This study aims to conduct a concept analysis on cultural competence in community healthcare. Clarification of the concept of cultural competence is needed to enable clarity in the definition and operation, research and theory development to assist healthcare providers to better understand this evolving concept. Rodgers' evolutionary concept analysis method was used to clarify the concept's context, surrogate terms, antecedents, attributes and consequences and to determine implications for further research. Articles from 2004 to 2015 were sought from Medline, PubMed, CINAHL and Scopus using the terms "cultural competency" AND "health," "cultural competence" OR "cultural safety" OR "cultural knowledge" OR "cultural awareness" OR cultural sensitivity OR "cultural skill" AND "Health." Articles with antecedents, attributes and consequences of cultural competence in community health were included. The 26 articles selected included nursing (n = 8), health (n = 8), psychology (n = 2), social work (n = 1), mental health (n = 3), medicine (n = 3) and occupational therapy (n = 1). Findings identify cultural openness, awareness, desire, knowledge and sensitivity and encounter as antecedents of cultural competence. Defining attributes are respecting and tailoring care aligned with clients' values, needs, practices and expectations, providing equitable and ethical care, and understanding. Consequences of cultural competence are satisfaction with care, the perception of quality healthcare, better adherence to treatments, effective interaction and improved health outcomes. An interesting finding is that the antecedents and attributes of cultural competence appear to represent a superficial level of understanding, sometimes only manifested through the need for social desirability. What is reported as critical in sustaining competence is the carers' capacity for a higher level of moral reasoning attainable through formal education in cultural and ethics knowledge. Our conceptual analysis incorporates moral reasoning in the definition of cultural competence. Further research to underpin moral reasoning with antecedents, attributes and consequences could enhance its clarity and promote a sustainable enactment of cultural competence.

Objective. To examine the effectiveness of simulated learning modules (SLMs) encompassing EXcellence in Cultural Experiential Learning and Leadership (EXCELL) core competencies in enhancing pharmacy students' professional communication skills. Methods. Students completed three hours of preparatory lectures and eight hours of workshops comprising six SLMs themed around pharmacy practice and pharmacy placements. Each SLM comprised role-plays with actors, facilitation using EXCELL Social Interaction Maps (SIMs), and debriefing. Evaluations of SLMs included quantitative and qualitative survey responses collected before, during and after workshops, and after placements. Facilitators reflected on SLMs as a pedagogic modality. Results. Student feedback was positive about SLMs as an effective learning tool. The majority indicated areas of new learning and found SLMs enhanced their professional skills and confidence. Facilitator feedback was positive, and suggested SLM optimization strategies. Conclusion. Student and teaching team recommendations will inform future curriculum development including the optimization of SLMs in pharmacy education.

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