Digital Equity in Healthcare Education: A Systematic Review of Access Frameworks and Interventions for Underrepresented Learners in Clinical Training

Digital tools now sit at the centre of clinical education, yet whether they reach all learners equally is unclear, particularly for those from underrepresented backgrounds. This systematic review identified and synthesised peer-reviewed and preprint literature on digital access, equity, and inclusion in the education of health professions learners published between 2014 and 2024. A single-reviewer structured search of bibliographic sources, reported following PRISMA 2020, identified 34 records, of which 33 were screened after duplicate removal and 22 met the inclusion criteria. The included studies comprised existing systematic and scoping reviews, conceptual frameworks, and a small number of primary evaluations including pilots, curriculum assessments, and student-led service-learning initiatives. Three findings emerged. First, the literature has converged on a multidimensional understanding of digital access, extending beyond connectivity to encompass affordability, adequacy, digital literacy, and cultural acceptability, although purpose-built frameworks for learners remain largely adapted from patient-facing models. Second, concrete educational interventions can teach and assess digital and telehealth competencies, with measurable short-term gains, but almost none disaggregate outcomes by learner background or include controlled comparison, so they cannot demonstrate reduced disparity for underrepresented learners specifically. Third, the evidence base is dominated by reviews and conceptual work, concentrated in high-income settings, and weak in direct learner-level measurement. The collective evidence supports the conclusion that the field possesses a mature conceptual vocabulary but lacks the comparative, learner-focused outcome studies required to establish whether its frameworks and interventions improve equity. Priorities are validated learner-level access measures, disaggregated reporting, and comparison-based evaluation designs. Given the small number of included primary studies and single-reviewer screening, these conclusions are interpreted cautiously.