Table 4 Summary of themes – Challenges in integrating content related to culture or cultural responsiveness

Perceptions of unimportance

Lack of understanding, awareness and/or interest

“I suppose a challenge is the staff designing the program being aware of cultural responsiveness and understanding that and prioritising that in a way they are including it not just in their teaching but their assessment … I suppose it’s an understanding of the educators that’s the first thing” [P3]

Teaching is focused on areas perceived to be important to physiotherapy

“I think there’s a lot of drive to include clinical or biomedical content, I guess non patient-centred aspects in the curriculum, and I guess that comes from the history of physiotherapy and the focus on the body … traditionally there’s been less attention of peoples’ opinions and experience of health, and on population health and social justice …” [P5]

Overcrowded curriculum

“The next challenge is then sort of getting through the processes and trying to embed it within our programs without it being at the expense of other things we need …” [P11]

Difficulty with access and use of resources

Difficult to access and/or find appropriate teaching staff

“I guess a challenge would be finding lecturers with appropriate skills and expertise in the area” [P18]

Difficult with finding and/or using resources

“… there is a lot of demographic or sociological kind of studies about how cultural groups behave or respond but really there hasn’t been a lot of intervention kind of research or trials to look at - if we do this, how does that improve cultural responsiveness? Therefore, it’s almost impossible to teach students how to behave [in a] culturally responsive manner.” [P1]

Challenging to teach

“… internationally there’s very few examples of very strong culturally responsive practice to draw on so it’s some way easy to teach around things like health and equity that you can usually demonstrate examples, but to think through and imagine, and create ways of working that are different but are useful to diverse communities that involve sort of flexibility and attentiveness and a change in clinician behaviour and attitude, I think that probably the teaching staff struggle with that” [P6]

Ensuring appropriate integration

“… I think that a real challenge is working out how to cover it appropriately and where” [P8]

Students’ perception of irrelevance

“I think there’s also the perception of students as well, unfortunately they don’t see the relevance … that’s the case with a number of physiotherapy modalities and techniques, they don’t see the relevance to the social side of things...” [P17]