In the 2003 Institute of Medicine report “Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare,” racial and ethnic minorities were shown to receive lower quality healthcare than their white counterparts. The report proposed cultural competence, defined as providers’ ability to understand and respond to patients’ cultural beliefs and needs, as a possible solution. Given that providers are key to delivering culturally competent care, understanding their perspectives is essential, yet they remain underexplored. This literature review examined 50 journal articles from 2003 to the present, focusing on the perspectives of healthcare providers, including physicians, nurses, medical students, and allied health professionals, regarding cultural competence training and practices. Patient and administrative perspectives were excluded due to extensive existing research in those areas. Articles were collected from PubMed and Google Scholar using the search terms “provider perspectives” and “cultural competence. Across the literature, providers recognized the importance of cultural competence and acknowledged structural barriers including time constraints, limited institutional support, and resistance to change as consistent limits on their ability to practice it. Cultural competence training shifted provider attitudes and communication awareness, but deeper challenges such as implicit bias and internalized stereotypes remained difficult to address and were rarely confronted in practice. The gap between providers' self-assessed competence and their actual behaviors suggested that individual effort alone is insufficient without institutional support. With stronger institutional support, providers' perspectives suggest cultural competence could reach further and give minority patients a more meaningful voice in care.

The current study is aimed at developing a closed-set bilingual Spanish-English sentence comprehension test. Current listening comprehension assessments in the U.S. are primarily available in English, despite the rapid growth of Spanish-English bilingual individuals, leaving a clinical assessment gap. The English version of the current test was developed in 2023, and the Spanish version is being developed for this study. Each test contains the same 50 sentences. As a closed-set test, listeners choose between four picture options that are made to require the listener to hear the full sentence to answer correctly. Participants are tested in quiet and in background speech. All sentences were produced in English and Spanish by a 21-year-old female native bilingual Spanish-English speaker. Careful attention to translation requirements, using a variety of methods, and input from experts in Spanish and in translational considerations, were applied. Once stimuli editing is complete, bilingual children and adults will be tested over multiple sessions on both versions of the sentences to determine test-retest reliability. All participants will also receive a language screening using the validated CELF-5 Screener. The goal of this study is to support the assessment of listening comprehension in bilingual children.