Evaluating awareness of Cultural Safety in the Australian midwifery workforce: A snapshot

Tania Fleming, Debra K. Creedy, Roianne West

Research output: Contribution to journalArticlepeer-review


Problem: There are no validated tools to measure midwives’ awareness of Cultural Safety. Background: Cultural Safety is an important component of midwifery practice. Measurement can inform practice and evaluate professional development strategies. Aim: To adapt and evaluate the Awareness of Cultural Safety Scale with the midwifery workforce. Methods: An online survey was distributed to members of Australian College of Midwives and Congress of Aboriginal and Torres Strait Islander Nurses and Midwives. Measures included the Awareness of Cultural Safety Scale — Revised, Self-assessment of Cultural Knowledge and Perceptions of Racism scales. Findings: The revised Awareness scale had a Cronbach's alpha of 0.87. Principal Component Analysis with varimax rotation produced a three-factor structure accounting for 67% of variance. Awareness scores correlated with Self-assessment of Cultural Knowledge (r = 0.22 p < 0.03) and Perceptions of Racism (r = 0.62 p < 0.001) scales. Educators scored significantly higher on awareness compared to clinicians (t (1,80) = −3.09, p = 0.003). Perceptions of Racism predicted Awareness of Cultural Safety scores (F (2,87) 29.25, adjusted r square = 0.39 p < 0.001 95% Confidence Interval = 1.09, 1.93). Discussion: The revised scale was a reliable and valid measure of Cultural Safety across a diverse sample of midwives. Midwives working in education settings have a higher awareness of Cultural Safety than clinical peers. Conclusion: The Awareness of Cultural Safety Scale can be used with midwives across practice settings. Professional organisations and education providers need to promote the professional responsibilities of midwives towards Cultural Safety in clinical practice and education.

Original languageEnglish
Pages (from-to)549-557
Number of pages9
JournalWomen and Birth
Issue number6
Publication statusPublished - Dec 2019
Externally publishedYes


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