S.H.-T. Tsuei is a doctoral student, Population Health Sciences, Global Health and Populations Field, Health Systems Specialization, Harvard University, Boston, Massachusetts, and affiliate member, Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. D. Lee is a medical student, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. C. Ho is a pediatric psychiatry fellow, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada. G. Regehr is senior scientist and associate director of research, Centre for Health Education Scholarship, and professor, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada. L. Nimmon is scientist, Centre for Health Education Scholarship, and assistant professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Acad Med. 2019 Nov;94(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 58th Annual Research in Medical Education Sessions):S28-S35. doi: 10.1097/ACM.0000000000002897.
Psychological safety (PS) is recognized as key in health professions education. However, most studies exploring PS in medical education have focused on mistreatment, thus focusing on what PS is not. The authors set out to explicitly explore learners' concept of PS in the context of medical education to better understand and define PS and its educational consequences for medical students.
This descriptive exploratory study was conducted in the context of a pilot peer-assisted learning (PAL) program. The program brought together residents and medical students for 16 semiformal learning sessions. Eight medical students from a PAL program were recruited for semistructured interviews to explore their experiences of PS. Transcripts were thematically analyzed using an inductive approach, and social ecological theory was integrated in the later stages of analysis.
Students described PS as not feeling judged. Having supportive relationships with peers and mentors improved PS. Students' sense of PS appeared to free them to focus on learning in the present moment without considering the consequences for their image in the eyes of others. Feeling safe also seemed to facilitate relationship building with the mentors.
A sense of PS appears to free learners from constantly being self-conscious about projecting an image of competence. This enables learners to be present in the moment and concentrate on engaging with the learning task at hand. The authors propose that the term "educational safety" be used to describe a relational construct that can capture the essence of what constitutes PS for learners.
心理安全感(PS)已被公认为健康专业教育的关键。然而,大多数探索医学教育中 PS 的研究都集中在虐待问题上,因此关注的是 PS 不是什么。作者着手在医学教育背景下明确探索学习者对 PS 的概念,以更好地理解和定义 PS 及其对医学生的教育后果。
这是一项描述性探索性研究,在试点同伴辅助学习(PAL)计划的背景下进行。该计划将住院医师和医学生聚集在一起进行 16 次半正式学习会议。从 PAL 计划中招募了 8 名医学生进行半结构化访谈,以探索他们对 PS 的体验。使用归纳方法对转录本进行主题分析,并在分析的后期阶段整合社会生态理论。
学生们将 PS 描述为不感到被评判。与同龄人建立支持性关系可以提高 PS。学生的 PS 感似乎使他们能够专注于当下的学习,而不必考虑自己在他人眼中形象的后果。感到安全似乎也有助于与导师建立关系。
PS 感似乎使学习者摆脱了对表现出能力形象的持续自我意识。这使学习者能够活在当下,专注于手头的学习任务。作者建议使用“教育安全”一词来描述一个关系结构,可以捕捉构成学习者 PS 的本质。