How I Do It: "Family Meetings" as a Structured Practice for Psychological Safety and Bidirectional Communication in...

Surgical residency training is marked by steep hierarchies that can suppress resident voice and impede the open communication necessary for a healthy learning environment. We describe a structured programmatic practice (the "Family Meeting") designed to cultivate psychological safety and promote bidirectional feedback within a general surgery residency.

Descriptive report of "Family Meetings" that are held at the conclusion of core curriculum didactic blocks and facilitated by a program director or associate program director, these sessions invite residents to surface concerns, identify solutions, and receive affirmation for speaking up. Review of pre- and postimplementation ACGME annual survey data from academic years 2022 to 2025 compared to national benchmarks.

Single academic general surgery residency program.

General surgery residents.

Resident-reported ability to raise concerns without fear was improved over the three-year period. There was sustained performance at or above national benchmarks on supervisor accessibility. Resident-reported satisfaction with downstream resolution of concerns remained unchanged over time.

"Family Meetings" require no special infrastructure and align directly with ACGME requirements for professionalism. Programs seeking a low-barrier, high-impact mechanism for resident engagement and culture-building may find this model readily adaptable, with the important caveat that visible follow-through on concerns raised is essential to sustaining its effectiveness.