Cultural Safety
By: Charlene Camillo and Starr McGahey-Albert
Charlene Camillo
Education Collaborator
Charlene Camillo is from the Moose Cree First Nation and of Italian heritage. She is a teacher and coach in the Thames Valley District School Board (TVDSB).
From 2016-2022, Charlene was the Learning Coordinator in TVDSB for First Nations, Métis, and Inuit Education. In this role, she led professional learning for staff and helped to develop various opportunities for Indigenous students. She also created lesson plans and resources for use in classrooms, and shared best practices in bringing Indigenous content into schools.
Charlene taught multiple subjects from 2010-2016 at Saunders Secondary School in London, ON. In 2022, she returned to Saunders and has been teaching History and Indigenous Studies while coaching Girls Basketball and Girls Hockey, and supporting the Indigenous Student Association.
Charlene has been fortunate to work with multiple First Nations as a teacher and a coach. She continues to take feedback and learning from Indigenous students and families to provide opportunities for staff and students to enhance their knowledge of Indigenous experiences.
Starr McGahey-Albert
Collaborating Writer
As educators who have worked to support educators to include more Indigenous content in their classrooms and schools, we recognize that one of the most important aspects of this work is cultural safety. More learning about Indigenous histories and experiences today is needed which involves highlighting the resilience of Indigenous Peoples, and the historical and ongoing harmful impacts of colonialism. This requires staff to reflect on their own learning and understanding, enhance their knowledge of Indigenous experiences from Indigenous Peoples and resources, and provide a safe classroom environment for all students. Although the examples in this blog focus on Indigenous experiences, we recognize that a culturally safe environment applies to all students and any topic that is connected to their identities, experiences, and emotions.
Striving for a culturally safe classroom is essential especially when preparing to bring traumatic and sensitive topics into the classroom. Educators should be aware that some students may experience emotional reactions when learning about topics that have affected their own lives, their family, and/or their communities. Students can also experience strong emotional reactions when learning about the adversity and challenges faced by others. It is impossible to know the full lived experiences and emotions of each student we work with. Before addressing traumatic and sensitive topics in the classroom, teachers need to take the necessary steps prior to the lesson, make a plan on how to prepare and debrief students, and ensure that resources are available to support students both during and after the learning experience.
This blog contains background information on cultural safety and how to work towards a culturally safe learning environment.
What is “cultural safety”?
The concept of cultural safety originated from improving practices when working Indigenous clients in the healthcare system in New Zealand in the 1980s. It is applicable in health care and other systems, and not only when working with Indigenous Peoples or topics connected to Indigenous experiences.
A commonly used definition of cultural safety was provided by Williams in 1999, who defined cultural safety as:
“an environment that is spiritually, socially and emotionally safe, as well as physically safe for people; where there is no assault, challenge or denial of their identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience of learning together” (p.213).
Culturally safe practices include actions which recognize and respect the cultural identities of others, and safely meet their needs, expectations and rights. Alternatively, culturally unsafe practices are those that “diminish, demean or disempower the cultural identity and well-being of an individual” (Nursing Council of New Zealand 2002, p. 9).
How does cultural safety apply to education?
Culturally safe practices include:
- action from educators to promote and respect identities,
- including necessary staff to support learning experiences, and
- taking time to learn about and meet the needs and rights of students.
Culturally unsafe practices:
“diminish, demean or disempower the cultural identity and well-being of an individual” (Nursing Council of New Zealand 2002, p. 9).
As revisions occur to multiple curriculum documents in Ontario to include more Indigenous content, each document contains information about the need for culturally safe learning environments.
It is important to create a learning environment that is respectful and that makes students feel safe and comfortable not only physically, socially, and emotionally but also in terms of their cultural heritage. A culturally safe learning environment is one in which students feel comfortable about expressing their ideas, opinions, and needs and about responding authentically to topics that may be culturally sensitive. Teachers should be aware that some students may experience emotional reactions when learning about issues that have affected their own lives, their family, and/or their community, such as the legacy of the residential school system. Before addressing such topics in the classroom, teachers need to consider how to prepare and debrief students, and they need to ensure that resources are available to support students both inside and outside the classroom.
From:
The example provided in the curriculum document, learning about the legacy of residential schools, is an important example to consider when it comes to cultural safety. Cultural safety is required for many topics, with the lived experiences of all students being the priority. Supporting a positive experience for everyone, Indigenous and non-Indigenous, is emphasized in prior learning from the implementation of cultural safety in health care systems in New Zealand.
Learning from the implementation of cultural safety practices in New Zealand
By 1992, cultural safety became a requirement for nursing and midwifery courses in New Zealand, in response to working towards improving the health outcomes of Indigenous Peoples. The training included supporting nurses’ in personal reflection and dispelling stereotypes.
“Traditionally, nurses were educated not to recognise people’s differences in the provision of nursing care. However, it is now believed that health professionals who operate from assumptions and stereotypical attitudes place the health of the people they care for at risk and seriously impair service delivery” (Papps, E., & Ramsden, I., 1996, p. 493).
The training pushed nurses and midwives to promote cultural safety through education and open-mindedness.
“Cultural safety requires that nurses care for people “regardful” of those things which make them unique. The teaching of cultural safety is designed to challenge students to identify that there are other ways in which people experience life and view the world. The guidelines developed by the Nursing Council of New Zealand for the teaching of cultural safety to nursing and midwifery students makes this clear. Being a member of a culture surrounds each person with a set of activities, values and experiences which are considered to be real and normal. People evaluate and define members of other cultural groups according to their own norms. When one group far outnumbers another, or has the power to impose its own norms and values upon another, a state of serious imbalance which threatens the identity, security and the ease of other cultural groups, thus creating a state of disease.
Within an educational programme, students identify social and personal attitudes, and have an opportunity to examine their own beliefs, values and assumptions about other people. The focus of cultural safety teaching is to educate student nurses and student midwives:
- to examine their own realities and the attitudes they bring to each new person they encounter in their practice;
- to be open minded and flexible in their attitudes toward people who are different from themselves, to whom they offer or deliver service;
- not to blame the victims of historical and social processes for their current plight;
- to produce a workforce of well-educated, self-aware registered nurses and midwives who are culturally safe to practice.” (Papps, E., & Ramsden, I., 1996, p. 493).
Personal reflection, learning, and unlearning, are all part of the process to also help educators work towards providing a culturally safe learning environment.
What is meant by “culture” and “safety” in cultural safety?
Understanding the meanings of “culture” and “safety” for service providers will be needed in order to support culturally safe experiences. Papps & Ramsden (1996) provided definitions with examples to support understanding of cultural safety:
“The term “culture” is used in its broadest sense within the concept of cultural safety and incorporates many elements, such as a particular way of living in the world, attitudes, behaviours, links and relationships with others. The nursing literature in New Zealand does not confine cultural values to the concept of ethnicity.
Cultural values are defined as:
Morals, beliefs, attitudes and standards that derive from a particular cultural group. Culture is not seen as ethno specific, but must include groups from within cultures, e.g. cultures of class, socialisation, sexual orientation, age etc.
The term “safety” is common in relation to the practice of health professionals to refer to whether someone is safe and/or competent in practice. The Nursing Council of New Zealand has clearly stated expectations of safety in nursing and midwifery practice. Safety is defined as “…nursing or midwifery action to protect from danger and/or reduce risk to patient/client/community from hazards to health and wellbeing. It includes regard for the physical, mental, social, spiritual and cultural components of the patient/client and the environment”. Unsafe nursing or midwifery practice on the other hand is defined as “…any action or omission which endangers the wellbeing, demeans the person or disempowers the cultural identity of the patient/client” (p. 493).
Cultural safety includes avoiding harm in experiences together. For educators, this will require getting to know more about each student individually through various classroom activities.
Who does cultural safety apply to?
The concept of cultural safety remains a primary focus when supporting the health of Indigenous Peoples, yet has broadened since 1992 in New Zealand.
Papps & Ramsden (1996) explained that cultural safety…
“has been further developed to include an emphasis on the relationship between nurses, midwives and health service consumers who differ from them by:
- age or generation
- gender
- sexual orientation
- socioeconomic status
- ethnic origin
- religious or spiritual belief
- disability
The inclusion of these categories highlights the use of the term “culture” in its broadest sense. Nurses cannot provide quality, patient focused care if they have unconscious negative attitudes towards patients who are different from them in any of these categories” (p. 496).
Who determines if a service is culturally safe?
Consumers, which could mean clients, students, or customers, are empowered to express if they felt safe with the service provided.
“Cultural safety places an obligation on the nurse or midwife to provide care within the framework of recognizing and respecting the difference of any individual. But it is not the nurse or midwife who determines the issue of safety. It is consumers or patients who decide whether they feel safe with the care that has been given” (Papps & Ramsden, 1996, p 493).
How can educators work towards culturally safe learning environments?
Cultural safety is important for all students. Learning and discussions that can be challenging and/or traumatic may be related to race, gender, sexual orientation, religion, and ongoing colonialism. These topics and more require educators to do work prior, during, and after the learning experience to support a culturally safe learning environment.
Applying cultural safety strategies will require ongoing learning and reflection from staff. This includes examining your own lived experiences and positions, and seeking information to learn more about the identities and lived experiences of the students in your classroom and the topics you will cover in the course.
Learning about student identities and lived experiences should happen throughout a course and through opportunities that are safe for students.
“In a culturally safe learning environment, each learner feels that their unique cultural background is respected and they are free to be themselves without being judged, put on the spot, or asked to speak for all members of their group. Unequal power relations are openly discussed and challenged in a manner that does not make learners feel that they (or groups they belong to) are being put down” (Antoine, A., Mason, R., Mason, R., Palahicky, S. & Rodriguez de France, C., 2018).
For example, the lesson Learning from Indigenous Peoples, includes a personal written reflection and students can share where they have previously learned about Indigenous Peoples. This information is important for educators to gain understanding of some of the past learning experiences and knowledge the students are bringing to the class. This can be an opportunity for students to share individually with their teacher what they are comfortable with disclosing about their own identities and experiences. Often students may share if they are Indigenous and their connections to their communities. For many reasons, there can be less pressure for students to share this information to just the teacher and not the entire class.
The chart below includes further examples of what to do and what not to do when working towards a culturally safe learning environment.
| DO | DO NOT |
|---|---|
| Acknowledge that every student and staff member has their own unique lived experiences. | Do not make assumptions about students or staff based on their identities. |
| Provide multiple opportunities to gain individual input and opinions from students through written responses or individual conversations on various topics. | Engage in class discussions on challenging topics until you have learned more about each individual student. This can help to avoid inaccurate, stereotypical, uninformed, or harmful opinions from entering the classroom space and negatively impacting others |
| Give all students and/or families notice of upcoming traumatic and/or challenging content and gather input from students prior to the learning in class. Example for secondary students Example for elementary students (forthcoming) | Do not move forward with teaching and learning about traumatic and sensitive topics until you have provided a summary of information to students and/or families about the upcoming learning, the opportunity for students to individually ask questions and/or seek clarification prior to engaging with the topics, and the opportunity to consent to the learning or make alternative plans if needed. |
| Remind students that the content will be shared during the middle of the school week to ensure they are prepared and supports can be in place in the day after the content is shared. | Do not provide traumatic and/or challenging content on the first or last day of the school week. |
| Check in with school support staff so they can be part of the support plan offered to students. | Do not proceed with teaching about traumatic and sensitive content without checking in with school support staff as they may be aware of students who may need support and/or may not be good timing for the student(s) to take part. |
| Proceed with teaching and learning after gaining feedback from each student and support staff. | Do not move forward without a plan created with support staff and clear communication to students and/or families about the support plan. |
| Consider what topics should be covered and in what settings. | Do not teach about traumatic content in virtual-only settings. |
Other strategies to consider
- Reflecting on self, one’s own culture and profession, power imbalances, attitudes and beliefs about ‘the other’
- Clear, value free, open and respectful communication
- Developing trust
- Avoiding and recognizing stereotypical barriers
Additional Resources
Webinar: Cultural Safety in the Classroom – Addressing Anti-Indigenous Racism in Education Settings
References
Antoine, A., Mason, R., Mason, R., Palahicky, S. & Rodriguez de France, C. (2018). Pulling Together: A Guide for Curriculum Developers. Victoria, BC: BCcampus. Retrieved from https://opentextbc.ca/indigenizationcurriculumdevelopers/
Nursing Council of New Zealand. (2002). Guidelines for cultural safety, the treaty of Waitangi, and Maori health in nursing and midwifery education and practice. Wellington: Nursing Council of New Zealand.
Papps, E., & Ramsden, I. (1996). Cultural Safety in Nursing: The new zealand experience. International Journal for Quality in Health Care, 8(5), 491–497. https://doi.org/10.1093/intqhc/8.5.491
Rodriguez de France, C. (2018). Pulling Together: A Guide for Curriculum Developers. Victoria, BC: BCcampus. Retrieved from https://opentextbc.ca/indigenizationcurriculumdevelopers/
Williams, R. (1999). Cultural safety – what does it mean for our work practice? Australian and New Zealand Journal of Public Health, 23(2), 213-214.