Medical Student Perceptions of Psychological Safety in the Clinical Learning Environment

Area of Science:

• Medical Education
• Healthcare Teams
• Psychological Safety

Background:

• Psychological safety enables students to take risks without fear of negative consequences in learning environments.
• Research has examined psychological safety in healthcare teams at organizational, team, and individual levels.
• While leadership's impact on student perceptions of psychological safety is known, organizational and individual factors require further exploration.

Purpose of the Study:

• To explore student perceptions of facilitators and barriers to psychological safety within the clinical learning environment.
• To identify key factors influencing psychological safety from the perspective of medical students.

Main Methods:

• A qualitative case study was conducted during the 2022-2023 Academic Year.
• Four focus groups were held with 23 third- and fourth-year medical students.
• Transcripts were analyzed using thematic analysis.

Main Results:

• Organizational supports, leadership behaviors (inclusive and exclusive), and individual student characteristics were identified as factors affecting psychological safety.
• High levels of organizational support and inclusive leadership behaviors are crucial for psychological safety.
• Organizational support or inclusive leadership can mitigate the impact of exclusive behaviors or organizational barriers.

Conclusions:

• Organizational support and inclusive leadership behaviors are key drivers of psychological safety in medical education.
• Psychological safety is influenced by a combination of factors, not in isolation.
• Individual educators and organizational support can promote psychological safety despite existing barriers or negative behaviors.