Gaslighting in the context of diagnostic safety: A concept analysis

Diagnostic errors significantly impact patient outcomes and are often linked to dysfunctional team dynamics. Gaslighting, characterized by patterned distortion and doubt induction, is increasingly recognized among health care professionals and may compromise diagnostic safety. Traditionally examined in provider-patient relationships, gaslighting within teams remains underexplored. This concept analysis examines gaslighting within health care teams in the context of diagnostic safety, identifying its defining attributes, antecedents, consequences, and implications. The Walker and Avant method was used to guide this concept analysis. A systematic literature search was conducted across PubMed, CINAHL Plus with Full Text, Medline, PsycINFO, and Embase, yielding 12 articles meeting inclusion criteria. Extracted data were analyzed to identify common themes, focusing on gaslighting's characteristics, triggers, and outcomes within interprofessional teams. Gaslighting in health care teams is characterized by dismissiveness, undermining behavior, and induced doubt in colleagues' clinical judgments. Antecedents include hierarchical power structures, workplace stress, and poor communication. Consequences involve emotional distress, loss of trust, and increased risk of diagnostic error. Tools like the Gaslighting at Work Questionnaire may assist in assessment. Recognizing and addressing gaslighting is critical to improving diagnostic safety. Organizational strategies must support psychological safety, open dialogue, and professional respect.