Diversity and cultural competence training in health care organizations: hallmarks of success.

The authors reviewed recent literature on diversity training interventions and identified effective practices for health care organizations. Self-reported satisfaction was especially likely to be found as a result of training, whereas attitude change measured by standardized instruments was mixed. Although those responsible for diversity training in the workplace agree that behavioral change is key, awareness building and associated attitude change remain the focus of most diversity training in the workplace. Consequently, the authors recommend a systems approach to diversity training interventions wherein training is a key component of a health care organization's strategic approach to organizational performance, and diversity training is linked to the organizations' strategic goals for improved quality of care. The systems approach requires these steps: determine diversity and cultural competence goals in the context of strategy, measure current performance against needs, design training to address the gap, implement the training, assess training effectiveness, and strive for continuous improvement. Higher level evaluations measuring whether employees have transferred learning from training to their jobs are paramount to the systems approach to diversity training interventions. Measuring other positive changes in a "return on investment" format can be used to convince stakeholders of training's value.