Cultural Safety in Patient-Centred Measurement Methodologies

Project Summary

Findings arising from the In Plain Sight (2020) report confirmed that Indigenous Peoples in British Columbia are faced with discrimination and racism in the healthcare system. Patient-reported experience measurement (PREMs) is essential to understanding the experiences of patients in the healthcare system— but it is important that PREMs for Indigenous Peoples are conducted in culturally safe ways.

Project Findings

To better understand cultural safety in PREMs, this research project had a two-fold approach: a scoping review and key informant interviews.

The scoping review focused on the methodology of published studies. In total, 79 articles were included and several key factors were found, including:

  • Exploring the extent to which Indigenous Peoples were involved in the research design and implementation of the study
  • Whether the findings were validated with Indigenous patient partners or communities.


The research project also included interviews with key informants. In total, eleven key informants were interviewed. We discussed how PREMs could be done in a culturally safe way with Indigenous Peoples. The historical and social context of colonization and the subsequent power imbalances between Indigenous patients and the healthcare system was a prominent factor in shaping experiences within healthcare settings.


Some key recommendations emerged, including:

  • Research in this area needs to be led by Indigenous individuals embedded in Indigenous communities with an understanding of the importance of reciprocity in relationships
  • The primacy of oral traditions and storytelling
  • All research activities need to be consistent with the principles of Indigenous data governance.


We anticipate this research will have two main outputs: the scoping review as well as findings from interviews with key informants.

This project is part of the Patient-Centred Measurement Cluster.


Elder Syexwaliya, Ann Whonnock
Darlene Wolfe
Victoria English
Christine Hunt
Danielle Behn-Smith
Jessy Dame
Nel Weiman
Becky Palmer
Mark Matthew

Sonia Isaac-Mann, Lead
Megan Misovic, Lead
Mathew Fleury, Lead ✉
Adam Finch
Leena Hasan
Nancy Laliberte
Katie Bauder
Jennifer Leason
Kara Turcotte
Sophia Speier

In Memoriam of Bill Blackwater
Brittany Barker
Diana Clarke
Delaram Farshad
Namaste Marsden
Alexa Norton
Erika Pulfer
Dion Thevarge
Ashok Krishnamurthy