Process evaluation of a diversity training program: The value of a mixed method strategy

Patients’ health and health needs are influenced by categories of difference like sex, gender, ethnic origin and socioeconomic status (SES). To enhance awareness of this diversity among patients and to provide holistic care for them, health professionals should first be aware of the relation between dimensions of diversity and patients’ health and health demands. This paper presents a formative process evaluation of a diversity sensitivity training programme for healthcare professionals. The training was implemented in three healthcare settings (mental healthcare, nursing home and hospital care). Mixed methods were used to monitor the implementation of the training and its effects after three years. Findings demonstrate that the training stimulated participants’ awareness, knowledge and critical attitudes towards diversity. Their motivation and willingness to take action regarding diversity was also enhanced. Yet these developments were less apparent among nursing home participants who felt less satisfied and did not develop a critical perspective on this issue. Qualitative data were helpful to explain differences between the settings. By means of the combination of quantitative and qualitative data, we can conclude that individual learning was not enough to guarantee a sensitive approach to diversity at the organizational level.

► A large set of methods and instruments can provide various sorts of data and in complementary and more comprehensive results. It is, the combination of qualitative and quantitative data (and not just the accumulation) that has shed more light on diversity.
► The range of potential outcomes of diversity training programmes will be limited if these programmes take place outside the workplace and does not take into account the structural barriers to implementing diversity in healthcare settings.
► Transformation in healthcare can be facilitated if diversity is approached as a dynamic and reflexive process on the core values and normative orientations that guide our healthcare practice in all its facets ranging from the composition of the staff to how we approach immigrant patients so that they feel welcome and empowered.
► The responsibility for the implementation of a complex concept like diversity cannot and should not be placed upon the shoulders of those with the lowest degree of education.
► Implementing diversity sensitive care is first of all the responsibility of highly qualified professionals, including management and staff.