Keywords
Cultural Competence
Diversity, Equity, and Inclusion (DEI)
Organizational Culture
Medical Education
How to Cite
Abstract
Background: Persistent inequities and the underrepresentation of marginalized groups in healthcare have been described as undermining workforce inclusion and patient experiences. People Resource Groups (PRGs) aim to support peer connection and institutional engagement; however, their roles in healthcare remain insufficiently characterized. This study examined how PRG members perceived their participation as contributing to cultural competence, equity, belonging, and professional identity within a healthcare organization.
Methods: Semi–structured interviews were conducted between April and November 2024 with seven members of two PRGs: FIRST Peoples (Indigenous) and Honor in Pride (LGBTQIA+). Interviews explored members’ experiences and perceived impacts of PRG participation. Data were analyzed using primarily deductive thematic analysis guided by the Campinha–Bacote model of cultural competence (awareness, knowledge, skill, encounters, and desire), while allowing for inductive insights. Findings reflect participant perspectives rather than measured clinical or organizational outcomes.
Results: Four themes emerged. Participants described experiences of cultural invisibility in the workplace. They perceived that PRG participation supported cultural humility and inclusive communication, which they associated with strengthened physician–patient relationships. Participants described PRGs as fostering belonging and cross–cultural solidarity and attributed increased confidence to engage in organizational initiatives to this participation. They emphasized the need for leadership support, protected time, and structural flexibility, noting limitations related to underfunding and inconsistent institutional integration.
Conclusions: PRG members perceived that participation supported cultural competence, belonging, and engagement within their organization. These findings represent member perspectives and warrant further study across settings.
References
1. Lewis ME, Wildcat S, Anderson A. Visioning an Effective Health Encounter: Indigenous Healthcare Experiences and Recommendations for Health Professionals. Int J Environ Res Public Health. 2023: [PMID: 37887655 10.3390/ijerph20206917]
2. Lewis ME, Blackmore I, Kamaka ML, Wildcat S, Anderson-Buettner A, Modde E, Myhra L, Smith JB, Stately AL. "Understand the Way We Walk Our Life": Indigenous Patients' Experiences and Recommendations for Healthcare in the United States. Int J Environ Res Public Health. 2025: [PMID: 40238544 10.3390/ijerph22030445]
3. Nguyen NH, Subhan FB, Williams K, Chan CB. Barriers and Mitigating Strategies to Healthcare Access in Indigenous Communities of Canada: A Narrative Review. Healthcare (Basel). 2020: [PMID: 32357396 10.3390/healthcare8020112]
4. Mitchell LA, Jacobs C, McEwen A. (In)visibility of LGBTQIA+ people and relationships in healthcare: A scoping review. Patient Educ Couns. 2023: 107828 [PMID: 37301011 10.1016/j.pec.2023.107828]
5. Stanford FC. The Importance of Diversity and Inclusion in the Healthcare Workforce. J Natl Med Assoc. 2020: 247 [PMID: 32336480 10.1016/j.jnma.2020.03.014]
6. Chantarat T, Rogers TB, Mitchell CR, Ko MJ. Perceptions of workplace climate and diversity, equity, and inclusion within health services and policy research. Health Serv Res. 2023: 314 [PMID: 35808931 10.1111/1475-6773.14032]
7. Gresh A, Ahmed N, Boynton-Jarrett R, Sharifi M, Rosenthal MS, Fenick AM. Clinicians' Perspectives on Equitable Health Care Delivery in Group Well-Child Care. Acad Pediatr. 2023: 1385 [PMID: 37302699 10.1016/j.acap.2023.06.010]
8. Kizilkaya S. The mediating role of physician trust in the relationship between medical mistrust and health-care system distrust. Cir Cir. 2024: 46 [PMID: 38537240 10.24875/CIRU.23000102]
9. O'Neill B, Ferrer R, O'Brien P, Watt G, Gottlieb L, Pinto A, Willems S, Currie J, Harriott D, Leitch J, Zsager A, Kidd M, Kiran T. Improving Equity Through Primary Care: Proceedings of the 2019 Toronto International Conference on Quality in Primary Care. Ann Fam Med. 2020: 364 [PMID: 32661039 10.1370/afm.2560]
10. Boland EM, Martin I, Jordan B, Decker-Tonnesen P, Bhagra A. Enhancing Belonging in Healthcare: A Commentary on Strategies for Organizational Leadership. J Healthc Leadersh. 2025: 117 [PMID: 40242833 10.2147/JHL.S473636]
11. Lafferty M, Strange W, Kaboli P, Tuepker A, Teo AR. Patient Sense of Belonging in the Veterans Health Administration: A Qualitative Study of Appointment Attendance and Patient Engagement. Med Care. 2022: 726 [PMID: 35880766 10.1097/MLR.0000000000001749]
12. Dhandayuthapani DSP, Shalini MK. A Conceptual Study On Employee Engagement And Its Impact On Employee Retention In Healthcare. International Journal of Research Publication and Reviews. 2024: 7203 10.55248/gengpi.5.0524.1303]
13. Schlachter S, Rolf S, Welbourne TM. Dynamics of Employee Resource Groups: Leader Experiences Driving Mutual Benefits for Employees and Employers. Compensation & Benefits Review. 2023: 119 10.1177/08863687231192179]
14. Jahan T, Yadav DA. The Impact of Employee Silence on Healthcare and Wellbeing in Sustainable Communities. International Journal of Research Publication and Reviews. 2024: 3199 10.55248/gengpi.5.0924.2673]
15. Fox MJ, Wu H. Terminology and Language Used in Indigenous-Specific Gender and Sexuality Diversity Studies: A Systematic Review. Social Sciences. 2023: 10.3390/socsci12030145]
16. McEwing E, Black T, Zolobczuk J, Dursun U. Moving Beyond the LGBTQIA+ Acronym: Toward Patient-Centered Care. Rehabil Nurs. 2022: 162 [PMID: 35687562 10.1097/RNJ.0000000000000378]
17. Campinha-Bacote J. The Process of Cultural Competence in the Delivery of Healthcare Services: a model of care. J Transcult Nurs. 2002: 181 [PMID: 12113146 10.1177/10459602013003003]
18. BenGhida D, Schellini M. Shadows Amidst: Cultural Identity in the Spectrum of Visibility and Invisibility. Photography and Culture. 2024: 77 10.1080/17514517.2024.2414685]
19. Mosley TJ, Zajdel RA, Alderete E, Clayton JA, Heidari S, Perez-Stable EJ, Salt K, Bernard MA. Intersectionality and diversity, equity, and inclusion in the healthcare and scientific workforces. Lancet Reg Health Am. 2025: 100973 [PMID: 40321651 10.1016/j.lana.2024.100973]
20. Gulati S, Weir C. Cultural Competence in Healthcare Leadership Education and Development. Societies. 2022: 10.3390/soc12020039]
21. Constantinou CS, Andreou P, Nikitara M, Papageorgiou A. Cultural Competence in Healthcare and Healthcare Education. Societies. 2022: 10.3390/soc12060178]
22. Pasztor J. Cultural Intelligence (CQ) and Cultural Exposure Through Mobility Programs. GiLE Journal of Skills Development. 2021: 50 10.52398/gjsd.2021.v1.i1.pp50-66]
23. Buki LP, Quintero Johnson JM, Knight K, Walton A. "Cultural and conceptual knowledge": Reformulation and conceptual analysis of a key component of the health literacy model. Soc Sci Med. 2024: 117150 [PMID: 39088929 10.1016/j.socscimed.2024.117150]
24. Restivo V, Minutolo G, Battaglini A, Carli A, Capraro M, Gaeta M, Odone A, Trucchi C, Favaretti C, Vitale F, Casuccio A. Leadership Effectiveness in Healthcare Settings: A Systematic Review and Meta-Analysis of Cross-Sectional and Before-After Studies. Int J Environ Res Public Health. 2022: [PMID: 36078706 10.3390/ijerph191710995]
25. Sze GW, Yuin YS, Durganaudu H, Pillai N, Yap CG, Jahan NK. Narrative Review of Leadership Development Programs among Medical Professionals. OALib. 2021: 1 10.4236/oalib.1107555]
26. Argyriadis A, Patelarou E, Paoullis P, Patelarou A, Dimitrakopoulos I, Zisi V, Northway R, Gourni M, Asimakopoulou E, Katsarou D, Argyriadi A. Self-Assessment of Health Professionals' Cultural Competence: Knowledge, Skills, and Mental Health Concepts for Optimal Health Care. Int J Environ Res Public Health. 2022: [PMID: 36141554 10.3390/ijerph191811282]
27. Konieczna A. The experience of social (in)visibility in narratives about ostracism. Communications. 2025: 838 10.1515/commun-2023-0153]
28. Grailey KE, Murray E, Reader T, Brett SJ. The presence and potential impact of psychological safety in the healthcare setting: an evidence synthesis. BMC Health Serv Res. 2021: 773 [PMID: 34353319 10.1186/s12913-021-06740-6]
29. Ford LG, Lewis C, Volberding JL. The Perceptions and Experiences Among Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Agender Patients of Quality of Care With Health Care Services. International Journal of Athletic Therapy and Training. 2024: 130 10.1123/ijatt.2022-0140]
30. Young R, Ayiasi RM, Shung-King M, Morgan R. Health systems of oppression: applying intersectionality in health systems to expose hidden inequities. Health Policy Plan. 2020: 1228 [PMID: 33179072 10.1093/heapol/czaa111]
31. Policardo GR, Prati F, Burak C, Van Assche J, Rubini M. Fostering Solidarity Among Ethnic Minority Groups: Addressing the Role of Inter-Minority Contact in Cross-Cultural Contexts. Int Rev Soc Psychol. 2025: 14 [PMID: 41127327 10.5334/irsp.1096]
32. Schmidt M, Steigenberger N, Berndtzon M, Uman T. Cultural diversity in health care teams: A systematic integrative review and research agenda. Health Care Manage Rev. 2023: 311 [PMID: 37615941 10.1097/HMR.0000000000000379]
33. Dib K, Belrhiti Z. Unpacking the black box of interprofessional collaboration within healthcare networks: a scoping review. BMJ Open. 2025: e101702 [PMID: 40514237 10.1136/bmjopen-2025-101702]
34. Haile SC. Communities of practice in action: how employee resource groups broker knowledge for underrepresented employees. Equality, Diversity and Inclusion: An International Journal. 2025: 1 10.1108/edi-02-2025-0110]
35. Whalen DH, Lewis ME, Gillson S, McBeath B, Alexander B, Nyhan K. Health effects of Indigenous language use and revitalization: a realist review. Int J Equity Health. 2022: 169 [PMID: 36437457 10.1186/s12939-022-01782-6]
36. Holcomb D, Gonyer M. Inclusive Language and Culturally Responsive Formal Mentorship. Critical Social Work. 2024: 10.22329/csw.v25i2.7903]
37. Tsuchida RE, Doan J, Losman ED, Haggins AN, Huang RD, Hekman DJ, Perry MA. Cultural Humility Curriculum to Address Healthcare Disparities for Emergency Medicine Residents. West J Emerg Med. 2023: 119 [PMID: 36976587 10.5811/westjem.2023.1.58366]
38. Mazzoli Smith L, Villar F, Wendel S. Narrative-based learning for person-centred healthcare: the Caring Stories learning framework. Med Humanit. 2023: 583 [PMID: 37208190 10.1136/medhum-2022-012530]
39. Beasley C, Jones-Locklear J, Jacobs MA. Cultural Competence with American Indian Clients: Workforce and Personal Development. N C Med J. 2021: 423 [PMID: 34750223 10.18043/ncm.82.6.423]
40. Cipta DA, Andoko D, Theja A, Utama AVE, Hendrik H, William DG, Reina N, Handoko MT, Lumbuun N. Culturally sensitive patient-centered healthcare: a focus on health behavior modification in low and middle-income nations-insights from Indonesia. Front Med (Lausanne). 2024: 1353037 [PMID: 38681051 10.3389/fmed.2024.1353037]
41. Becker ES. Exploring the Peer Leadership Network of Rehabilitation Healthcare Professionals Following Leader Development Training. J Healthc Leadersh. 2024: 39 [PMID: 38288295 10.2147/JHL.S443203]
42. Távora I, Saqib SI, Kauser S. Advancing Equality, Diversity and Inclusion Through Voice for All: The Role of Employee Resource Groups. British Journal of Management. 2025: 10.1111/1467-8551.70025]
43. Jain S, Brocchini J, Radhakrishan P, Sall D. Preparing IM Residents to Care for Indigenous Peoples: A Co-Produced Indigenous Health Curriculum. J Gen Intern Med. 2025: 3340 [PMID: 40634651 10.1007/s11606-025-09729-7]
44. Chen YS, Liao KC, Yau SY. From hesitation to participation: a narrative review of facilitators and barriers for healthcare professionals' engagement in medical education research. BMC Med Educ. 2025: 302 [PMID: 40001074 10.1186/s12909-025-06792-w]
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Jenna Brocchini, Seema Jain, Dana Sall, Priya Radhakrishnan Dr.