Pre-licensure nursing students' experiences of psychological safety: A qualitative descriptive study

Organizational learning is essential for consistently providing safe, efficient, high-quality patient care. Psychological safety is foundational for organizational learning. For pre-licensure nursing students psychological safety is crucial for both their learning and patient safety. Understanding pre-licensure nursing students' experiences of psychological safety can guide efforts to cultivate clinical environments conducive to learning and excellent patient care.

The objective of this study was to gain insight into pre-licensure nursing students' first-hand experiences with psychological safety in clinical settings.

A qualitative, descriptive design was used for this study.

Participants were recruited from 12 different nursing programs across eight states.

A total of 26 pre-licensure nursing students participated in this study. Included were students who had completed at least one clinical rotation, but had not yet obtained licensure as a registered nurse.

Semi-structured interviews were conducted via telephone. Interviews were analyzed using a constant comparative approach to thematic analysis.

Four primary themes emerged from the data, two of which had sub-themes: 1) Feeling Self-Conscious, with the sub-themes Expecting Expectations and Interpreting Feedback; 2) Engaging; 3) Learning and Performing; and 4) Moving Forward, with the sub-themes Using Coping Strategies and Developing Confidence.

This study reinforces the importance of psychological safety for nursing students' learning and for patient safety. Feeling psychologically safe allowed students to engage in the clinical setting, to learn from their experiences, and to perform their very best. With these insights, faculty and clinical preceptors can cultivate effective learning environments where patients can also receive safe, high-quality patient care.