Creating Culturally Safe Care

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Tailoring nursing education to provide more culturally safe care to Indigenous peoples.
Posted On: May 03, 2024
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(L-R) Dr. Kateryna Metersky, Affiliate Scientist at The Institute for Education Research; Kaveenaa Chandrasekaran, Master of Nursing candidate at the Toronto Metropolitan University; and Suzanne Ezekiel, clinical nurse specialist at Unity Health Toronto and an Indigenous community member who provided advice and input on the study.

To bridge education gaps and foster cultural sensitivity, a study from UHN’s The Institute for Education Research (TIER) explored the perceptions of nursing students on the experiences of Indigenous peoples within Canada’s healthcare system. Their results revealed strategies for tailoring nursing education to ensure more culturally safe and compassionate care. 

Indigenous communities have long faced health inequities marked by a higher burden of illness, inequitable health factors, and premature mortality. Indigenous peoples encounter discrimination every day, including in healthcare settings. 

In 2015, the Truth and Reconciliation Commission of Canada developed 94 calls to action to address the impact of residential schools and promote reconciliation in Canada. This involved urging nursing students to understand Indigenous history and be trained to provide culturally safe care.  

The Canadian Association of Schools of Nursing developed strategies to integrate Indigenous health content into nursing education; however, the effectiveness of these educational initiatives remains largely unknown.  

Dr. Kateryna Metersky, Affiliate Scientist at TIER and a nurse at UHN’s Toronto Western Hospital, led a research team to explore nursing student knowledge and understanding of the experiences of Indigenous peoples within the Canadian health care system and identify how educators can better equip students. 

Fifteen nursing students from a university in Ontario, Canada, discussed and shared reflections on a video from the Aboriginal Peoples Television Network, the first national Indigenous broadcaster in the world, entitled “Indigenous Peoples and the Problems in Health Care”.  

In their reflections, students showed a deep understanding of the complex factors impacting Indigenous health, including racism, historical injustices, and structural barriers to accessing healthcare, particularly those living in remote communities.  

Students also identified strategies to help provide culturally safe care, such as building trust-based relationships, establishing rapport, eliminating unconscious biases, and developing advocacy skills to challenge social inequities within Canada’s complex healthcare system.  

“Examining the educational content of nursing programs is important to assessing the value of education provided and tailoring future curriculum to better address knowledge gaps,” concludes Dr. Metersky. “Future work should be conducted to determine the impact of tailored curriculum on preparing students to become culturally compassionate practitioners.”  

This work was supported by UHN Foundation. 

Metersky K, Chandrasekaran K, Ezekiel S. Undergraduate Nursing Student Reflections on Indigenous Peoples' Experiences With the Canadian Health Care System. Nurs Educ Perspect. 2024 Mar 7. doi: 10.1097/01.NEP.0000000000001255. 


There are complex historical, socioeconomic, and political factors that impact Indigenous peoples’ healthcare experience and access. It is critical that healthcare providers, including nurses, understand these inequities and provide safe and compassionate care.