Review objectives

The objectives of this scoping review are: (1) To identify and describe the methods, interventions, and approaches used to incorporate EDI principles into rehabilitation healthcare education; (2) To evaluate the impact of these EDI programs on learners’ outcomes, including cultural competence, student attitudes, and professional practice.

Our definition of EDI encompasses strategies aimed at reducing disparities, fostering inclusive learning environments, and addressing systemic barriers in healthcare education. Additionally, “rehabilitation education” refers broadly to training and curricula designed for healthcare professionals in fields such as physiotherapy, occupational therapy, and speStakeholder Involvementech-language pathology, among others.

Eligibility criteria

The eligibility criteria for inclusion in this review will follow the Population, Concept, and Context (PCC) framework outlined by JBI [21]. Studies will be included based on the following criteria:

Information sources

The comprehensive search strategy will be developed by a health sciences librarian (CDC) and the research team, with input from rehabilitation experts. The search strategy will be first developed in Medline and validated by retrieving a key set of relevant studies and peer-reviewed using the PRESS strategy [22]. Searches will not be limited by a time period. Keywords will include Equity, Diversity, Inclusion, Cultural Competence, Rehabilitation Education, Healthcare Education, Curriculum Development, Cultural Sensitivity, Bias in Education, Inclusive Teaching, and specific rehabilitation professions such as Physiotherapy Education, Occupational Therapy Education, Speech-Language Pathology Education. Boolean operators (AND, OR) will combine these terms. The search will be limited to studies published in English, but no date restrictions will be applied. The MEDLINE search strategy will be translated into EMBASE, PubMed, CINAHL, ERIC, Scopus, and PsycINFO. Reference lists of included studies will be searched for citations. We will also conduct a hand search of key journals and publications focusing on rehabilitation education and EDI, such as Disability and Rehabilitation, Journal of Rehabilitation Research and Development, Journal of Allied Health, and Medical Education.

We will conduct a comprehensive search of grey literature to uncover non-indexed sources, such as dissertations, government reports, conference materials, practice guidelines, and educational resources. This search will utilize databases like Open Grey, Conference Proceedings Index, ProQuest Dissertations and Theses, and Google. Given resource limitations, the grey literature search will be restricted to Canada and the United States to maintain feasibility. This geographic focus will allow for a more efficient allocation of resources, ensuring a thorough review within these regions.

We will collect and store the bibliographic details of all included sources using EndNote [23]. After removing duplicates, the references will be imported into Covidence for further processing without any limitations on language, date, or study type [24].

Study selection

The study selection process will follow the PRISMA-Scoping Review Extension guidelines (PRISMA-SCr) [25]. A two-step screening process will be employed. Two reviewers will independently assess the titles and abstracts according to the selection criteria, categorizing them as ‘include,’ ‘exclude,’ or ‘uncertain.’ Any disagreements will be addressed through discussion between the reviewers, with a third reviewer consulted if consensus cannot be reached. For studies marked as ‘included’ or ‘maybe,’ full-text articles will be retrieved and reviewed independently in duplicate to confirm eligibility. The same two independent reviewers will review full-text articles of potentially eligible studies. Studies that meet the inclusion criteria will be retained for data extraction. If there is disagreement at this stage, the third reviewer (MTH) will adjudicate. Throughout all phases inter-rater reliability will be measured using Cohen’s kappa [26].

As with the academic literature, two independent reviewers will assess grey literature sources, and inter-rater reliability will be measured using Cohen’s kappa [26].

Data extraction

Two reviewers will independently review and chart all included studies using a pilot-tested data abstraction form. Charting will involve organizing, categorizing, and interpreting the data based on key themes and issues. A pilot test will be conducted on approximately four articles to ensure consistency and refine the data abstraction process. Any necessary adjustments will be made and shared with the team before extracting data from the remaining articles.

The following data will be extracted when available (subject to change depending on the included studies): study citation, publication type (published or unpublished), study design (e.g., quantitative, qualitative, mixed methods), study context (e.g., location, healthcare setting), intervention details (e.g., goal-setting process, EDI dimensions addressed, outcomes), and the educational context (e.g., undergraduate, graduate, clinical training). Discrepancies in data extraction will be resolved through discussion, and in case of missing data or uncertainties, the primary authors will be contacted for clarification. However, in line with the scoping review methodology, we expect the data charting process to be iterative, evolving based on the literature identified [27]. A study quality assessment or meta-analysis of quantitative results will not be performed, as these are not within the scope or objectives of this review. Instead, all included studies will be synthesized.

To enhance the rigor and generalizability of our findings, we will apply the Mixed Methods Appraisal Tool (MMAT) to assess the quality of included studies, particularly those employing mixed-methods approaches [28]. This tool will allow for a systematic evaluation of methodological quality across qualitative, quantitative, and mixed-methods studies, strengthening the reliability of our synthesis [28].

Data analysis and synthesis

A narrative synthesis approach will be employed to analyze the extracted data, providing a detailed overview of the methods, strategies, and interventions identified across the studies. This synthesis will primarily summarize the key findings related to integrating EDI practices into rehabilitation education. It will focus on how these practices are applied within educational settings and their impact on learner outcomes. Given the nature of scoping reviews, a formal quality assessment of the included studies will not be conducted [27]. However, a brief commentary on the methodological rigor of the included studies will be provided, noting any potential limitations or biases that may have affected the interpretation of findings. Through a systematic review of the literature, we will identify recurring themes and patterns in implementing EDI strategies, noting the various ways these interventions are designed and executed.

The narrative synthesis will also highlight variations in approaches, evaluating how different methods contribute to the diverse outcomes observed across studies. This process will allow for an exploration of the contextual factors—such as the setting, participant demographics, and cultural contexts—that may influence the effectiveness of EDI interventions. A thematic analysis will be conducted to categorize and critically analyze the interventions, identifying the key components of each approach and assessing their reported effectiveness.

Where feasible, the results will be grouped and analyzed according to specific types of interventions, such as curriculum-based reforms, experiential learning opportunities, and educator training programs. This categorization will enable us to better understand how different EDI strategies contribute to various educational outcomes, including cultural competence improvements, student attitude shifts, and professional behavior changes. In addition to qualitative synthesis, we will provide frequency counts for each type of intervention and outcome, offering a clearer view of the prevalence and commonality of different EDI practices across the studies. By drawing connections between intervention types and their associated impacts and documenting the frequency with which each approach is applied, this analysis will provide a clearer understanding of which approaches are most effective in integrating EDI principles into rehabilitation education, and offer guidance for future educational practices in this field.

Stakeholder involvement

In our study, we are adopting an integrated knowledge translation approach by actively engaging knowledge users throughout all stages of the research process [29]. Our team includes two key knowledge users who assisted with the research objectives and study methodology. However, as the review continues, their involvement will ensure that our findings are aligned with the needs of rehabilitation professionals and policymakers, and they will offer valuable input at various stages, from suggesting additional information sources to leading knowledge translation activities at the end of the study. In addition to involving our core knowledge users, we will extend our consultation to other rehabilitation educators and practitioners to ensure broad perspectives are considered. We will also recruit additional shareholders, including rehabilitation educators, students, and patient partners, to be consulted to ensure the relevance and applicability of the findings. Input from stakeholders will be sought during the interpretation phase to inform the implications of the review’s findings for practice, policy, and future research directions. This collaborative effort will help us refine our results and enhance the relevance of the research.

Initially, we will reach out to rehabilitation educators, students, and patient partners through targeted recruitment strategies, such as leveraging professional networks, academic institutions, and patient advocacy groups. To engage potential participants, we will use email invitations, social media platforms, and direct outreach at relevant conferences or events. Our recruitment materials will clearly outline the purpose of the study, the expected time commitment, and the benefits of involvement.

Once recruited, stakeholders will be engaged through a series of virtual and in-person meetings, scheduled throughout the study. These meetings will provide an opportunity for stakeholders to review key findings, ask questions, and provide feedback. We will ensure that the meetings are structured to facilitate meaningful dialogue, with clear agendas, and will offer flexible scheduling to accommodate diverse availability. Stakeholders will also have the option to participate in smaller focus groups or one-on-one consultations, depending on the review stage. Regular check-ins will be scheduled at key milestones of the study, particularly during the data interpretation phase, to ensure ongoing engagement and to gather their insights on the implications of the findings for practice, policy, and future research directions. While the community of practice will provide input on knowledge dissemination strategies, we acknowledge the importance of ensuring methodological replicability. Therefore, stakeholder engagement will not be used to introduce new data sources beyond those identified through our systematic search strategy. Instead, their role will focus on refining interpretations and ensuring that findings are presented in ways that maximize impact and applicability for rehabilitation education stakeholders.

In addition to meetings, we will use online collaboration tools (e.g., shared documents and surveys) to gather input asynchronously, providing stakeholders with opportunities to contribute in a manner that best suits their schedules. This multi-method approach will ensure continuous engagement and a thorough understanding of the findings from multiple perspectives.

Ethics and dissemination

Ethical approval is not required since this scoping review involves the analysis of existing literature and does not involve direct interaction with human participants. Stakeholder involvement in this study is limited to consultation on knowledge dissemination strategies and interpretation of findings, rather than participation in data collection or research activities. As such, this engagement does not meet the threshold for requiring ethics approval. The scoping review results will be disseminated through academic journals and presentations at conferences (e.g., The International Conference on Aging, Innovation & Rehabilitation). A summary of the findings will also be shared with stakeholders, including educators and rehabilitation professionals, to inform future training practices and improve EDI integration in rehabilitation education.

The scoping review is expected to take approximately six-twelve months from the initial search to final report submission.

Limitations

Several limitations must be considered in this scoping review protocol. First, the focus on gray literature conducted in Canada and the United States may limit the generalizability of the findings to other regions where rehabilitation education and healthcare practices may differ. Additionally, relying on English-language publications and excluding non-peer-reviewed sources outside these countries could introduce a bias, particularly in areas with differing educational and healthcare systems. Another limitation is the heterogeneity of the studies included in this review. The inclusion of a wide variety of study designs, such as qualitative, quantitative, and mixed-methods approaches, may make it challenging to compare outcomes across interventions. Furthermore, the broad range of EDI interventions and measured learner outcomes may complicate the findings’ synthesis. We acknowledge the limitations of using policy documents and reports that may not explicitly assess the impacts of DEI interventions within research environments. However, these sources provide valuable contextual information on broader structural and policy-level influences that shape inclusive rehabilitation education. To mitigate potential biases and confounding variables, we will critically assess these documents using established frameworks for evaluating policy impact and evidence quality.