Cultural competence, cultural humility and cultural safety in medical care: from intercultural dialogue to health equity

Introduction: healthcare is delivered in diverse societies, where language and belief differences generate communication barriers and inequities. Cultural competence, humility, and safety are proposed as responses. Objective: to analyze the conceptual foundations, educational approaches, evidence on outcomes, and practical applications of cultural competence, humility, and safety, addressing language barriers, Indigenous peoples, migrants, and traditional medicine. Development: cultural competence is widely taught in medical curricula, yet its evaluation relies on self-reported measures, with scarce evidence of improved patient health outcomes. A shift is needed toward self-reflection, patient-defined safety, and structural determinants. Professional interpreters enhance communication, Indigenous-led governance is central to safe hospitals, and traditional medicine integration aligns with the WHO strategy. Conclusions: a culturally responsive medical practice requires combining individual reflection, longitudinal patient-centered training, language access, and institutional changes that share power with communities, grounded in an equity-based intercultural approach.