Biigiiweyan (“Coming Home”): Social Work and Health Care with Indigenous Peoples from Competency to Safety


  • Cyndy Baskin Ryerson University
  • Cindy Hare
  • Cindy Peltier
  • Sean Lougheed
  • Patricia Chabbert
  • Catherine Boudreau
  • Brenda Bruner
  • Louise Moir


Cultural competency reproduces simplistic assumptions about Indigenous Peoples that are reminiscent of imperialism (Pon, 2009), directing service providers to become more sensitive to so called “norms”, “practices” and “behaviours” (Baskin, 2016). This freezes culture, ignores diverse languages and histories as well as the places and contexts that animate the realities of Indigenous Peoples. The result is limited understanding of the systemic and structural challenges and the skills needed by helpers to navigate and advocate against such barriers. Going beyond cultural competency to safety includes an awareness of ways in which “historical, economical, and social contexts” influence our position (Gerlach, 2012, p. 152) in terms of power and privilege. It recognizes current expressions of colonization and prioritizes Indigenous healing and wellness practices within helping relationships. Based on two years of research with Elders, Knowledge Keepers, community members, helping professionals, educators and students, Biigiiweyan is a cultural safety training model that offers a roadmap for educational and training programs to make the jump from competency to safety. Founded in Indigenous ways of knowing and relating, Biigiiweyan utilizes interprofessional training and live actor simulation and offers a rubric of cultural safety learning outcomes defined by Indigenous Peoples.   

Author Biography

Cyndy Baskin, Ryerson University

Associate Professor

School of Social Work


Acton, R., Saltera, P., Lenoya, M., Stevenson, R. (2017). Conversations on cultural sustainability: Stimuli for embedding Indigenous knowledges and ways of being into curriculum. Higher Education Research & Development 36(7), 1311–1325.

Bartlett, C., Marshall, M., & Marshall, A. (2012). Two-Eyed Seeing and other lessons learned within a co-learning journey of bringing together indigenous and mainstream knowledges and ways of knowing. Journal of Environmental Studies and Sciences. 2. 10.1007/s13412-012-0086-8.

Baskin, C. (2016). Strong helpers’ teachings: The value of Indigenous knowledges in the helping professions. Toronto: Canadian Scholars’ Press.

Bourassa, C., McElhaney, J., & Oleson, E. (2016). Cultural safety. Retrieved from

Brascoupé, S. & Waters, C. (2009). Cultural safety: Exploring the applicability of the concept of cultural safety to Aboriginal health and community wellness. International Journal of Indigenous Health 5(2), 6-41.

Brooks-Cleator, L., Phillipps, B., & Giles, A. (2018). Culturally safe health initiatives for Indigenous Peoples in Canada: A scoping review. Canadian Journal of Nursing Research 50(4), 202–213. DOI: 10.1177/0844562118770334.

Canadore College (2017). Canadore College advancing culturally safe health care conditions. Retrieved from

Carey, M. (2015). The limits of cultural competence: An Indigenous studies perspective. Higher Education Research & Development 34(5), 828–840.

Churchill, M., Parent-Bergeron, M., Smylie, J., Ward, C., Fridkin, A., Smylie, J., & Firestone, M. (2017). Evidence brief: Wise practices for Indigenous-specific cultural safety training. Retrieved from 2017%20Wise%20Practices%20in%20Indigenous%20Specific%20Cultural%20Safety%20Training%20Programs.pdf

Compton-Osmond, A. (2017). Aboriginal community social work: Committing to anti-oppressive practice. CASW. Retrieved from

Dumbrill, G. C., & Yee, J.Y. (2018). Anti-oppressive social work: Ways of knowing, talking, and doing. Toronto: Oxford University Press.

Dzidic, P., Breen, L.J., & Bishop, B.J. (2013). Are our competencies revealing our weaknesses? A critique of community psychology practice competencies. Global Journal of Community Psychology Practice 4(4), 1-10. Retrieved from

First Nations Health Authority (n.d). FNHA’s Policy Statement on Cultural Safety and Humility. Retrieved from CULTURAL%20COMPETENCY%20PAPER/FNHA-Policy-Statement-Cultural-Safety-and-Humility.pdf

Geniusz, W.M. (2009). Our knowledge is not primitive: Decolonizing botanical Anishinaabe teachings. NY: Syracuse University Press.

Green, S., Bennett, B., & Betteridge, S. (2016). Cultural responsiveness and social work – a discussion. Social Alternatives 35(4), 66-72.

Hart, M. & G. Rowe (2016). Legally entrenched oppressions: The undercurrent of First Nation People’s experiences with Canada’s social welfare policies. In H. Weaver, (Ed.), Social issues in contemporary Native America: Reflections from Turtle Island, (pp. 23-44). New York: Routledge.

Hollinsworth, D. (2013). Forget cultural competence; Ask for an autobiography. Social Work Education 32(8), 1048–1060. (2016). Urban Indigenous peoples. Retrieved from

Kirmayer, L.J. (2012). Rethinking cultural competence. Transcultural Psychiatry 49(2) 149–164. DOI: 10.1177/1363461512444673

Kitching, G.T., Firestone, M., Schei, B., Wolfe, S., Bourgeois, C., O’Campo, P., Rotondi, M., Nisenbaum, R., Maddox, R., & Smylie, J. (2019). Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada. Canadian Journal of Public Health, p. 1-10.

Koptie, S. (2009). Irihapeti Ramsden: The public narrative on cultural safety. First Nations Child and Family Review 4(2), 30-43.

Kovach, M. (2010). Conversational method in Indigenous research. First Peoples Child & Family Review 5(1), 40-48.

Kurtz, D.L.M., Janke, R., Vinek, J., Wells, T., Hutchinson, P., & Froste, A. (2018). Health Sciences cultural safety education in Australia, Canada, New Zealand, and the United States: A literature review. International Journal of Medical Education 9, 271-285. DOI: 10.5116/ijme.5bc7.21e2271.

Nestel, D., & Bearman, M. (Eds.) (2015). Simulated patient methodology: Theory, evidence and practice. Oxford, UK: John Wiley & Sons Ltd. DOI:10.1002/9781118760673

Ontario Federation of Indigenous Friendship Centres. (n.d.). Indigenous cultural competency training (ICCT). Retrieved from

Owens, B. (2019). Tailoring cultural safety training in health care to local context of Indigenous communities. Canadian Medical Association Journal, 191(30), E845-E846.

Palaganas, J.C., Epps, C., & Raemer, D.B. (2014). A history of simulation-enhanced interprofessional education. Journal of Interprofessional Care, 28(2), 110-115. DOI: 10.3109/13561820.2013.869198

Peltier, C. (Forthcoming). Indigenous conceptions of living well. In R. Schiff & H. Møller (Eds.), Health and health care in the Canadian north (pp. 329-340). Toronto: University of Toronto Press.

Pitama, S. G., Palmer, S. C., Huria, T., Lacey, C., and Wilkinson, T. (2018). Implementation and impact of indigenous health curricula: a systematic review. Medical Education, 52(9), 898-909.

Pon, G. (2009). Cultural competency as new racism: An ontology of forgetting. Journal of Progressive Human Services 20(1), 59-71. doi10.1080/10428230902871173.

Prue, R.E. (2016). A standpoint view of the social work profession and Indigenous Peoples in the United States: From the profession’s origins through first century. In H. Weaver, (Ed.), Social issues in contemporary Native America: Reflections from Turtle Island, (pp. 59-76). New York: Routledge.

Reading, C.L., & Wien, F. (2009). Health Inequalities and Social Determinants of Aboriginal People’s Health. Prince George, BC: National Collaborating Centre for Aboriginal Health. Retrieved from

Rego, C. (2014). The importance of in practice when providing care to Aboriginal People. OCSWSSW. Retrieved from

Sasakamoose, J., Bellegarde, T., Sutherland, W., Pete, S., McKay-McNabb, K. (2017). Miýo-pimātisiwin developing Indigenous cultural responsiveness theory (ICRT): Improving Indigenous health and well-being. The International Indigenous Policy Journal 8(4). Retrieved from: DOI:10.18584/iipj.2017.8.4.1

Snowshoe, A., & Starblanket, N. (2016). Eyininiw mistatimwak: The role of the Lac La Croix Indigenous pony for First Nations youth mental wellness. Journal of Indigenous Wellbeing Te Mauri – Pimatisiwin, 1(2), 60–76.

Stein, S. (2020). ‘Truth before reconciliation’: The difficulties of transforming higher education in settler colonial contexts. Higher Education Research and Development, 39(1), 156-170.

Thomas, L., Reedy, G., & Gill, E. (2014). Learning to work together: How interprofessional simulation enables undergraduate medics in their understanding of interprofessional practice. BMJ Simulation and Technology Enhanced Learning 14(1):A80-A81.

Truth and Reconciliation Commission of Canada. (2015). Calls to action. Retrieved from

Walters, K.L., Simoni, J.M., Evans-Campbell, T., Udell, W., Johnson-Jennings, M., Pearson, S.R., MacDonald, M.M, & Duran, B. (2016). Mentoring the mentors of underrepresented racial/ethnic minorities who are conducting HIV Research: Beyond cultural competency. AIDS Behaviour 20, S288–S293. DOI 10.1007/s10461-016-1491-x

Yaphe,S., Richer, F., & Martin, C. (2019). Cultural Safety training for health professionals working with Indigenous populations in Montreal, Quebec. International Journal of Indigenous Health 14(1), 60-84. DOI 10.32799/ijih.v14i1.30861






Beyond “cultural competency”: Confronting whiteness in social work