Aboriginal Cultural Safety Initiative

Recipient of the Canadian Race Relations Foundation 2012 Best Practices Award of Excellence

Toronto Star interview with Dr. Shah on December 12, 2012     Video Link

Local doctor uses golden years to advocate for native health issues

Ignored No Longer

Help aboriginal patients through a program to build doctors’ understanding and empathy

Aboriginal people in Toronto may face premature death: study (CBC)

The Aboriginal Cultural Safety Initiative: An innovative health sciences curriculum in Ontario colleges and universities Credit to Publisher: AHRNetS, c/o CAHR, University of Victoria


Ontario has the highest number of Aboriginal peoples in Canada. Of the total 1,172,785 persons of Aboriginal ancestry in Canada in 2006, 242,490 (21.0%) live in Ontario. Almost 78% of Aboriginal people reside in off-reserve (rural, non-reserve and urban) communities. The Aboriginal population has generally noted they have experienced culturally insensitive healthcare they receive and have noted that at times they also meet with subtle and overt racism.  One of the proposed solutions is to train all front line health care professionals in the area of Aboriginal cultural safety. Currently there are approximately 57,000 students enrolled in health related post-secondary  programmes in Ontario. The results of our initial environmental scan indicated that except for medical schools, a few nursing schools and schools with Aboriginal-specific curricula, all other programmes had little to no Aboriginal content in their curriculum. It is our belief that in order for front line health care and social services workers to provide culturally competent care for Aboriginal clients, students require exposure to Aboriginal cultural sensitivity training.

Cultural Safety

Cultural safety was first introduced by Irihapeti Ramsden, a Maori nurse in Aotearoa (New Zealand), in 1990. Her description of the term explained that cultural safety moves beyond cultural sensitivity and cultural competence (i.e. having knowledge about the culture of “the other”) in that it analyzes power imbalances in society, as well as political ideals of self-determination and de-colonization.

Cultural safety incorporates the following:

  • Cultural awareness, the acknowledgement of difference;
  • Cultural sensitivity, the recognition of the importance of respecting difference; and
  • Cultural competence, which focuses on the skills, knowledge, and attitudes of practitioners
  • Cultural safety involves self-reflection and an understanding that cultural values and norms of the client may be different due to unique socio-political histories.
  • Self-reflection leads to empathy, the capability to share another being's emotions and feelings, which in turms improves the therapeutic encounter with clients and their communities, leading to better health outcomes.
  • Empathy could also lead to advocacy and social justice work  on behalf of clients and their communities

Cultural Safety Initiative    

Video of  The Aboriginal Cultural Safety Initiative   youtube

 We used the "First Nations, Inuit and Metis Health Core Competencies: A curriculum framework for continuing medical education"  document published by the Indigenous Physicians Association of Canada as a framework from which we developed a generic core competency for all health sciences students in the area of Aboriginal cultural safety with the help of  Aboriginal experts in academia. Topics for the cultural safety module include Indigenous worldviews, impacts of colonization (Indian Act, Residential School System), health determinants and health outcomes, gaps in mainstream health and social services for Aboriginal service users, and concepts of health and healing in an Aboriginal context. Due to time constraints within post-secondary curricula as identified in our Environmental Scan results, we have developed a two to three hour classroom session for students touching on these major topics.

The Logo Depicts:

  • The medicine wheel with the four quadrants represents wholistic health
  • The moccasin represents “empathy”, the experience of walking in another’s shoes
  • The sun rays pointing forward denote progress, a new day
  • The four human figures represents all peoples joining hands and walking forward together

Course Objectives:

1. Learners will gain a better understanding of the historical, political and cultural issues that impact the health of Aboriginal peoples in Canada.
2. Learners will understand the connection between the historical and current government practices and policies towards First Nations, Inuit and Métis Peoples and the related impacts on their social determinants of health, access to health services and intergenerational health outcomes.
3. Learners will understand Aboriginal concepts of health and healing.
4. Learners will, through a process of self-reflection, identify, acknowledge and analyze their own cultural values or considered emotional responses to the many diverse histories, cultures, world views, values, and contemporary events relating to First Nations, Inuit and/or Métis people. (Source: Indigenous Physicians Association of Canada)

The information will be presented in three modules.

1. Colonial and Post-Colonial Policies youtube

    Presentation in pdf format, Part1

2. Health Determinants and Health Statusyoutube

    Presentation in pdf formart, Part2

3. Aboriginal Concept of Health and Healing youtube

    Presentation in pdf format, Part3

Environmental Scan: Preparing Ontario's Health Sciences Students for Aboriginal Cultural Safety: Download Executive Summary-Environmental Scan

The grant for this program was provided by the Trillium Foundation and Ontario Ministry of Training, Colleges and Universities.

Dr. Chandrakant Shah,
Programme Director Anishnawbe Health Toronto 
225 Queen Street East Toronto, ON  M5A 1S4 
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