Introduction: health professionals must address culture and diversity in practice. Clinical assessment and treatment have been linked to race and ethnicity (Schitai, 2004, Smedley et al., 2003). Research has addressed culture and diversity in traditional learning environments (Ladson-Billings, 1995*Grant and Sleeter, 2006), yet, little exists related to virtual communities. This is troubling because virtual environments are increasingly being used as platforms for indoctrination, communication, and assessment for clinical education. Theoretical framework: virtual communities encourage participants to try on different identities (Gee, 2003), and reflect on the consequences of their decisions while wearing them. This paper introduces a new framework: the ecology of culturally competent educational design, providing a launching point for development and evaluation of cultural competence in virtual worlds. Conclusion: virtual worlds provide a useful and safe medium for integration of cultural competence training in clinical education, which is paramount because it influences patient diagnosis and outcome. © 2011 Inderscience Enterprises Ltd.
