Recent changes to Health and Care Professions Council standards, alongside an increased emphasis on equality, diversity, and inclusion (EDI) within higher education and healthcare, prompted a review of how cultural competence was addressed across our pre-registration Speech and Language Therapy programmes.<\/p>\n
A curriculum review of EDI-related content led by Linda Jose highlighted strengths in awareness-raising while also identifying opportunities for more in-depth exploration of power, bias, structural inequality, and culturally responsive practice, particularly in ways that connected learning across modules and into clinical practice.<\/p>\n
This review took place within the reality of an already crowded curriculum, where adding standalone sessions risked further fragmentation and reduced coherence. There was also the recognition that cultural competence should not be treated as a discrete topic, but embedded within curricula and supported as a developmental process across students\u2019 academic and clinical journeys.<\/p>\n
This work focused on pre-registration undergraduate and postgraduate Speech and Language Therapy cohorts, where cultural competence is a core professional outcome.<\/p>\n
\n
The Solution<\/span><\/strong><\/h3>\nCultuRACE is a longitudinal, curriculum-embedded programme framework for cultural competence education, developed and facilitated within pre-registration Speech and Language Therapy programmes. Rather than adding standalone content, it was designed to strengthen and connect existing learning across academic modules and clinical education. CultuRACE is not a new theory of cultural competence, but a practical pedagogical response to the persistent challenge of teaching it well.<\/p>\n
The programme was designed and facilitated by Linda Jose, with iterative refinement informed by student feedback and curriculum review. Professor Helen Stringer championed the work and contributed to facilitation, while LTDS colleagues Matt Laidler and Emma McCulloch supported the refinement and delivery of the LEGO\u00ae Serious Play\u00ae session.<\/p>\n
Informed by Campinha-Bacote\u2019s (2002) process model of cultural competence, CultuRACE frames cultural competence as an ongoing, experiential process rather than a fixed or assessable endpoint.<\/p>\n
CultuRACE comprises five thematically sequenced sessions:<\/p>\n
\n- \n
Sessions 1\u20132: Culture, identity, unconscious bias, anti-racism, and allyship.<\/p>\n<\/li>\n
- \n
Sessions 3\u20134: Health inequalities, systemic racism, decolonising healthcare and professional responsibility using experiential approaches, including LEGO\u00ae Serious Play\u00ae.<\/p>\n<\/li>\n
- \n
Session 5: A bespoke CultuRACE digital board game integrating learning through scenario and discussion.<\/p>\n<\/li>\n<\/ul>\n
Across all sessions, experiential, playful, and dialogic pedagogies supported engagement with sensitive topics. Activities externalised thinking, encouraged multiple perspectives and reduced pressure for personal disclosure while promoting psychological safety.<\/p>\n
The digital board game was developed through workshops and focus groups with staff and students, with feedback informing iterative refinement. Similar feedback also informed ongoing development of the cultural competence self-rating tool.<\/p>\n
![\"\"](\"http:\/\/microsites.ncl.ac.uk\/casestudies\/files\/2026\/03\/CultuRACE_Linda-Jose-300x300.png\")
The CultuRACE logo<\/p><\/div>\n
CultuRACE was intentionally designed around transferable pedagogical principles, including experiential learning, dialogic engagement, structured reflection, and psychological safety, enabling adaptation across disciplines, cohort sizes and resource contexts.<\/p>\n
Evaluation was embedded to support both student learning and programme refinement. Learner reflection, session feedback, and a self-designed cultural competence self-rating tool (undergoing validation) informed iterative development. In later sessions, reflections formed part of summative assessment of reflective practice (rather than cultural competence). With ethical approval and student consent, reflections were also used to support understanding of the impact the CultuRACE sessions had on students’ learning.<\/p>\n
\nThe impact (results)<\/span><\/strong><\/h3>\nEarly implementation indicated positive learning impacts, with strong student engagement in complex and sensitive topics. Students described confidence in engaging with discussions related to culture, bias, inequality, and professional responsibility, and valued the structured yet open learning environment.<\/p>\n
Students highlighted:<\/p>\n
\n- Confidence engaging in difficult conversations<\/li>\n
- Awareness of their own assumptions and positionality<\/li>\n
- Appreciation of playful and hands-on approaches to serious topics<\/li>\n
- Ability to connect learning to clinical placements and future professional practice<\/li>\n<\/ul>\n
Changes were observed in students\u2019 self-rated cultural competence across the domains of awareness, knowledge, and skills, while cultural desire remained stable. These findings are informing ongoing refinement and validation of the cultural competence self-rating tool.<\/p>\n
Embedding reflection within summative assessment helped position cultural competence learning as a core element of professional education. Student reflections demonstrated engagement with power, inequality, and ethical complexity, and described how learning may inform future clinical decision-making.<\/p>\n
\nLessons learned<\/span><\/strong><\/h3>\nEmbedding cultural competence longitudinally supported deeper engagement and enabled students to revisit learning as academic and clinical experience developed.<\/p>\n
Playful and experiential pedagogies supported psychologically safe engagement with sensitive topics by externalising thinking and reducing defensiveness.<\/p>\n
Learner stage mattered: undergraduate students particularly benefited from early awareness-building, while postgraduate students drew more heavily on prior clinical and life experience.<\/p>\n
Dialogic and experiential approaches require sufficient protected curriculum time, compressed sessions reduced opportunities for deeper discussion and collaborative problem-solving.<\/p>\n
Facilitator confidence, reflexivity, and comfort with uncertainty were critical to building trust, psychological safety, and meaningful dialogue.<\/p>\n
\nTips for colleagues<\/span><\/strong><\/h3>\n\n- Think longitudinally: cultural competence develops over time, not in a single session.<\/li>\n
- Prioritise psychological safety through clear facilitation and shared ground rules.<\/li>\n
- Use playful and experiential approaches to support engagement with sensitive topics.<\/li>\n
- Focus on reflection and dialogue rather than \u201cright answers.\u201d<\/li>\n
- Design around transferable pedagogical principles so approaches can be adapted across contexts.<\/li>\n
- Centre learner reflection within evaluation processes, recognising its importance for student learning and ongoing improvement.<\/li>\n<\/ul>\n
Next steps include refining the CultuRACE framework, supporting wider adoption, and exploring adaptation across disciplines, programmes, and interprofessional settings.<\/p>\n
\nSkills and attributes<\/span><\/strong><\/h3>\nStudents were able to develop the following attributes:<\/p>\n
Sessions 1\u20132: Culture, identity, unconscious bias, anti-racism, and allyship.<\/p>\n<\/li>\n
Sessions 3\u20134: Health inequalities, systemic racism, decolonising healthcare and professional responsibility using experiential approaches, including LEGO\u00ae Serious Play\u00ae.<\/p>\n<\/li>\n
Session 5: A bespoke CultuRACE digital board game integrating learning through scenario and discussion.<\/p>\n<\/li>\n<\/ul>\n
Across all sessions, experiential, playful, and dialogic pedagogies supported engagement with sensitive topics. Activities externalised thinking, encouraged multiple perspectives and reduced pressure for personal disclosure while promoting psychological safety.<\/p>\n
The digital board game was developed through workshops and focus groups with staff and students, with feedback informing iterative refinement. Similar feedback also informed ongoing development of the cultural competence self-rating tool.<\/p>\n
The CultuRACE logo<\/p><\/div>\n
CultuRACE was intentionally designed around transferable pedagogical principles, including experiential learning, dialogic engagement, structured reflection, and psychological safety, enabling adaptation across disciplines, cohort sizes and resource contexts.<\/p>\n
Evaluation was embedded to support both student learning and programme refinement. Learner reflection, session feedback, and a self-designed cultural competence self-rating tool (undergoing validation) informed iterative development. In later sessions, reflections formed part of summative assessment of reflective practice (rather than cultural competence). With ethical approval and student consent, reflections were also used to support understanding of the impact the CultuRACE sessions had on students’ learning.<\/p>\n
\n
The impact (results)<\/span><\/strong><\/h3>\nEarly implementation indicated positive learning impacts, with strong student engagement in complex and sensitive topics. Students described confidence in engaging with discussions related to culture, bias, inequality, and professional responsibility, and valued the structured yet open learning environment.<\/p>\n
Students highlighted:<\/p>\n
\n- Confidence engaging in difficult conversations<\/li>\n
- Awareness of their own assumptions and positionality<\/li>\n
- Appreciation of playful and hands-on approaches to serious topics<\/li>\n
- Ability to connect learning to clinical placements and future professional practice<\/li>\n<\/ul>\n
Changes were observed in students\u2019 self-rated cultural competence across the domains of awareness, knowledge, and skills, while cultural desire remained stable. These findings are informing ongoing refinement and validation of the cultural competence self-rating tool.<\/p>\n
Embedding reflection within summative assessment helped position cultural competence learning as a core element of professional education. Student reflections demonstrated engagement with power, inequality, and ethical complexity, and described how learning may inform future clinical decision-making.<\/p>\n
\nLessons learned<\/span><\/strong><\/h3>\nEmbedding cultural competence longitudinally supported deeper engagement and enabled students to revisit learning as academic and clinical experience developed.<\/p>\n
Playful and experiential pedagogies supported psychologically safe engagement with sensitive topics by externalising thinking and reducing defensiveness.<\/p>\n
Learner stage mattered: undergraduate students particularly benefited from early awareness-building, while postgraduate students drew more heavily on prior clinical and life experience.<\/p>\n
Dialogic and experiential approaches require sufficient protected curriculum time, compressed sessions reduced opportunities for deeper discussion and collaborative problem-solving.<\/p>\n
Facilitator confidence, reflexivity, and comfort with uncertainty were critical to building trust, psychological safety, and meaningful dialogue.<\/p>\n
\nTips for colleagues<\/span><\/strong><\/h3>\n\n- Think longitudinally: cultural competence develops over time, not in a single session.<\/li>\n
- Prioritise psychological safety through clear facilitation and shared ground rules.<\/li>\n
- Use playful and experiential approaches to support engagement with sensitive topics.<\/li>\n
- Focus on reflection and dialogue rather than \u201cright answers.\u201d<\/li>\n
- Design around transferable pedagogical principles so approaches can be adapted across contexts.<\/li>\n
- Centre learner reflection within evaluation processes, recognising its importance for student learning and ongoing improvement.<\/li>\n<\/ul>\n
Next steps include refining the CultuRACE framework, supporting wider adoption, and exploring adaptation across disciplines, programmes, and interprofessional settings.<\/p>\n
\nSkills and attributes<\/span><\/strong><\/h3>\nStudents were able to develop the following attributes:<\/p>\n
Changes were observed in students\u2019 self-rated cultural competence across the domains of awareness, knowledge, and skills, while cultural desire remained stable. These findings are informing ongoing refinement and validation of the cultural competence self-rating tool.<\/p>\n
Embedding reflection within summative assessment helped position cultural competence learning as a core element of professional education. Student reflections demonstrated engagement with power, inequality, and ethical complexity, and described how learning may inform future clinical decision-making.<\/p>\n
\n
Lessons learned<\/span><\/strong><\/h3>\nEmbedding cultural competence longitudinally supported deeper engagement and enabled students to revisit learning as academic and clinical experience developed.<\/p>\n
Playful and experiential pedagogies supported psychologically safe engagement with sensitive topics by externalising thinking and reducing defensiveness.<\/p>\n
Learner stage mattered: undergraduate students particularly benefited from early awareness-building, while postgraduate students drew more heavily on prior clinical and life experience.<\/p>\n
Dialogic and experiential approaches require sufficient protected curriculum time, compressed sessions reduced opportunities for deeper discussion and collaborative problem-solving.<\/p>\n
Facilitator confidence, reflexivity, and comfort with uncertainty were critical to building trust, psychological safety, and meaningful dialogue.<\/p>\n
\nTips for colleagues<\/span><\/strong><\/h3>\n\n- Think longitudinally: cultural competence develops over time, not in a single session.<\/li>\n
- Prioritise psychological safety through clear facilitation and shared ground rules.<\/li>\n
- Use playful and experiential approaches to support engagement with sensitive topics.<\/li>\n
- Focus on reflection and dialogue rather than \u201cright answers.\u201d<\/li>\n
- Design around transferable pedagogical principles so approaches can be adapted across contexts.<\/li>\n
- Centre learner reflection within evaluation processes, recognising its importance for student learning and ongoing improvement.<\/li>\n<\/ul>\n
Next steps include refining the CultuRACE framework, supporting wider adoption, and exploring adaptation across disciplines, programmes, and interprofessional settings.<\/p>\n
\nSkills and attributes<\/span><\/strong><\/h3>\nStudents were able to develop the following attributes:<\/p>\n
- \n
- Think longitudinally: cultural competence develops over time, not in a single session.<\/li>\n
- Prioritise psychological safety through clear facilitation and shared ground rules.<\/li>\n
- Use playful and experiential approaches to support engagement with sensitive topics.<\/li>\n
- Focus on reflection and dialogue rather than \u201cright answers.\u201d<\/li>\n
- Design around transferable pedagogical principles so approaches can be adapted across contexts.<\/li>\n
- Centre learner reflection within evaluation processes, recognising its importance for student learning and ongoing improvement.<\/li>\n<\/ul>\n
Next steps include refining the CultuRACE framework, supporting wider adoption, and exploring adaptation across disciplines, programmes, and interprofessional settings.<\/p>\n
\nSkills and attributes<\/span><\/strong><\/h3>\n
Students were able to develop the following attributes:<\/p>\n
![\"\"](\"http:\/\/microsites.ncl.ac.uk\/casestudies\/files\/2026\/03\/Linda-Jose-cropped-150x150.jpg\")
<\/td>\n