Pediatric Resident Psychological Safety, Learning, and Family Trust During Family-Centered Rounds.

Area of Science:

• Medical Education
• Patient-Centered Care
• Qualitative Research

Background:

• Psychological safety (PS) is crucial for resident learning during family-centered rounds (FCR), yet it is understudied.
• Concerns exist that resident learning on rounds may erode family trust, but this is not well-understood.

Purpose of the Study:

• To describe pediatric residents' experiences with PS during FCR.
• To explore families' perspectives on learning and trust during FCR.

Main Methods:

• Qualitative study using grounded theory methodology.
• Focus groups and interviews with 25 pediatric residents and 15 family members.
• Thematic saturation achieved through iterative coding and constant comparative method.

Main Results:

• Residents defined PS as feeling comfortable asking questions and admitting errors without judgment.
• Resident autonomy support and positive team dynamics positively influenced PS.
• Families recognized the value of trainee learning and found resident interpersonal skills, alongside attending physician oversight, crucial for trust.

Conclusions:

• Pediatric residents report diverse levels of PS during FCR.
• Supporting resident autonomy enhances PS.
• Families' trust is primarily built on resident interpersonal skills, not negatively impacted by resident uncertainty.