Training Pharmacists in providing cultural safety for Aboriginal and Torres Strait Islander Australians

Abstract

Culturally safe healthcare delivery is increasingly recognised as essential in addressing the persistent health disparities experienced by Aboriginal and Torres Strait Islander people. The concept of cultural safety requires healthcare professionals to engage in reflexivity, acknowledge power imbalances, and ensure care is defined as safe by those receiving it. Despite national mandates and accreditation requirements, the implementation of cultural safety in Australian pharmacy education remains inconsistent and often symbolic.

This PhD addresses the urgent need for systematic approaches to embedding, mapping, and evaluating cultural safety within pharmacy curricula. The research aimed to assess the inclusion of cultural safety across all accredited pharmacy programs in Australia; develop curriculum mapping tools based on the Aboriginal and Torres Strait Islander Health Curriculum Framework; evaluate constructive alignment in a newly revised curriculum; amplify First Nations voices in curriculum co-design; and reflect critically on the researcher's own positionality.

Using a multi-method approach, the thesis involved a systematic scoping literature review, a national and local audit of pharmacy schools’ cultural safety teaching, an institutional level curriculum mapping study, a constructive alignment analysis and a community consultation study. Reflexivity and relationality were also key to the methodology.

Findings revealed widespread inclusion of cultural content but poor alignment to outcomes

and assessments. Cultural safety was often not scaffolded, assessed, or treated with the same rigour as clinical content. However, the thesis demonstrates that structured mapping and alignment tools can support meaningful reform.

This thesis offers a replicable model for embedding cultural safety in health curricula. While focused on pharmacy, its methods and findings have broad relevance for improving equity and accountability across all health disciplines.