Factors influencing intercultural doctor–patient communication: A realist review

• Intercultural communication is comparable with patient-centered communication.
• The context and mechanisms of intercultural communication influence outcome.
• Mechanisms for training are communication objectives, core and specific communication skills.
• Realist review uses an explanatory focus to learn the interplay of communication.

ObjectiveDue to migration, doctors see patients from different ethnic backgrounds. This causes challenges for the communication. To develop training programs for doctors in intercultural communication (ICC), it is important to know which barriers and facilitators determine the quality of ICC. This study aimed to provide an overview of the literature and to explore how ICC works.MethodsA systematic search was performed to find literature published before October 2012. The search terms used were cultural, communication, healthcare worker. A realist synthesis allowed us to use an explanatory focus to understand the interplay of communication.ResultsIn total, 145 articles met the inclusion criteria. We found ICC challenges due to language, cultural and social differences, and doctors’ assumptions. The mechanisms were described as factors influencing the process of ICC and divided into objectives, core skills and specific skills. The results were synthesized in a framework for the development of training.ConclusionThe quality of ICC is influenced by the context and by the mechanisms. These mechanisms translate into practical points for training, which seem to have similarities with patient-centered communication.Practice implicationsTraining for improving ICC can be developed as an extension of the existing training for patient-centered communication.