This New Zealand-based research examined how effective cultural competency education is in improving health practitioner proficiency and addressing health inequities for minoritised patient groups. Their systematic review included 23 studies published up to December 2017 that involved undergraduate or postgraduate medical, nursing or allied health students or practitioners. All studies documented indigenous health learning outcomes, pedagogical practices and student evaluations. An interpretive synthesis informed by actor-network theory revealed three key themes in the data: (1) indigenous health as an emerging curriculum (drivers of institutional change, increasing indigenous capacity and leadership, and addressing deficit discourse); (2) institutional resource allocation to indigenous health curricula (placement within the core curriculum, time allocation, and resources constraining pedagogy); and (3) impact of the curriculum on learners (acceptability of the curriculum, learner knowledge, and learner behaviour). The study researchers conclude that systematic barriers acting on and within educational networks have not only limited the developmental capacity of indigenous health curricula, but also supported and sustained hidden curricula. Consequently, there is insufficient institutional investment to support a comprehensive curriculum. They call for investigations to explore these political and network intermediaries acting on cultural competence curricula in health professional education and to identify ways to overcome these barriers, in order to achieve cultural competency learning outcomes.
