Introduction
This guide is intended to support osteopaths in their daily practice by helping them understand and meet regulatory obligations, maintain safety, and continuously improve the quality of care provided to diverse populations, particularly Aboriginal and Torres Strait Islander peoples.
As registered allied health practitioners, osteopaths must comply with the Australian Health Practitioner Regulation Agency’s (Ahpra) Code of Conduct1, the Capabilities of Osteopathic practice2, and a range of legislation governing their scope of practice.
Reading these guidelines can count towards your Continuing Professional Development (CPD) requirements. See the Osteopathy Board of Australia’s Continuing professional Development Registration Standard.
Why is cultural safety important for good clinical care?
Culturally safe care supports a whole-body approach by considering social, cultural, emotional, and physical influences on health. It is fundamental to good clinical practice because it directly affects trust, communication, and health outcomes. Without it, even technically excellent care can miss the mark. Health consumers are far more likely to engage honestly when they feel respected and safe; and cultural safety recognises that the health consumer decides whether care feels safe, not the practitioner.
Importantly, a lack of cultural safety, whether intentional or not, contributes to poorer outcomes, particularly for Aboriginal and Torres Strait Islander peoples and other marginalised groups. From a regulatory perspective, culturally unsafe practice isn’t just poor manners, it can undermine care quality and professional accountability.
What is cultural safety about?
Ahpra defines culturally safe practise as the ongoing critical reflection of health practitioner knowledge, skills, attitudes, practising behaviours and power differentials in delivering safe, accessible and responsive healthcare free of racism3.
For Aboriginal and Torres Strait Islander peoples, cultural safety is determined by individuals, families and communities3. This requires ongoing commitment from osteopaths towards learning, self-awareness and reflection, and culturally sensitive communications in order to foster respectful and mutually beneficial relationships with clients.
There are many elements that make up culturally safe practice, these include, but are not limited to1:
Aboriginal and Torres Strait Islander Context:
Osteopaths in Australia must develop working knowledge of the unique health factors, history, spirituality, and connection to country of Aboriginal and Torres Strait Islander peoples and the impacts of colonialism. This ensures respectful, effective care delivery that addresses historical and ongoing health determinants.
Systemic Change:
Cultural safety is a fundamental standard for all health professionals. Osteopaths should advocate for systemic changes to help eliminate racism and ensure equitable, responsive care across the whole healthcare system.
Educational Integration:
Cultural safety training and awareness is a key professional capability of osteopathy and thus all university courses have embedded cultural safety training, including Aboriginal and Torres Strait Islander history, culture, and health needs to equip practitioners with the necessary knowledge and skills.
The Osteopathy Board of Australia has developed the core competencies required of all Australian registered osteopaths. These competencies are outlined in the 2019 document Capabilities for Osteopathic Practice2, which details the essential attributes, knowledge, and skills osteopaths must demonstrate to practice ethically and safely.
Key Principles of Cultural Safety
Ahpra, in partnership with the National Indigenous Health Leadership Forum have developed the Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-20253 . This Strategy sets out that to ensure culturally safe and respective practice, all registered health practitioners, including osteopaths must:
- Acknowledge colonisation and systemic racism, and the social, cultural, behavioural and economic factors which impact individual and community health.
- Acknowledge and address individual racism, personal biases, assumptions, stereotypes and prejudices and provide care that is holistic and free of bias and racism.
- Recognise the importance of self-determined decision-making, partnership and collaboration in healthcare which is driven by the individual, family and community.
- Foster a safe working environment through leadership to support the rights and dignity of Aboriginal and Torres Strait Islander people and colleagues.
Cultural safety in practice
To deliver culturally safe care, osteopaths should aim to:
- Create safe inclusive environments where cultural differences are respected and celebrated
- Support the rights and dignity of Aboriginal and Torres Strait Islander peoples and their decision-making and collaboration with individuals, families, and communities.
- Use culturally appropriate communication, to ensure healthcare consumers feel heard and respected.
- Tailor interventions to align with health care consumers’ cultural values, beliefs, and preferences, particularly for Aboriginal and Torres Strait Islander peoples, by incorporating their history, spirituality, and connection to country.
- Collaborate with health consumers, families, and communities to develop management plans that promote self-determination and meet diverse needs.
- Engage in continuous critical reflection of personal knowledge, skills, attitudes, biases and power dynamics to deliver safe, accessible, and racism-free care.
- Advocate for policies and practices that promote cultural safety in the workplace and broader healthcare system.
- Commit to lifelong professional development in cultural safety, enhancing knowledge, skill, and competencies for working with Aboriginal and Torres Strait Islander peoples.
- Stay informed about updated guidelines and standards on the Ahpra website.
By embedding cultural safety principles, osteopaths can contribute to an equitable healthcare system that is free from racism and discrimination and that responds to the diverse needs of all clients, particularly Aboriginal and Torres Strait Islander peoples. Ongoing education, self-reflection and advocacy are essential to championing culturally safe practice.