Advancing the practice of cultural safety in physiotherapy: a scoping review
Bibliographic record
Abstract
PURPOSE: This scoping review synthesizes literature on cultural safety in physiotherapy, identifying recommended practices at individual, organizational and systemic levels. It also evaluates the extent of engagement with Indigenous Peoples to advance this work. METHODS: Following up-to-date methodological guidance and reported according to PRISMA-ScR standards, a comprehensive search was conducted in September 2024 across MEDLINE, Embase, CINAHL and PsycINFO databases with no date restrictions. Grey literature, including regulatory guidelines, was also reviewed. Data were analyzed using a mixed deductive-inductive approach and a conceptual framework created comprising six cultural safety principles: (1) sharing power, (2) supporting cultural identity, (3) practicing critical reflexivity, (4) communicating safely, (5) supporting Indigenous leadership, and (6) building partnerships. These were examined using a socio-ecological lens across individual, organizational, and systemic levels. RESULTS: Among 39 documents reviewed, 72% addressed individual-level practices, 62% organizational and 44% systemic. Additionally, 41% involved Indigenous authorship or collaboration. Findings synthesize various practices aligned with cultural safety principles and identify emerging themes, including valuing time, creating space, and regulating cultural safety. CONCLUSION: This review highlights the need to shift from individual to broader organizational and systemic change. It offers a foundation for advancing cultural safety within physiotherapy practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.044 | 0.141 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.029 | 0.027 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.009 | 0.008 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".