Department of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, 4245 Roosevelt Way NE, Box 354765, Seattle, WA, 98107, USA.
Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
J Gen Intern Med. 2022 Jul;37(9):2291-2296. doi: 10.1007/s11606-022-07493-6. Epub 2022 Jun 16.
Psychological safety is the perception that an environment is safe for interpersonal risk taking, exposing vulnerability, and contributing perspectives without fear of being shamed, blamed, or ignored. The presence of psychological safety has been associated with improved team learning and innovation, leader inclusivity, and team members' sense of belonging. In medical education, psychological safety has additional benefits: it allows learners to be present in the moment and to focus on the tasks at hand, and reduces trainee focus on image. Several key features of psychologically safe environments have already been described, including the presence of high-quality relationships, the absence of social positioning, a learner-driven and flexible learning agenda, the lack of formal assessment, and time for debriefing. However, many of the structures and cultural traditions in medical education are in clear opposition to these features. This paper describes the current barriers to psychological safety in medical education, and sets out an agenda for change. In accordance with benefits seen in other sectors, we anticipate that an emphasis on relationships and psychological safety will support the learning, inclusion, and success of medical trainees.
心理安全感是一种认知，即认为环境对于人际风险承担、暴露脆弱性以及贡献观点是安全的，而不会担心受到羞辱、责备或忽视。心理安全感的存在与团队学习和创新的改善、领导者的包容性以及团队成员的归属感有关。在医学教育中，心理安全感还有额外的好处：它允许学习者活在当下，专注于手头的任务，并减少学员对形象的关注。心理安全环境的几个关键特征已经被描述过，包括高质量关系的存在、没有社会定位、以学习者为中心和灵活的学习议程、缺乏正式评估以及进行汇报的时间。然而，医学教育中的许多结构和文化传统明显与这些特征相悖。本文描述了医学教育中心理安全感的当前障碍，并制定了变革议程。根据其他领域看到的好处，我们预计对关系和心理安全感的重视将支持医学学员的学习、包容和成功。
