Psychological Safety in Health Professions Education: Insights and Strategies from a Global Community of Practice

Overview

Journal Front Med (Lausanne)

Date 2025 Feb 10

PMID 39927270

Authors

Chaoyan Dong

Lisa Altshuler

Nobutaro Ban

Lee Yuen Wong

Fatima Elbasri Abuelgasim Mohammed

Chao Tian Tang

Elizabeth Kachur

Affiliations

Soon will be listed here.

Abstract

Psychological safety is the belief that one will not be punished or humiliated for speaking up, sharing ideas, raising concerns, or making mistakes. There are various threats to psychological safety in health professions education (HPE). This commentary applies Clark's model of psychological safety (Inclusion Safety, Learner Safety, Contributor Safety, Challenger Safety) to five different HPE settings (classroom instructions, clinical training, simulation-based training, online instructions, interprofessional education). Setting-specific threats and strategies for enhancing psychological safety are discussed.

References

Lewis K, Bohnert C, Gammon W, Holzer H, Lyman L, Smith C . The Association of Standardized Patient Educators (ASPE) Standards of Best Practice (SOBP). Adv Simul (Lond). 2018; 2:10. PMC: 5806371. DOI: 10.1186/s41077-017-0043-4. View

McGaghie W, Miller G, Sajid A, Telder T . Competency-based curriculum development on medical education: an introduction. Public Health Pap. 1978; (68):11-91. View

McGaghie W, Issenberg S, Petrusa E, Scalese R . A critical review of simulation-based medical education research: 2003-2009. Med Educ. 2010; 44(1):50-63. DOI: 10.1111/j.1365-2923.2009.03547.x. View

Bajaj K, Meguerdichian M, Thoma B, Huang S, Eppich W, Cheng A . The PEARLS Healthcare Debriefing Tool. Acad Med. 2018; 93(2):336. DOI: 10.1097/ACM.0000000000002035. View

Reimschisel T, Herring A, Huang J, Minor T . A systematic review of the published literature on team-based learning in health professions education. Med Teach. 2017; 39(12):1227-1237. DOI: 10.1080/0142159X.2017.1340636. View

Verbree A, Isik U, Janssen J, Dilaver G . Inclusion and diversity within medical education: a focus group study of students' experiences. BMC Med Educ. 2023; 23(1):61. PMC: 9875758. DOI: 10.1186/s12909-023-04036-3. View

Rudolph J, Simon R, Dufresne R, Raemer D . There's no such thing as "nonjudgmental" debriefing: a theory and method for debriefing with good judgment. Simul Healthc. 2008; 1(1):49-55. DOI: 10.1097/01266021-200600110-00006. View

Kolbe M, Eppich W, Rudolph J, Meguerdichian M, Catena H, Cripps A . Managing psychological safety in debriefings: a dynamic balancing act. BMJ Simul Technol Enhanc Learn. 2022; 6(3):164-171. PMC: 8936758. DOI: 10.1136/bmjstel-2019-000470. View

van Loon K, Scheele F . Improving Graduate Medical Education Through Faculty Empowerment Instead of Detailed Guidelines. Acad Med. 2020; 96(2):173-175. DOI: 10.1097/ACM.0000000000003386. View

10.

ODonovan R, McAuliffe E . Exploring psychological safety in healthcare teams to inform the development of interventions: combining observational, survey and interview data. BMC Health Serv Res. 2020; 20(1):810. PMC: 7456753. DOI: 10.1186/s12913-020-05646-z. View

11.

McLaughlin R, OBrien C, Weinstein M, Anderson R, Cameron J, Romig B . Clinical Education in Transition: Recommendations and Strategies: A Report of the ASAHP Clinical Education Task Force. J Allied Health. 2019; 48(4):237-247. View

12.

ODonovan R, McAuliffe E . A systematic review exploring the content and outcomes of interventions to improve psychological safety, speaking up and voice behaviour. BMC Health Serv Res. 2020; 20(1):101. PMC: 7011517. DOI: 10.1186/s12913-020-4931-2. View

13.

Grailey K, Murray E, Reader T, Brett S . The presence and potential impact of psychological safety in the healthcare setting: an evidence synthesis. BMC Health Serv Res. 2021; 21(1):773. PMC: 8344175. DOI: 10.1186/s12913-021-06740-6. View

14.

van Baarle E, Hartman L, Rooijakkers S, Wallenburg I, Weenink J, Bal R . Fostering a just culture in healthcare organizations: experiences in practice. BMC Health Serv Res. 2022; 22(1):1035. PMC: 9375400. DOI: 10.1186/s12913-022-08418-z. View

15.

Teshome B, Desai M, Gross C, Hill K, Li F, Samuels E . Marginalized identities, mistreatment, discrimination, and burnout among US medical students: cross sectional survey and retrospective cohort study. BMJ. 2022; 376:e065984. PMC: 8938931. DOI: 10.1136/bmj-2021-065984. View

16.

Holtman M, Frost J, Hammer D, McGuinn K, Nunez L . Interprofessional professionalism: linking professionalism and interprofessional care. J Interprof Care. 2011; 25(5):383-5. DOI: 10.3109/13561820.2011.588350. View

17.

MacNeill H, Masters K, Nemethy K, Correia R . Online learning in Health Professions Education. Part 1: Teaching and learning in online environments: AMEE Guide No. 161. Med Teach. 2023; 46(1):4-17. DOI: 10.1080/0142159X.2023.2197135. View

18.

Bouye K, McCleary K, Williams K . Increasing Diversity in the Health Professions: Reflections on Student Pipeline Programs. J Healthc Sci Humanit. 2018; 6(1):67-79. PMC: 5890504. View

19.

Abd El-Shafy I, Delgado J, Akerman M, Bullaro F, Christopherson N, Prince J . Closed-Loop Communication Improves Task Completion in Pediatric Trauma Resuscitation. J Surg Educ. 2017; 75(1):58-64. DOI: 10.1016/j.jsurg.2017.06.025. View

20.

Rudolph J, Raemer D, Simon R . Establishing a safe container for learning in simulation: the role of the presimulation briefing. Simul Healthc. 2014; 9(6):339-49. DOI: 10.1097/SIH.0000000000000047. View