Psychological Distress in the Era of Psychological Safety

There has been a growing disconnect between learners and educators within medical education. As the landscape of medical education has been altered post-pandemic and cultural shifts favor "safe spaces," we sought to explore the tension that exists between a sense of safety and the discomfort inherent within the learning process. Through separate focus groups conducted with trainees and faculty, a common theme emerged: a sense of vulnerability. Trainees feel a strong sense of vulnerability when receiving feedback, particularly when given in public or when expectations were unclear. Educators feel a sense of vulnerability that their feedback will be interpreted as "retaliatory teaching." This sense of vulnerability was heightened in situations that emphasized the tension between personal well-being vs altruism, safe spaces vs accountability to high standards, and advocacy for system change vs power hierarchy. We must acknowledge this vulnerability and the resulting tensions that can ensue due to the competing commitments of medical training. By cultivating a culture of mutual growth and respect, we can create a learning environment that embodies the highest standards of medicine.