Diversity, Psychological Safety, and Cultural Humility

By: Sabrina Beroz

One of the four core values of the National League for Nursing (NLN) is diversity, a key element of the modern landscape across work, social, and educational systems. As understood by the NLN, the term encompasses diversity of thought, people, race/ethnicities, and values. The power of diversity, and our response to others who are different, can profoundly impact relationship building, teamwork, and learning. Those who value and embody the strength of inclusion and diversity advance health care across the nation and global community.

As schools of nursing embrace experiential and collaborative learning where students participate in groups, it is crucial to recognize the uniqueness and value of each individual’s contribution. Broadening to the practice environment, health care professionals work in teams of people diverse in rank and social identity. So, how can we create inclusive, trusting environments in the service of learning? How do we avoid failed collaboration? The answer to these questions is: by leveraging diversity through psychological safety and cultural humility (Edmondson & Roloff, 2009; Foronda, 2019).

Psychological safety is the perception and confidence that all members of the group or team will be valued for their contributions, without ridicule or embarrassment (Lioce, 2020). The International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best PracticeSM: Simulation Glossary points to the importance of recognizing the psychological aspect of unintentional bias and cultural differences (INACSL Standards Committee, 2016). Members of all identity groups come to the learning experience with preconceived assumptions that may lead to misunderstanding. By examining and questioning our own assumptions, we start to overcome the barriers to collaboration and psychological safety. We mitigate bias and enhance psychological safety when we adopt this basic assumption: “We believe everyone is intelligent, capable, cares about doing their best and wants to improve” (Center for Medical Simulation, 2004, p. 1).

Psychological safety fosters learning toward mutual goals rather than self-protection. Those learning or working in psychologically safe environments are genuinely interested in group members and have a commitment to excellence. Ultimately, group diversity leverages each individual’s skill set and knowledge, not possible in more secular groups.

Now, let’s consider the Theory of Cultural Humility as a way to advance mutual understanding, learning, and professional interactions. This theory differentiates itself from cultural competence by embracing lifelong learning (Foronda, 2019). The theory defines diversity as the differences among people and positive outcomes as mutual empowerment and respect for others. It is designed to lead individuals and teams when working in a diverse world. The theory encompasses the Rainbow Model of Cultural Humility and provides a roadmap for self-reflection toward achieving positive outcomes. The model emphasizes the rainbow in a contextual way for understanding diversity and cultural humility.

In summary, both psychological safety and cultural humility provide health care professionals with tools for working in diverse groups. It is essential that nursing, nursing education, and health care professionals incorporate diversity and inclusion into the culture of learning and practice.


Center for Medical Simulation. (2004). Basic assumption [Class handout]. Cambridge, MA Center for Medical Simulation.

Edmondson, A., & Roloff, K. (2009). Leveraging diversity through psychological safety. Rotman Magazine, 47-51.

Foronda, C. (2019). A theory of cultural humility. Journal of Transcultural Nursing, 31(1), 7-12.

INACSL Standards Committee (2016, December). INACSL standards of best practice: SimulationSM Simulation glossary. Clinical Simulation in Nursing, 12(S), S39-S47. http://www.inacsl.org/i4a/pages/index.cfm?pageID=340

Lioce, L. (2020). Healthcare simulation dictionary. https://www.ssih.org/dictionary

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