Why Cultural Safety Training Isn’t Working (And How to Build Trust That Sticks)
If cultural safety is on your radar but still feels hard to define—or even harder to implement—this article helps you see what’s getting in the way. Drawing on recent cross-sector research, it maps the patterns that separate surface-level efforts from systems that actually build trust. Whether you're facing a mandate or just trying to lead better, you'll walk away clearer on what makes cultural safety work (and where most organizations miss the mark).
Summary
This article pulls from recent research across healthcare, education, policy, and organizational studies to clarify what cultural safety actually looks like in workplace settings. It distinguishes cultural safety from cultural competence and psychological safety, emphasizing its roots in power redistribution and structural accountability. Key findings include: (1) cultural safety must be defined by those most impacted, not by dominant group perceptions; (2) training without system change often leads to drift or backlash; (3) invisibilized norms—particularly whiteness—sustain harm when left unnamed; and (4) meaningful safety is built through organizational design, not individual sentiment. Drawing on studies across Australia, Canada, New Zealand, Ireland, and the U.S., this article highlights effective micro-strategies and infrastructure models that support durable change. It closes with a core reminder: cultural safety isn’t a mindset—it’s a design choice.
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Intro
Despite its growing visibility, there’s little consensus on what cultural safety actually requires in day-to-day organizational practice. It’s often conflated with cultural competence or psychological safety, but the research tells a different story. Cultural safety is not a sentiment or a skillset—it’s a system-level condition defined by the people most impacted by inequity, and enabled through organizational accountability, not individual good will (Miller, Morda, & Sonn, 2025; Kelly et al., 2024).
This article distills insights from recent, cross-sector literature to clarify what cultural safety is, why current efforts often fall short, and what kinds of structural conditions make it possible. For leaders, practitioners, and teams navigating cultural safety expectations (whether by mandate or mission) this synthesis offers a grounded starting point. Not a playbook, but a pattern map.
Why Isn’t Cultural Safety Training Working?
In workplace contexts, cultural safety is often misunderstood as a softer form of cultural competence; something you develop through training, reflection, or increased “awareness.” But the literature makes clear that it’s not a static trait or personal quality. Cultural safety is a dynamic condition that must be continuously negotiated, defined by those who are most at risk of harm within a given system—not by those who hold institutional power (Brumpton et al., 2024; Kelly et al., 2024; Miller et al., 2025).
Many well-intentioned efforts collapse this distinction. In healthcare and education settings, for example, trained professionals often describe cultural safety as treating everyone the same, being respectful, or not making assumptions (Miller et al., 2025; Shabbar, 2024). These framings emphasize politeness and neutrality, rather than power, colonization, or systemic inequity. As a result, safety becomes mis-defined as the absence of overt conflict rather than the presence of structural conditions that allow people to exist without needing to perform, assimilate, or explain their experience (Brumpton et al., 2024; Shabbar, 2024).
This gap isn’t just theoretical. In a recent Australian study, general practice registrars overwhelmingly failed to reflect the national standard that cultural safety must be defined by Aboriginal and Torres Strait Islander patients (Brumpton et al., 2024). Some even interpreted a patient’s discomfort as a failure to understand they were being respected (Brumpton et al., 2024). This framing misplaces responsibility, locating safety in perception rather than design.
The implication is clear: cultural safety isn’t about adopting the right attitude. It’s about shifting whose definition of “safe” gets operationalized inside your systems. When dominant group professionals are the ones naming what counts as respectful or inclusive, power imbalances are maintained—often under the guise of fairness (Shabbar, 2024; Kelly et al., 2024).
What Causes Cultural Safety to Break Down (Even When People Mean Well)?
One of the most consistent findings across cultural safety literature is that harm often occurs not because people intend it, but because power goes unacknowledged (Brumpton et al., 2024; Shabbar, 2024; Cassidy & Byrne, 2024). When dominant norms are treated as neutral, the people most impacted by structural inequity are expected to adapt to systems which may be causing harm (Shabbar, 2024; Cassidy & Byrne, 2024).
This becomes especially visible in workplaces where leadership models, policies, or team norms reward sameness in the name of professionalism or fairness. In practice, that often means that minoritized employees are asked to self-regulate—holding discomfort, translating feedback, or masking cultural difference—while the organization maintains a surface-level commitment to inclusion (Miller et al., 2025; Cassidy & Byrne, 2024).
In two recent studies, white professionals described feeling culturally unsafe when clients challenged their behavior or asked them to adapt—despite the fact that they held institutional power in those settings (Brumpton et al., 2024; Shabbar, 2024). These reactions reflect a reversal of roles, where discomfort is mistaken for harm, and authority is used to reassert control. When safety is framed as comfort for those in power, marginalized people are forced to manage not only their own experience, but the emotional responses of others.
Without an explicit analysis of power, cultural safety efforts can quickly stall. Even well-designed training or dialogue initiatives can reinforce the status quo if they do not address whose experience is centered, and who is expected to adjust. Power avoidance doesn’t create safety—it makes systems more fragile, because the realities most critical to change remain unnamed.
What the research makes clear is that cultural safety isn’t about removing all discomfort. It’s about shifting the terms of engagement so that discomfort no longer disproportionately burdens those most impacted by inequity. Ensuring that institutional power is used to reduce harm, not redistribute it.
What Makes Cultural Safety Stick?
Across the literature, cultural safety is described not as a one-time achievement, but as a condition that must be supported by sustained organizational infrastructure (Kelly et al., 2024; Hendry et al., 2025; Cassidy & Byrne, 2024). It isn’t created through intention, interpersonal dynamics, or emotional intelligence alone. Instead, safety becomes possible when the broader system is designed to support it, through policies, structures, rhythms, and relationships that reduce harm and distribute accountability (Kelly et al., 2024; Hendry et al., 2025; Miller et al., 2025).
Many practitioners interviewed in recent studies had received cultural training, but struggled to apply what they learned once they returned to environments that didn’t reinforce or reward culturally safe behavior (Miller et al., 2025; Brumpton et al., 2024). Some were left to navigate systemic racism, peer hostility, or unclear expectations with little support (Miller et al., 2025; Shabbar, 2024). In these settings, training became disconnected from practice, highlighting that without reinforcement from leadership, policy, or design, even well-developed interventions quickly lose traction (Miller et al., 2025; Brumpton et al., 2024).
But when structural support is intentionally designed in, the story changes. In one long-term workplace initiative, safety was actively supported through affinity groups, accountability frameworks, and a shared expectation that discomfort would be named and contained—not bypassed or punished (Hendry et al., 2025). Notably, more than 70% of the organization opted into the program voluntarily, challenging the assumption that resistance is a personal flaw rather than a system design issue (Hendry et al., 2025).
Similarly, in community-based care and education contexts, researchers highlighted that safety was best established when marginalized participants weren’t simply consulted, but directly co-created the conditions of care, governance, or feedback (Kelly et al., 2024; Durmush et al., 2024). These models didn’t just offer access but redesigned access points, embedding care into places where people already felt safe, rather than expecting them to engage on institutional terms (Kelly et al., 2024; Durmush et al., 2024).
The consistent thread across these findings is that cultural safety doesn’t emerge from belief—it emerges from design. Not just what people are told to value, but what the system makes possible.
How Do You Rebuild Trust When Cultural Safety Training Isn’t Enough?
Cultural training is often the first response when organizations try to address inclusion or equity gaps. But across studies, it’s clear that training alone is not enough to produce cultural safety, particularly when the surrounding system remains unchanged (Miller et al., 2025; Brumpton et al., 2024; Durmush et al., 2024).
In multiple sectors, participants who had completed cultural awareness or cultural competency programs still lacked shared language around racism, colonization, and power (Brumpton et al., 2024; Shabbar, 2024). Some interpreted cultural safety as being kind or nonjudgmental, and framed the work in terms of good intentions rather than systemic repair (Brumpton et al., 2024; Miller et al., 2025). Others described returning to workplaces that were actively hostile to cultural safety efforts—where colleagues dismissed identity-based concerns or where leadership deprioritized professional development and cultural responsiveness (Miller et al., 2025; Shabbar, 2024).
This isn’t just a failure of understanding—it’s a failure of alignment. When staff are taught one thing but see another rewarded or enforced in practice, trust erodes. In this context, training becomes a reputational risk: not only does it fail to create meaningful change, it can increase cynicism among those who already feel unsafe or unsupported (Miller et al., 2025; Durmush et al., 2024).
By contrast, programs that embedded cultural safety into the broader system—through staffing, scheduling, space design, leadership modeling, and feedback structures—saw more durable change (Hendry et al., 2025; Kelly et al., 2024). In these contexts, people didn’t just learn about cultural safety, they experienced it in practice. And that experience made further learning possible.
The key insight across these studies is that cultural safety cannot depend on individual learning alone. It must be supported, reinforced, and held by the system itself.
What Does Real Cultural Safety Action Actually Look Like?
One of the most powerful insights from the literature is that cultural safety isn’t built through sweeping overhauls. In fact, some of the most effective strategies are small in scope but high in relational and structural impact. They’re not meant to solve everything at once—they’re designed to shift momentum in systems where trust has stalled (Kelly et al., 2024; Hendry et al., 2025).
In healthcare, education, and community care settings, researchers found that even modest moves—like shifting a meeting location to a culturally safe space, embedding land acknowledgments into session structure, or redesigning intake conversations—created deeper trust and participation (Kelly et al., 2024; Durmush et al., 2024; Hendry et al., 2025). These weren’t symbolic gestures. They were operational adjustments that made safety real by redistributing power, honoring lived expertise, and meeting people where they already felt a sense of belonging (Kelly et al., 2024; Durmush et al., 2024; Hendry et al., 2025).
Importantly, these shifts were rarely about what leaders believed. They were about what leaders enabled. In several studies, cultural safety gained traction when time was protected, discomfort was anticipated, and structural permission was granted to flex norms that were causing harm (Hendry et al., 2025; Cassidy & Byrne, 2024).
This is a critical lesson for organizations that feel stuck: the next move doesn’t have to be massive. But it does need to be designed for traction. That might mean shifting a single team rhythm, embedding a feedback mechanism, piloting a new onboarding moment, or reassessing how and where care is extended.
What matters is not how much gets changed—it’s who gets to define what counts as safety, and whether the system is willing to listen.
Conclusion
Across contexts, the research is clear: cultural safety isn’t about having the right values, saying the right things, or even meaning well—it’s about what the system enables (Kelly et al., 2024; Hendry et al., 2025; Miller et al., 2025). When organizations focus only on individual awareness or intent, they often miss the deeper structural shifts that actually reduce harm and build trust (Brumpton et al., 2024; Shabbar, 2024; Cassidy & Byrne, 2024).
What distinguishes cultural safety from other equity frameworks is that it begins from the perspective of those most impacted—it asks not what leaders intended, but what people experienced (Brumpton et al., 2024; Kelly et al., 2024). It doesn’t assume safety can be installed from the top down; it assumes it must be co-defined, co-created, and continuously evaluated in context (Durmush et al., 2024; Hendry et al., 2025).
This isn’t a deficit story. It’s a systems story. Most cultural safety failures are not due to lack of care, but to misalignment: between training and practice, between policy and experience, between stated values and everyday design (Miller et al., 2025; Brumpton et al., 2024). And the solutions that work aren’t necessarily complex. They’re intentional. They start with a clear understanding of power, a willingness to question defaults, and a shift toward structures that do more than include—they protect (Shabbar, 2024; Cassidy & Byrne, 2024).
For leaders and teams navigating this work in real time, the most strategic next step may not be a bold new initiative. It may be a smaller, better-designed move. One that makes it easier for people to stay, speak, heal, or lead (Kelly et al., 2024; Hendry et al., 2025).
Because when safety becomes structural, the rest of the system gets smarter.
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References
Brumpton, K., Woodall, H., Evans, R., Neill, H., Sen Gupta, T., McArthur, L., & Ward, R. (2024). Exploring how Australian general practice registrars define cultural safety with Aboriginal and Torres Strait Islander patients: A mixed method study. BMC Primary Care, 25(166). https://doi.org/10.1186/s12875-024-02422-4
Cassidy, T., & Byrne, G. (2024). It is leadership, but (maybe) not as you know it: Advocating for a diversity paradigm in sports leadership and beyond. Behavioral Sciences, 14(10), 860. https://doi.org/10.3390/bs14100860
Durmush, G., Craven, R. G., Yeung, A. S., Mooney, J., Horwood, M., Vasconcellos, D., Franklin, A., Duncan, C., & Gillane, R. (2024). Enabling Indigenous wellbeing in higher education: Indigenous Australian youth-devised strategies and solutions. Higher Education, 87, 1357–1374. https://doi.org/10.1007/s10734-023-01067-z
Hendry, J., Del Guercio, G., Behn Smith, D., Louie, A., Henry, B., & Jongbloed, K. (2025). Unlearning clubs: Creating environments of cultural safety, anti-racism, and trustworthiness in population and public health. BMC Public Health, 25(1125). https://doi.org/10.1186/s12889-025-22034-6
Kelly, J., Owen, K., Tyrell, K., Clemente, K., Steffens, M., Sinclair, N., Reynolds, S., Allan, W., & the AKction Project. (2024). Codesigning culturally safe oral health care with First Nations Kidney Warriors experiencing kidney disease in South Australia. BMC Oral Health, 24, 864. https://doi.org/10.1186/s12903-024-04617-8
Miller, K., Morda, R., & Sonn, C. C. (2025). Tokenistic or transformative? An exploration of culturally safe care in Australian mental health nursing. International Journal of Mental Health, 54(1), 4–21. https://doi.org/10.1080/00207411.2024.2304379
Shabbar, F. (2024). ‘Racialised nudity’ in social work education: Critical reflections on cross-cultural pedagogies. Social Work Education, 1–15. https://doi.org/10.1080/02615479.2024.2400215
Shannon, B., Ryder, C., Abasilim, C., Almberg, K. S., Bonney, T., Forst, L., & Friedman, L. S. (2025). Occupational determinants of health and well-being for Indigenous populations in the United States: Findings from the National Health Interview Survey, 2020–2022. American Journal of Public Health, 115(5), 736–746. https://doi.org/10.2105/AJPH.2024.307959
