Development of the Awareness of Cultural Safety Scale: A pilot study with midwifery and nursing academics

T. Milne, D. K. Creedy, R. West

Research output: Contribution to journalArticlepeer-review


Background: Rates of academic success of Indigenous students compared to other students continues to be significantly lower in many first world countries. Professional development activities for academics can be used to promote teaching, learning and support approaches that value Indigenous worldviews. However, there are few valid and reliable tools that measure the effect of academic development strategies on awareness of cultural safety. 

Objectives: To develop and validate a self-report tool that aims to measure nursing and midwifery academics' awareness of cultural safety.

Methods: This study followed a staged model for tool development. This included: generation of items, content validity testing and expert Indigenous cultural review, administration of items to a convenience sample of academics, and psychometric testing. An online survey consisting of demographic questions, Awareness of Cultural Safety Scale (ACSS), and awareness of racism items was completed by academics undertaking a professional development program on cultural safety. 

Findings: Ratings by experts revealed good content validity with an index score of 0.86. The 12-item scale demonstrated good internal reliability (Cronbach's alpha of 0.87). An evaluation of construct validity through factor analysis generated three factors with sound internal reliability: Factor 1 (Cultural Application, Cronbach's alpha = .85), Factor 2 (Cultural Support, Cronbach's alpha = .70) and Factor 3 (Cultural Acknowledgement, Cronbach's alpha = .85). The mean total scale score was 46.85 (SD 7.05, range 31-59 out of a possible 60). There was a significant correlation between scores on the Awareness of Cultural Safety Scale and awareness of racism scores (r = .461, p = .002). 

Conclusion: Awareness of cultural safety is underpinned by principles of respect, relationships, and responsibility. Results indicated the ACSS was valid and reliable. Completion of the scale aimed to foster purposeful consideration by nursing and midwifery academics about their perceptions and approaches to teaching in order to improve Indigenous student success.

Original languageEnglish
Pages (from-to)20-25
Number of pages6
JournalNurse Education Today
Publication statusPublished - 1 Sep 2016
Externally publishedYes


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