Effects of strategies to tackle racism experienced by healthcare professionals: a systematic review

Abstract

Objectives: The objective of this study is to evaluate the effect of equality, diversity and inclusion (EDI) training interventions on race inequalities experienced by healthcare professionals.

Design: Systematic review.

Data sources: Cochrane, MEDLINE and Embase databases were searched from database inception to February 2024.

Eligibility criteria: Randomised trials, observational studies and mixed-methods studies published in English were included. Studies that reported the effects of EDI training interventions targeting healthcare professionals were included.

Date extraction and synthesis: A narrative synthesis approach was used to evaluate the impact of EDI interventions on healthcare professionals.

Results: 17 studies were included. EDI interventions were delivered using several methods including didactic, group discussion, game-based learning or a combination of methods. Out of nine studies, eight (88.9%) interventions resulted in an improvement in knowledge and awareness. Five studies reviewed the effect on cultural competence and four (80.0%) improved cultural competence. Out of eight studies, six (75.0%) resulted in willingness to change and skills gained to promote behavioural change. Most of the improvements seen were with theory-based, multimethod curriculum in comparison to a non-theory-based didactic approach. However, there was insufficient evidence to suggest that these interventions impact the racism that healthcare professionals from an ethnic/racial minoritised group experience.

Conclusions: EDI interventions may improve healthcare workers' knowledge and awareness of racial inequalities and cultural competence. Although a willingness to change may occur and behavioural change is promoted, there is insufficient evidence from this review to suggest that this reduces the experience of racism.

Keywords: Education, Medical; Hospitals; Job Satisfaction; Psychological Stress; Quality of Life; Systematic Review.

Figure 1. PRISMA flow diagram. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Figure 2. Risk of Bias for the studies using a quasi-experimental design and qualitative using the Joanna Briggs Institute Tool.

Figure 3. Key themes identified from the literature in keeping with the three categories of EDI interventions. EDI, equality, diversity and inclusion.