Embedding Cultural Safety in General Practice Training: A Community-Informed Educational Framework

Cultural safety is a core expectation of contemporary general practice and an essential component of high-quality healthcare for Aboriginal and Torres Strait Islander peoples. Defined by the Australian Health Practitioner Regulation Agency (Ahpra) as an ongoing, reflective practice that addresses systemic racism, recognizes power imbalances, and remains determined by the patient, cultural safety has historically been challenging to operationalise within clinical education and trainee assessment. Traditional educational tools predominantly focus on observable behaviors and technical competence, offering limited capacity to evaluate relational trust, reflexivity, and awareness of power dynamics.

To address this implementation barrier, researchers conducted a multi-phase qualitative and consensus-development study across Australian general practice settings to construct a community-informed model. Methodology incorporated interviews with general practitioners (GPs), GP registrars, and Aboriginal and Torres Strait Islander participants, alongside a modified nominal group technique incorporating yarning and a modified eDelphi process involving Aboriginal and Torres Strait Islander health, education, and community leadership experts.

The synthesised framework articulates core knowledge domains, practising behaviours, and clinical skills aligned with the Ahpra definition of cultural safety. It identifies specific components that can be supported and evaluated during GP supervision and assessment while emphasizing the central role of patient perspectives. The findings offer practical guidance for training organisations, supervisors, and registrars to move beyond procedural or checklist-based methods toward relational, patient-determined care.