4 Lifelong and Relational Interculturality: Cultural Safety and Cultural Humility
Christina Page
Learning Objectives
By the time you have completed the content in this chapter, you should be equipped to:
- Define cultural safety and cultural humility
- Describe how these models support lifelong intercultural learning
- Explain why it is important to focus on relational aspects and the experience of those we interact with when evaluating intercultural effectiveness
Cultural Safety: The Impact of our Actions
The concept of cultural safety emerged from New Zealand and was first developed from considerations about unequal healthcare outcomes experienced by Māori people. Cultural safety has since expanded to various sectors including education, community services, and workplace settings (Williams, 1999). In its development, cultural safety is grounded in questions about why some communities, such as Indigenous peoples, have unequal and often negative outcomes when engaging with health care, education, and other social structures.
Cultural safety proposes that simply knowing information about culture is not enough to ensure effective interculturality. Rather, when we are engaging in intercultural relationships, cultural safety asks us to think critically about inequalities, and how they are rooted in colonization and other unjust structures. When we engage in a process of learning to practice in culturally safe ways, we need to engage in self-reflection on our own cultural identities, and how social and cultural contexts shape the systems we are a part of (Ward et al., 2016).
Unlike cultural awareness or sensitivity, which are merely starting points, cultural safety represents an outcome determined by those receiving the service, focusing on whether they feel safe, respected, and able to express their cultural identity without judgment (Ward et al., 2016).
It is important to recognize that the cultural safety framework was developed in an Indigenous context and so is particularly relevant when we consider how we act in a good way in our relationship with Indigenous peoples.
Cultural Humility: A Framework for Intercultural Understanding
Cultural humility, introduced by Tervalon and Murray-García (1998), provides university students with a valuable approach to understanding intercultural development as a relational process. Cultural humility is “a process of openness, self-awareness, being egoless, and incorporating self-reflection and critique after willingly interacting with diverse individuals” (Foronda et al., 2016, p. 213). Rather than positioning cultural understanding as a skill or competency that we achieve, cultural humility frames it as an ongoing developmental journey. The idea of cultural humility aligns well with the idea of interculturality and its relational focus.
Cultural humility consists of several interconnected elements. Self-reflection requires examining one’s cultural background and inherent biases. Supportive dialogue involves engaging in meaningful conversations with individuals from different cultural backgrounds. Openness necessitates a willingness to acknowledge knowledge limitations and learn from others. When these elements work together, they foster environments characterized by mutual respect, empowerment, and optimal learning.
Table Alt-text: Model of Cultural Humility. Cultural humility includes self-reflection and critique, supportive dialogue, and openness. It results in respect, empowerment, and optimal learning. Cultural humility acknowledges diversity, while also acknowledging power relationships in the broader society and in professional relationships.
Although cultural humility discussions frequently appear in social work, healthcare, and counselling psychology literature, the approach is beneficial in any field where we interact with other people. The model emphasizes personal development through cultivating openness and genuine curiosity about others’ lived experiences. It highlights self-reflection as a crucial strategy for integrating experiences in ways that promote authentic growth. Furthermore, it emphasizes that interculturality requires dialogue and conversation within relationships. In other words, those who emphasize cultural humility are likely to believe that understanding cultural dimensions is not enough for effective intercultural relationships. Those who practice cultural humility would be cautious about making assumptions based on someone’s assumed national culture, and instead would prefer to ask questions and find out about the individual cultural identities of the person they are relating with.
A significant strength of cultural humility lies in its acknowledgment of power relationships that shape intercultural business encounters. These power dynamics are present both in societal inequalities between dominant and non-dominant cultural groups and in professional relationships within organizations. In corporate settings, cultural humility encourages examination of how leadership roles create power imbalances with employees, which inevitably influence workplace interactions and team dynamics. Leaders in organizations benefit from understanding how power operates in cross-cultural contexts. This knowledge supports the creation of psychologically safe environments where employees feel valued and empowered to contribute their authentic insights.
For university students developing professional identities, cultural humility offers a thoughtful framework that balances self-awareness with genuine openness to others’ experiences, creating a foundation for meaningful intercultural engagement throughout their academic and professional careers.
One critique of cultural humility is whether it should apply to those who are not from the dominant culture. For example, some who question cultural humility ask whether it is right to ask someone who experiences marginalization because of their race, disability, or other aspect of their identity to practice humility in relationships with others. These critics would state that cultural humility applies mostly to those with more power in an intercultural interaction.
Comparison of Intercultural Competence, Cultural Safety, and Cultural Humility
When we think about cultural humility and cultural safety, it is helpful to think about how these approaches contrast with each other, and with competence-based models. The chart below compares cultural competence, cultural humility and cultural safety.
| Aspect | Intercultural Competence | Cultural Safety | Cultural Humility |
|---|---|---|---|
| Definition | A range of cognitive, affective, behavioural, and linguistic skills that lead to effective and appropriate communication with people of other cultures (Deardorff, 2006) | An outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in systems; determined by the person receiving care (Ward et al., 2016) | A process of self-reflection to understand personal and systemic biases, and to develop respectful relationships based on mutual trust (Tervalon & Murray-García, 1998) |
| Primary Focus | Knowledge, skills, and behaviours to communicate effectively across cultures | Patient/client experience and feelings of safety; environment free of racism and discrimination | Self-reflection, lifelong learning, and acknowledging limitations of one’s cultural knowledge |
| Who Determines Success | Generally determined by the provider’s ability to demonstrate specific skills and knowledge | The recipient of services determines whether they feel culturally safe | Ongoing process without a specific endpoint; focuses on the journey rather than achievement |
| Power Dynamics | May acknowledge but less emphasis on systemic power differentials | Explicitly addresses power imbalances in healthcare and other systems | Focuses on dismantling power imbalances through self-awareness and humility |
| Learning Approach | Skills-based approach that can be taught and measured | Focuses on creating environments where people feel respected and empowered | Emphasizes lifelong learning and being a humble learner about others’ experiences |
| Historical Context | Developed from cross-cultural education and communication studies | Developed in New Zealand nursing education to address disparities in care experienced by Māori people | Emerged as a critique of the “mastery” implied in competence approaches |
| Key Components | Mindfulness, cognitive flexibility, tolerance for ambiguity, behavioural flexibility, cross-cultural empathy | Protection of cultural identity, focus on differences, understanding power dynamics in services | Self-reflection, addressing biases, lifelong learning, respectful engagement, acknowledging oneself as a learner |
Reflection Point
Review the comparison chart above. Consider how each perspective informs your understanding of your intercultural development.
- How does cultural competence inform your understanding of interculturality?
- How does the idea of cultural humility shape your understanding of how you show up in intercultural relationships?
- How does cultural safety help you to understand the limits of cultural competence and cultural humility?
Case Study
Review the case study below. What practices do you think illustrate effective cultural humility or cultural safety?
A Journey Toward Cultural Safety: Amir’s Story
The Internship
Amir, a final-year business student, began an internship at Horizon Community Development, a non-profit serving diverse immigrant communities. His first assignment was developing promotional materials for a financial literacy program aimed at recently arrived refugee families. The South Sudanese community had not been engaging with the existing approach—sleek brochures featuring stock images of individuals reviewing finances alone.
Rather than immediately redesigning the materials based on his own assumptions, Amir asked Sophia, the Marketing Director, if he could first meet with members of the South Sudanese community. “That’s not our usual process,” Sophia said. Amir respectfully pushed back, believing community involvement would lead to more effective results.
Building Relationships
Sophia arranged for Amir to meet with Nyamal, a respected figure in the South Sudanese community. Before discussing the project, he took time to listen to her stories about her community’s journey, challenges, and aspirations. “Most organizations just want to tell us what they think we need,” Nyamal said. “They rarely take the time to understand who we are.”
When they finally discussed the program, Nyamal explained several cultural barriers: financial decisions in her community are communal, not individual, and many members are more comfortable with oral communication than written materials. Amir asked thoughtful follow-up questions rather than making assumptions, and Nyamal noted he was the first person from Horizon to ask about their own financial traditions rather than assuming they had none.
Over the following weeks, Amir worked with Nyamal and other community members to redesign the promotional approach. They created visuals featuring families and community groups, incorporated storytelling elements, and arranged for community elders to introduce the program at cultural gatherings. When Sophia questioned the deviation from brand guidelines, Amir explained that the changes were grounded directly in community input about their values and communication preferences.
Reflection and Outcome
At a community feedback session, one participant said: “This is the first time an organization has shown our families accurately. You’ve represented our community values rather than just translating your materials into our language.”
In his internship journal, Amir reflected: “I learned that cultural safety isn’t about my own ideas of what should work. It’s important for community members feel respected and accurately represented in our communications.”
Two months later, attendance from the South Sudanese community increased by 300%. “We’ve never seen this level of engagement before,” Sophia acknowledged. “I think we need to reconsider how we develop materials for all our diverse communities.” Amir recognized that cultural safety was not a one-time project, but an ongoing process of listening and acting based on relational learning.
Conclusion
Cultural humility and cultural safety both work to help us understand that interculturality extends beyond self-development. We cannot consider ourselves to be interculturally effective without considering both our relationships with others and the social context we are working within. These models invite us to be particularly aware of when institutional power imbalances and historical inequalities influence our relationships.
Chapter References
Deardorff, D. K. (2006). Identification and assessment of intercultural competence as a student outcome of internationalization. Journal of Studies in International Education, 10(3), 241–266. https://doi.org/10.1177/1028315306287002
Foronda, C., Baptiste, D.-L., Reinholdt, M. M., & Ousman, K. (2016). Cultural humility: A concept analysis. Journal of Transcultural Nursing, 27(3), 210–217. https://doi.org/10.1177/1043659615592677
Tervalon, M., & Murray-García, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117–125. https://doi.org/10.1353/hpu.2010.0233
Ward, C., Branch, C., & Fridkin, A. (2016). What is Indigenous cultural safety—And why should I care about it? Visions Journal, 11(4), 29. https://www.heretohelp.bc.ca/visions/indigenous-people-vol11/what-indigenous-cultural-safety-and-why-should-i-care-about-it
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. https://doi.org/10.1111/j.1467-842X.1999.tb01240.x
Attribution Statement
AI Statements:
The comparison chart was adapted from content generated by Perplexity AI. (2025, May 21). Comparing cultural approaches in healthcare and education [AI-generated response]. https://www.perplexity.ai/
The case study was adapted from content generated by Perplexity AI. (2025, May 21). A journey toward cultural safety: Amir’s story [AI-generated case study]. https://www.perplexity.ai/
An outcome of intercultural practice, based on respectful engagement that recognizes and works to address power imbalances. Whether cultural safety has been achieved is determined by the person receiving the service - based on whether they feel safe, respected, and able to express their cultural identity without judgment.
A process of openness, self-awareness, and self-reflection practiced when interacting with diverse individuals. Cultural humility frames intercultural understanding as an ongoing developmental journey rather than a competency to be achieved. Its elements include self-reflection, supportive dialogue, and openness.
A component of cultural humility; engaging in meaningful, open conversations with individuals from different cultural backgrounds to promote mutual learning and respect.
