Psychological safety in European medical students' last supervised patient encounter: A cross-sectional survey

To investigate the association between European medical students' psychological safety in and experiences from their last supervised patient encounter.

A cross-sectional online survey among European medical students. Bivariable and multivariable linear regression was used to explore the associations between the dependent variable psychological safety and independent variables concerning students' experiences from their last supervised patient encounter.

A total of 886 students from more than 25 countries participated. The variables most strongly associated with psychological safety were supervisor coaching and modelling behaviour, adjusted beta 0.4 (95%CI 0.3 to 0.5) and 0.1 (95%CI 0.1 to 0.2) per unit respectively on a one-to-five-point scale, and studying in Northern Europe, adjusted beta 0.4-0.5 compared to other regions. There was a weak negative association (reduced score on psychological safety) for being supervised by a medical doctor with <5 years' experience and a positive association for student confidence. Student gender, student seniority, speciality, whether peers were present, number of previous encounters with the supervisor and supervisor articulation and exploration behaviour were not associated in multivariable analysis.

Coaching might be a good primary focus to improve supervision practices, as participation with feedback is known to be beneficial for learning and coaching was strongly associated with psychological safety. Supervisors in western, eastern, and southern Europe might have to work harder to create psychological safety than their northern colleagues.