education, 80(8), 966-974.

Garvan, G. J., Garvan, C. W., & Behar-Horenstein, L. S. (2016). Developing and testing the short-form knowledge, efficacy, and practices instrument for assessing cultural competence. Journal of Dental Education, 80(10), 1245-1252.

Behar-Horenstein, L. S., Feng, X., Roberts, K. W., Gibbs, M., Catalanotto, F. A., & Hudson-Vassell, C. M. (2015). Developing dental students' awareness of health care disparities and desire to serve vulnerable populations through service-learning. Journal of Dental Education, 79(10), 1189-1200.

Alrqiq, H. M., Scott, T. E., & Mascarenhas, A. K. (2015). Evaluating a cultural competency curriculum: Changes in dental students' perceived awareness, knowledge, and skills. Journal of Dental Education, 79(9), 1009-1015.

White-Means, S.,  Dong, Zhiyong, Hufstader, M., & Brown, L.T.(2009). Cultural competency, race, and skin tone bias among pharmacy, nursing, and medical students: Implications for addressing health disparities. Medical Care Research and Review, 66(4), 436-55. PMID: 19369696.

Cantey, D. S., Randolph, S. D., Molloy, M. A., Carter, B., & Cary, M. P. (2017). Student-developed simulations: Enhancing cultural awareness and understanding social determinants of health. Journal of Nursing Education, 56(4), 243-246. doi:10.3928/01484834-20170323-11 PMID:28383751

Lonneman, W. (2015). Teaching strategies to increase cultural awareness in nursing students. Nurse Educator, 40(6), 285-288. doi:10.1097/nne.0000000000000175. PMID:25997149

White-Means, S.,  Dong, Zhiyong, Hufstader, M., & Brown, L.T.(2009). Cultural competency, race, and skin tone bias among pharmacy, nursing, and medical students: Implications for addressing health disparities. Medical Care Research and Review, 66(4), 436-55. PMID: 19369696.

White-Means, S.,  Dong, Zhiyong, Hufstader, M., & Brown, L.T.(2009). Cultural competency, race, and skin tone bias among pharmacy, nursing, and medical students: Implications for addressing health disparities. Medical Care Research and Review, 66(4), 436-55. PMID: 19369696.

Academic Medicine Theme Issue on Cultural Competence

Academic Medicine publishes special theme articles on cultural competence, 78(6), June 2003:

Beagan, B. L. (2003). Teaching social and cultural awareness to medical students: "It's all very nice to talk about it in theory, but ultimately it makes no difference". Academic Medicine, 78(6), 605-614. PMID: 12805041

Betancourt, J. R. (2003). Cross-cultural medical education: Conceptual approaches and frameworks for evaluation. Academic Medicine, 78(6), 560-569. PMID: 12805034

Crampton, P., Dowell, A., Parkin, C., & Thompson, C. (2003). Combating effects of racism through a cultural immersion medical education program. Academic Medicine, 78(6), 595-598. PMID: 12805038

Crandall, S. J., George, G., Marion, G. S., & Davis, S. (2003). Applying theory to the design of cultural competency training for medical students: A case study. Academic Medicine, 78(6), 588-594. PMID: 12805037

Drouin, J., & Rivet, C. (2003). Training medical students to communicate with a linguistic minority group. Academic Medicine, 78(6), 599-604. PMID: 12805039

Hixon, A. L. (2003). Beyond cultural competence. Academic Medicine, 78(6), 634. PMID: 12805045

Kagawa-Singer, M., & Kassim-Lakha, S. (2003). A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes. Academic Medicine, 78(6), 577-587. PMID: 12805036

Pena Dolhun, E., Munoz, C., & Grumbach, K. (2003). Cross-cultural education in U.S. medical schools: Development of an assessment tool. Academic Medicine, 78(6), 615-622. PMID: 12805042

Tang, T. S., Bozynski, M. E., Mitchell, J. M., Haftel, H. M., Vanston, S. A., & Anderson, R. M. (2003). Are residents more comfortable than faculty members when addressing sociocultural diversity in medicine? Academic Medicine, 78(6), 629-633. PMID: 12805044

Taylor, J. S. (2003). Confronting "culture" in medicine's "culture of no culture". Academic Medicine, 78(6), 555-559. PMID: 12805033

Tervalon, M. (2003). Components of culture in health for medical students' education. Academic Medicine, 78(6), 570-576. PMID: 12805035

Wear, D. (2003). Insurgent multiculturalism: Rethinking how and why we teach culture in medical education. Academic Medicine, 78(6), 549-554. PMID: 12805032

Wright, S. M., & Carrese, J. A. (2003). Serving as a physician role model for a diverse population of medical learners. Academic Medicine, 78(6), 623-628. PMID: 12805043

Resources by Category

Center for Substance Abuse Treatment (US). (2014). Treatment improvement protocol (TIP): Improving cultural competence (No. 59). Rockville, MD: Substance Abuse and Mental Health Services Administration (US). Retrieved from

Dreachslin, J.L., Gilbert, J.M., & Malone, B. (2012). Diversity and cultural competence in health care: A systems approach. John Wiley & Sons.

Hark, L., & DeLisser, H. (2009). Achieving cultural competency: A case-based approach to training health professionals. Blackwell Publishing Ltd.

Nageswara Rao, A.A., Warad, D.M., Weavefr, A.L., Schleck, C.D., & Rodriguez, V. (2018). Cross-cultural medical care training and education: A national survey of pediatric hematology/oncology fellows-in-training and fellowship program directors. Journal of Cancer Education, (Jan 27). doi: 10.1007/s13187-018-1326-8. [Epub ahead of print]. PMID: 29380222

Constantinou, C.S., Papageorgiou, A., Samoutis, G., & McCrorie, P. (2017). Acquire, apply, and activate knowledge: A pyramid model for teaching and integrating cultural competence in medical curricula. Patient Education Counseling, (Dec 30), pii: S0738-3991(17)30662-6. doi: 10.1016/j.pec.2017.12.016. PMID: 29305063

Dauvrin, M. & Lorant, V. (2015). Leadership and cultural competence of healthcare professionals: A social network analysis. Nursing Research, 64(3), 200-10. doi: 10.1097/NNR.0000000000000092. PMID: 25871625

Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing: A literature review. Journal of Transcultural Nursing, 26(3),308-21. doi: 10.1177/1043659614524790. PMID: 24817206

Torres, I. (2015). How to recognize your cultural competence. The ASHA Leader, 20, 6-7. doi:10.1044/leader.FMP.20032015.6

Verdon, S., McLeod, S., & Wong, S. (2015). Supporting culturally and linguistically diverse children with speech, language and communication needs: Overarching principles, individual approaches. Journal of Communication Disorders, 58, 74-90. doi:10.1016/j.jcomdis.2015.10.002 PMID: 26513218

Aleksejuniene, J., Zed C., & Marino, R. (2014). Self-perceptions of cultural competence among dental students and recent graduates. Journal of Dental Education, 78(3),389-400. PMID: 24609341 

Tummala-Narra, P., Singer, R., Li, Z., Esposito, J., & Ash, S. E. (2012). Individual and systemic factors in clinicians' self-perceived cultural competence. Professional Psychology: Research and Practice, 43(3), 165-174. doi:10.1037/a0025783

Betancourt, J.R., Green, A.R., Carrillo, J.E., & Ananeh-Frimpong II, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118, 293-302. doi: 10.1093/phr/118.4.293 PMID: 12815076

Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117-25. doi: 10.1353/hpu.2010.0233 PMID: 10073197

Association of American Medical Colleges (AAMC). (2015). Assessing change: Evaluating cultural competence education and training. Retrieved from

Effective Health Care Program. (2014). Improving cultural competence to reduce health disparities for priority populationsRetrieved from

Health Research & Educational Trust. (2013). Becoming a culturally competent health care organizationRetrieved from

American Dental Education Association. (2018). Need for diversity. Retrieved from

American Nurses Association. (2018). Cultural competence tools. Retrieved from

American Speech-Language-Hearing Association. (2018). Cultural competence. Retrieved from

US Department of Health and Human Services Office of Minority Health. (2018). Homepage. Retrieved from

American Physical Therapy Association. (2017). Cultural competence in physical therapy. Retrieved from

American Pharmacists Association. (2008). Learning aids: Essentials of cultural competence in pharmacy practiceRetrieved from