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Aim(s): To synthesise the literature about transgender and non‐binary people's experiences of cervical cancer screening and identify ways to improve screening. Background: Transgender people often face barriers to accessing health services including cervical screening, where transgender people have a lower uptake than cisgender women. Design: A scoping review was undertaken following the Arksey and O'Malley (2005) framework and the PRISMA‐ScR checklist. Following database searching of Medline via PubMed, Web of Science, Scopus and CINHAL, 23 papers published between 2008 and 2003 were included. Papers were included if they shared trans and non‐binary people's experiences of cervical screening and were written in English. There were no date or geographical data restrictions due to the paucity of research. Results: Transgender people experience barriers to cervical screening including gender dysphoria, a history of sexual trauma, and mistrust in health professionals or health services, which can result in having negative experiences of screening or avoiding screening. Health professionals can help to create a positive experience by informing themselves about best practices for trans+ health. Conclusion: Changes are required to improve transgender people's experiences and uptake of cervical screening. Improving medical education about trans health and updating health systems would help to combat issues discussed. Implications for the Profession and/or Patient Care: Having an understanding of the reasons why accessing health services can be more difficult for transgender people will help health professionals to provide appropriate care for transgender patients. This paper details this in the context of cervical cancer screening and can be applied to other areas of healthcare. Reporting Method: We have adhered to relevant EQUATOR guidelines and used the PRISMA‐ScR reporting method. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Teaching can be challenging, especially when teachers are under-prepared to enter a workforce with a constantly changing landscape. Preparing teachers for STEM content has generated multiple approaches from varying perspectives. While some scholars advocate for content expertise, others promote pedagogy or social context as approaches for translating STEM content for students. Yet, many contend that teachers must be culturally knowledgeable to respond to student diversity effectively. While these arguments are valuable and needed, many have not considered the interconnectedness of these approaches, often used in silos. This conceptual paper unpacks some of these arguments using the social constructivism theory of learning as the epistemic lens to examine and interpret what STEM teacher knowledge should encompass in the 21st-century diversified classroom. After thoroughly evaluating the core elements of three commonly used teacher constructs, this paper presents an integrative, holistic teacher knowledge—culturally responsive pedagogical knowledge (CRPK) framework that considers the necessary qualities that teachers must possess that are functional, content-focused, and pedagogically inclusive. The proposed CRPK construct would be a valuable programmatic tool for teacher preparation, curriculum development, and classroom praxis. [ABSTRACT FROM AUTHOR]

Cultural safety is increasingly recognised as imperative to delivering accessible and acceptable healthcare for First Nations Peoples within Australia and in similar colonised countries. A literature review undertaken to inform the inaugural Caring for Australians with Renal Insufficiency (CARI) guidelines for clinically and culturally safe kidney care for Aboriginal and Torres Strait Islander peoples revealed a timeline of the emergence of culturally safe kidney care in Australia. Thirty years ago, kidney care literature was purely biomedically focused, with culture, family and community viewed as potential barriers to patient 'compliance' with treatment. The importance of culturally informed care was increasingly recognised in the mid-1990s, with cultural safety within kidney care specifically cited from 2014 onwards. The emergence timeline is discussed in this paper in relation to the five principles of cultural safety developed by Māori nurse Irihapeti Ramsden in Aotearoa/New Zealand. These principles are critical reflection, communication, minimising power differences, decolonisation and ensuring one does not demean or disempower. For the kidney care workforce, culturally safe care requires ongoing critical reflection, deep active listening skills, decolonising approaches and the eradication of institutional racism. Cultural safety is the key to truly working in partnership, increasing Indigenous Governance, respectful collaboration and redesigning kidney care., (© 2024 The Authors. Nursing Inquiry published by John Wiley & Sons Ltd.)

Linking Immigrants with Nutrition Knowledge (Project LINK) was a service-learning cultural competence training programme completed by undergraduate dietetic students enrolled in the University of Saskatchewan's (USASK) nutrition and dietetic programme.This paper evaluates the impact of participation in the programme on students' cultural competence. We conducted a cross-sectional survey and qualitative analysis of reflective essays of 107 participants of Project LINK from 2011 to 2014. Cumulative logistic regression models assessed the impact of the intervention on students' cultural competencies. The Akaike information criterion compared models and Spearman correlation coefficient identified possible correlation among pre- and post-intervention data points. Student reflective essays were analyzed by inductive thematic analysis.All cultural competencies improved comparing pre- and post-participation in Project LINK. Odds of increasing one level of student knowledge were 110 times of that prior to Project LINK. Comparing student competencies before and after Project LINK, the odds of increasing one level of students' skills were six times greater, five times greater for increasing one level of students' ability to interact or encounter , and 2.8 times greater for increasing one level of students' attitude .The results of this study indicate Project LINK has successfully increased cultural competence and underscores the importance of combining opportunities for practical experience in addition to classroom-based training on cultural competence.

Simple Summary: This paper delves into the persistent issue of unequal access to medical imaging, with a particular focus on breast cancer screening and its impact on marginalized communities and racial/ethnic minorities. Central to our discussion is the role of scientific mobility among radiologists in fostering healthcare policy changes that promote diversity and cultural competence. We propose various strategies to bridge this gap, including cultural education, sensitivity training, and diversifying the radiology workforce. These measures aim to improve communication with diverse patient groups and reduce healthcare disparities. Additionally, we explore the challenges and advantages of teleradiology as a means to extend medical imaging services to underserved areas. In the context of artificial intelligence, we emphasize the critical need to validate algorithms across diverse populations to ensure unbiased and equitable healthcare outcomes. Overall, this paper underscores the importance of international collaboration in addressing global access barriers, presenting it as a key to mitigating disparities in medical imaging access and contributing to the pursuit of equitable healthcare. Access to medical imaging is pivotal in healthcare, playing a crucial role in the prevention, diagnosis, and management of diseases. However, disparities persist in this scenario, disproportionately affecting marginalized communities, racial and ethnic minorities, and individuals facing linguistic or cultural barriers. This paper critically assesses methods to mitigate these disparities, with a focus on breast cancer screening. We underscore scientific mobility as a vital tool for radiologists to advocate for healthcare policy changes: it not only enhances diversity and cultural competence within the radiology community but also fosters international cooperation and knowledge exchange among healthcare institutions. Efforts to ensure cultural competency among radiologists are discussed, including ongoing cultural education, sensitivity training, and workforce diversification. These initiatives are key to improving patient communication and reducing healthcare disparities. This paper also highlights the crucial role of policy changes and legislation in promoting equal access to essential screening services like mammography. We explore the challenges and potential of teleradiology in improving access to medical imaging in remote and underserved areas. In the era of artificial intelligence, this paper emphasizes the necessity of validating its models across a spectrum of populations to prevent bias and achieve equitable healthcare outcomes. Finally, the importance of international collaboration is illustrated, showcasing its role in sharing insights and strategies to overcome global access barriers in medical imaging. Overall, this paper offers a comprehensive overview of the challenges related to disparities in medical imaging access and proposes actionable strategies to address these challenges, aiming for equitable healthcare delivery. [ABSTRACT FROM AUTHOR]

Background: To provide better quality healthcare services to patients with different linguistic and cultural backgrounds, the cross-cultural competence of medical professionals is important. However, assessing and improving the cross-cultural competence of healthcare professionals is difficult in Japan, as there is no standardized scale to measure the competence. This study's purpose was to translate the Cross-Cultural Competence instrument for Healthcare Professionals (CCCHP), which was developed and used in Europe, and to examine its reliability and validity among Japanese nurses., Methods: During June and July 2021, nursing staff were invited to take web- and paper-based surveys in Okinawa Japan. The CCCHP (five-factor model with 27 items across motivation, attitude, skills, emotion, and knowledge) was translated using a combination translation method, and a five-point Likert scale was used for responses. Exploratory and confirmatory factor analyses and known-group method were used to examine structural validity, while Cronbach's alpha coefficient was used to test reliability., Results: A total of 294 responses were analyzed; 77.2% had more than five years of experience. Since the fit index indicated that the five-factor model was not a good fit, it was modified to a four-factor model (J-CCCHP24) by moving three variables, removing the knowledge factor, and using the error covariance of the variables. The fit index after the modification was improved to comparative fit index (CFI) = 0.92, Tucker-Lewis index (TLI) = 0.91, root mean square error of approximation (RMSEA) = 0.05, and standardized root mean square residual (SRMR) = 0.06, and Cronbach's alpha was 0.85. The mean scores of J-CCCHP24 were significantly higher in the group with a history of overseas travel, higher foreign language skill, training in intercultural care, experience of foreign patient care, and intercultural interactions outside the workplace than in the group without these characteristics., Conclusion: This study confirmed the validity and reliability of the modified Japanese version of the CCCHP (four-factor model with 24 items). The results suggest that the exposure to different cultures on a personal level may help improve nurses' cross-cultural competence. Further refinement of this scale for practical use would encourage the implementation of necessary countermeasures to improve the cross-cultural competence of Japanese healthcare professionals., (© 2024. The Author(s).)

Background: It is important to have a pharmacy workforce that is culturally competent to recognise a patient's health beliefs to improve medication adherence and reduce poor treatment outcomes., Aim: This systematic review aimed to identify, critically appraise and summarise how cultural competency is conceptualised, developed and embedded in pre-qualification pharmacy education., Method: Medline, Scopus, PsychInfo, Web of Knowledge, CINAHL, and Embase databases were searched for relevant papers published in English between January 2012 and December 2021, following PRISMA guidelines. Data from included papers were thematically analysed. Educational quality of papers was appraised using the GREET criteria. This systematic review was registered on PROSPERO, CRD42021295875., Results: The review included 47 papers (46 studies) with 18 papers meeting ≥ 9 points on the GREET criteria thus considered of good educational quality. Forty papers focused on educational interventions implemented to pharmacy students only, the remaining included students from different health disciplines. Half of the educational interventions focused on cultural competence in general. Most educational interventions lasted over a week and 21 were compulsory. Cultural competence conceptualisation varied; a focus on knowledge about different cultures or on culturally competent behaviours or a continuum with knowledge at one end and behaviour at the other., Conclusion: There is variation in how cultural competence is embedded in pharmacy programmes, which could be a reflection of the differences in how educators conceptualised cultural competence. Further research is needed to develop a unified understanding of the meaning of cultural competence and how it can be embedded in pharmacy education., (© 2023. The Author(s).)

Aboriginal and Torres Strait Islander people in Australia face disparities in accessing culturally safe and appropriate health services. While current cultural safety and responsiveness frameworks set standards for improving healthcare practices, ensuring accountability and sustainability of changes, necessitates robust mechanisms for auditing and monitoring progress. This study examined existing cultural safety audit tools, and facilitators and barriers to implementation, in the context of providing culturally safe and responsive healthcare services with Aboriginal and Torres Strait Islander people. This will assist organisations, interested in developing tools, to assess culturally responsive practice. A scoping review was undertaken using Medline, Scopus, CINAHL, Informit and PsychInfo databases. Articles were included if they described an audit tool used for healthcare practices with Aboriginal and Torres Strait Islander people. Selected tools were evaluated based on alignment with the six capabilities of the Indigenous Allied Health Australia (IAHA) Cultural Responsiveness in Action Framework. Implementation barriers and facilitators were identified. 15 papers were included. Audit tools varied in length, terminology, domains assessed and whether they had been validated or evaluated. Seven papers reported strong reliability and validity of the tools, and one reported tool evaluation. Implementation facilitators included: tool comprehensiveness and structure; effective communication; clear organisational responsibility for implementation; commitment to prioritising cultural competence; and established accountability mechanisms. Barriers included: the tool being time-consuming and inflexible; responsibility for implementation falling on a small team or single staff member; deprioritising tool use; and lack of accountability for implementation. Two of the six IAHA capabilities (respect for the centrality of cultures and inclusive engagement) were strongly reflected in the tools. The limited tool evaluation highlights the need for further research to determine implementation effectiveness and sustainability. Action-oriented tools, which comprehensively reflect all cultural responsiveness capabilities, are lacking and further research is needed to progress meaningful change within the healthcare system., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: First Nations, Inuit, and Métis (FNIM) peoples experience systemic health disparities within Ontario's healthcare system. Learning health systems (LHS) is a rapidly growing interdisciplinary area with the potential to address these inequitable health outcomes through a comprehensive health system that draws on science, informatics, incentives, and culture for ongoing innovation and improvement. However, global literature is in its infancy with grounding theories and principles still emerging. In addition, there is inadequate information on LHS within Ontario's health care context. Methods: We conducted an environmental scan between January and April 2021 and again in June 2022 to identify existing frameworks, guidelines, and tools for designing, developing, implementing, and evaluating an LHS. Results: We found 37 relevant sources. This paper maps the literature and identifies gaps in knowledge based on five key pillars: (a) data and evidence‐driven, (b) patient‐centeredness, (c) system‐supported, (d) cultural competencies enabled, and (e) the learning health system. Conclusion: We provide recommendations for implementation accordingly. The literature on LHS provides a starting point to address the health disparities of FNIM peoples within the healthcare system but Indigenous community partnerships in LHS development and operation will be key to success. [ABSTRACT FROM AUTHOR]

Objective Design Setting Participants Results Conclusion There is a shortage of nurses, Aboriginal Health Practitioners, GPs and other staff in remote Australian health clinics. There is also high turnover of staff, leading to questions of ‘who’ is appropriate for remote First Nations practice? The aim of this paper was to identify the characteristics of staff who are likely to work well in remote First Nations settings, from the perspectives of remote health practitioners.This is a qualitative study involving content analysis of interviews.The study is conducted in and with 11 Aboriginal Community Controlled Health Services across northern and central Australia.Eighty‐four staff working in these clinics who spoke about staff qualities suited to remote practice.Participants identified a range of qualities desirable in remote practitioners, which were grouped into three topics: (1) professional qualifications and experience, including cultural skills; (2) ways of working, including holisitic approach, resilience, competence, and being a team player, approachable, flexible and hard‐working; and (3) specific community needs, namely the need for local First Nations staff, male practitioners and returning short‐term staff. The combination of experiences, ways of working, and fit to both the team and community were emphasised.Identifying the characteristics of staff who are likely to work well in these settings can inform recruitment strategies. This study found that a combination of professional qualifications, skills and experience as well as ways of working, individual characteristics and needs of communities are desirable for working in remote, First Nations settings. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, transgender, queer, and other sexual orientation and gender minority (LGBTQ+) youth and families have been under a social and legislative attack in the United States in recent years, marked by a stark increase in gender‐affirming care bans and religious rights cases before the U.S. Supreme Court. LGBTQ+ graduate students in mental health fields—particularly those who seek to work in family court settings—have specific needs that are often unmet in their educational and clinical training environments. Furthermore, the over‐representation of LGBTQ+ youth in the child welfare and juvenile justice systems necessitates specialized knowledge and skills that many clinicians and educators are currently lacking. This paper discusses the unique challenges facing LGBTQ+ graduate students and provides research‐based suggestions for professors, administrators, and supervising clinicians who seek to provide a holistic and humanizing educational experience that produces clinicians who can respond to the evolving needs of LGBTQ+ individuals in family court settings and beyond. Key points for the family court community: LGBTQ+ individuals experience unique stressors stemming from identity‐related stigma, prejudice, and discrimination, which can negatively affect their health and success in educational and work settings.Familiarity with this minority stress may motivate LGBTQ+ individuals to pursue careers in mental health, particularly in family court settings.LGBTQ+ graduate students often lack professors and clinical supervisors who are knowledgeable about working with LGBTQ+ individuals, leading to inadequate training and experiences that negatively impact their functioning across domains.Research highlights the need for more culturally responsive and affirming classroom and field training environments to support LGBTQ+ graduate mental health students who seek to make a difference in the legal system. [ABSTRACT FROM AUTHOR]

Teaching can be challenging, especially when teachers are under-prepared to enter a workforce with a constantly changing landscape. Preparing teachers for STEM content has generated multiple approaches from varying perspectives. While some scholars advocate for content expertise, others promote pedagogy or social context as approaches for translating STEM content for students. Yet, many contend that teachers must be culturally knowledgeable to respond to student diversity effectively. While these arguments are valuable and needed, many have not considered the interconnectedness of these approaches, often used in silos. This conceptual paper unpacks some of these arguments using the social constructivism theory of learning as the epistemic lens to examine and interpret what STEM teacher knowledge should encompass in the 21st-century diversified classroom. After thoroughly evaluating the core elements of three commonly used teacher constructs, this paper presents an integrative, holistic teacher knowledge—culturally responsive pedagogical knowledge (CRPK) framework that considers the necessary qualities that teachers must possess that are functional, content-focused, and pedagogically inclusive. The proposed CRPK construct would be a valuable programmatic tool for teacher preparation, curriculum development, and classroom praxis.

Rural transgender individuals face heightened disparities relative to other transgender individuals. However, social workers and psychologists receive minimal training in transgender client care. The current study used one-way repeated measures ANOVAs to investigate the effectiveness of transgender-specific cultural competency training for social workers and psychologists working with rural clients to improve knowledge, awareness, and self-efficacy (i.e., competency) concerning transgender clients' needs. Results indicated significant differences in the change of competency among participants assigned to a transgender-specific group compared to those assigned to a general multicultural group. Thematic analysis of participants' responses to course evaluations also supported the course effectiveness. [ABSTRACT FROM AUTHOR]

To achieve expertise, transplant surgeons in Turkiye undergo rigorous training, including medical school, residency, compulsory service, and extensive training in transplant surgery. Despite their high academic and clinical knowledge level, success in transplant surgery heavily depends on cultural competency. Through semi-structured interviews with 21 transplant surgeons specializing in kidney and liver transplants in Ankara, this study reveals how health illiteracy, culture, and folklore create significant barriers. Surgeons navigate these challenges while enduring harsh working conditions. This research highlights the critical role of cultural competency in transplant surgery, emphasizing the necessity for surgeons to understand and address the diverse cultural needs of their patients. Key findings indicate that surgeons must balance medical expertise with cultural sensitivity to deliver effective care. This study identifies four main cultural barriers: spiritual trust, family politics, health illiteracy, and subcultural incompetency. Effective transplant surgery requires a combination of theoretical proficiency and cultural awareness to meet a patient's needs and improve surgical outcomes. [ABSTRACT FROM AUTHOR]

Conflict in Ukraine has disrupted the lives of millions of people, including orphaned children. Yet, the consequences of the war in Ukraine extend beyond the Ukrainian border. The current crisis also impacts Ukrainian adoptees in the United States. Social workers are in a position to help children and families dealing with the effects of the crisis. My narrative adds another voice to the academic conversation from the perspective of a Ukrainian adoptee and a licensed clinical social worker working on coming to terms with multicultural identity as it pertains to the war in Ukraine. Additionally, it guides social workers who may be working with current or future adoptees in a therapeutic space by emphasizing the importance of culturally sensitive and trauma-informed services to address the intersection of institutionalization, adoption transition, and the impact of the current crisis in Ukraine. [ABSTRACT FROM AUTHOR]

This study assumes that the young generation in the US is demographically diverse but psychologically alike, especially in their shopping behaviors and fashion preferences; therefore, businesses might not need to differentiate their offers, in contrast to the suggestions of past research. The purpose of this study is to examine whether young female consumers from different races/ethnicities/cultures show heterogeneous or homogeneous shopping orientations and preferences toward fashion products. This study is quantitative research with two separate surveys. In contrast to the previous literature, the results showed homogenous shopping orientations and fashion attribute and style preferences among the young ethnic groups in the US. Marketers and educators are recommended to consider the homogeneity of today's young female consumers' fashion preferences, while respecting the diversity/heterogeneity of demographics among ethnic groups. [ABSTRACT FROM AUTHOR]

Background: Migration is increasing globally, and societies are becoming more diverse and multi-ethnic. Medical school curricula should prepare students to provide high-quality care to all individuals in the communities they serve. Previous research from North America and Asia has assessed the effectiveness of medical cultural competency training, and student preparedness for delivery of cross-cultural care. However, student preparedness has not been explored in the European context. The aim of this study was to investigate how prepared final-year medical students in the Republic of Ireland (ROI) feel to provide care to patients from other countries, cultures, and ethnicities. In addition, this study aims to explore students' experiences and perceptions of cross-cultural care. Methods: Final-year medical students attending all six medical schools within the ROI were invited to participate in this study. A modified version of the Harvard Cross-Cultural Care Survey (CCCS) was used to assess their preparedness, skill, training/education, and attitudes. The data were analysed using IBM SPSS Statistics 28.0, and Fisher's Exact Test was employed to compare differences within self-identified ethnicity groups and gender. Results: Whilst most respondents felt prepared to care for patients in general (80.5%), many felt unprepared to care for specific ethnic patient cohorts, including patients from a minority ethnic background (50.7%) and the Irish Traveller Community (46.8%). Only 20.8% of final-year students felt they had received training in cross-cultural care during their time in medical school. Most respondents agreed that they should be assessed specifically on skills in cultural competence whilst in medical school (83.2%). Conclusions: A large proportion of final-year medical students surveyed in Ireland feel inadequately prepared to care for ethnically diverse patients. Similarly, they report feeling unskilled in core areas of cross-cultural care, and a majority agree that they should be assessed on aspects of cultural competency. This study explores shortcomings in cultural competency training and confidence amongst Irish medical students. These findings have implications for future research and curricular change, with opportunities for the development of relevant educational initiatives in Irish medical schools. [ABSTRACT FROM AUTHOR]

Background: Pen-pal clubs (PPC) are used worldwide for students to learn about different cultures and other skillsets without the need for travel. Many medical students are interested in global health opportunities abroad but costs, scheduling, and other barriers allow few to participate in such experiences. It is important that medical students have nuanced global medical perspectives and can contribute to the global medical community. Objective: The purpose of this study is to demonstrate that an international medical student PPC improves medical students' perspectives of cultural competency and global health engagement. Methods: In 2021, a novel medical student PPC was established that began between an American and Japanese medical school. Following a shareholders meeting, it was decided that the number of medical schools involved globally be expanded through previous institutional affiliations and online presences. In total, the club connected 50 American medical students and 52 medical students from 17 high- and middle-income countries. The primary form of communication was online; pen-pals were encouraged to communicate monthly using provided topics, although frequency and way of communication was their discretion. In February 2022, American PPC members were emailed a qualitative survey to assess the PPC's impact. Results: The survey was completed by 42% of American PPC members, 95% of which were 22-26 years. Participants were preclinical medical students, 60% whom were female and the majority either white (47%) or Asian (43%). Overall, the PPC positively influenced American medical students' perception of global medicine, medical education, and their cultural competency after joining the PPC compared to prior (P = 0.004). Conclusion: PPCs encourage medical students to think from a global perspective and foster open-mindedness within varying social and cultural contexts. Having a global communication platform for students during medical school education may be an additional way to train aspiring global leaders. [ABSTRACT FROM AUTHOR]

Objective: Over the past three decades, cultural competence has been widely promoted in the health disciplines, including in health education and promotion, as a tool to address health disparities and promote health equity among diverse populations. Cultural intelligence (CQ), or the individual's capability to adjust to cultural situations based on multiple factors including cognitive, metacognitive, motivational and behavioural characteristics, can be another useful tool when addressing the needs of diverse groups. The goal of this study was to assess the level of CQ among health education specialists and its relationship with cultural competence skills (CCS) among members of this group. Design: Five hundred and forty randomly selected health education specialists in the USA completed an online survey. The survey included questions to assess CQ, CCS and demographic information. Descriptive statistics and analysis of variance were used to analyse the data. Results: Results from the study showed that there was a significant variation in CQ among health education specialists based on race/ethnicity, education, the percentage of cultural/racial/ethnic diverse people they serve, and participation in professional development training. There was also a positive correlation between CQ and CCS, and between each of the CQ capabilities and CCS. Finally, both CQ metacognitive and cognitive capabilities were significant predictors of the overall CCS score. Conclusion: Findings from this study showed that CQ is associated with CCS among health education specialists. The results of the study suggest that health education specialists should consider CQ a useful tool with which to increase CCS. [ABSTRACT FROM AUTHOR]

Introduction: Educators require focused training to foster the development of intercultural competence in nurses. Training programs for educators need to be based on a comprehensive profile with a focus on intercultural learning. This study aims to define and validate a profile of the Intercultural Nursing Educator (INE). Method: The Delphi method was used with an iterative, multi-stage process to transform opinions into group consensus. A total of 46 European, African, and American experts from the nursing and intercultural field participated. Inclusion criteria required English at a level of B2, expertise in the field of intercultural competence, experience in teaching intercultural competence in the nursing context, and publications focused on intercultural topics. Results: The INE profile was developed and all 126 competencies were validated. Discussion and conclusion: The profile is freely available on the project website and provides the basis for curricula, training programs and assessment of the required competences. [ABSTRACT FROM AUTHOR]

Abstract Introduction First Nations, Inuit, and Métis (FNIM) peoples experience systemic health disparities within Ontario's healthcare system. Learning health systems (LHS) is a rapidly growing interdisciplinary area with the potential to address these inequitable health outcomes through a comprehensive health system that draws on science, informatics, incentives, and culture for ongoing innovation and improvement. However, global literature is in its infancy with grounding theories and principles still emerging. In addition, there is inadequate information on LHS within Ontario's health care context. Methods We conducted an environmental scan between January and April 2021 and again in June 2022 to identify existing frameworks, guidelines, and tools for designing, developing, implementing, and evaluating an LHS. Results We found 37 relevant sources. This paper maps the literature and identifies gaps in knowledge based on five key pillars: (a) data and evidence‐driven, (b) patient‐centeredness, (c) system‐supported, (d) cultural competencies enabled, and (e) the learning health system. Conclusion We provide recommendations for implementation accordingly. The literature on LHS provides a starting point to address the health disparities of FNIM peoples within the healthcare system but Indigenous community partnerships in LHS development and operation will be key to success.