de Guillebon Eleonore, He Celestine, Akhtar Saadia, Pietrzak Robert H, Ripp Jonathan, Peccoralo Lauren
Office of Well-Being and Resilience, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1604, New York, NY, 10029, USA.
Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Gen Intern Med. 2025 Feb;40(2):361-367. doi: 10.1007/s11606-024-09034-9. Epub 2024 Oct 1.
Data on the potential protective effect of psychological safety (PS) on well-being and satisfaction among physicians are lacking.
We sought to examine (1) prevalence of PS; (2) relationship between PS, burnout, and intent to leave one's job (ILJ); and (3) demographic and occupational factors associated with PS within our physician faculty.
Participants: An institution-wide survey was sent to all faculty within our eight-hospital health system, between July and September 2022.
PS was assessed using the seven-item Fearless Organization Questionnaire and burnout with the Maslach Burnout Inventory-2. Demographics and a measure of ILJ were assessed. Multivariable logistic regression analyses were conducted to determine associations between PS, burnout, ILJ, and demographic and occupational correlates of PS.
A total of 867 out of 3086 total estimated clinical faculty members (28.1%) participated in the survey. The majority were 40 and older (67.4%), female (51.9%), white (60.0%), and married/partnered (80.4%); worked in ambulatory care departments (53.7%); and ranked assistant or associate professors (75.8%). On average, 57.6% of physicians evaluated their workplace as psychologically safe (range across items = 40.9-69.9%), with 35.2% screening positive for burnout and 13.4% reporting ILJ. After adjusting for demographic and occupational characteristics, each standard deviation unit increase in PS scores was associated with 27% lower odds of screening positive for burnout (odds ratio (OR) = 0.73, 95% confidence interval (CI) = 0.63-0.84) and 38% lower odds of ILJ (OR = 0.62, 95% CI = 0.52-0.74). Female gender was associated with lower scores of PS.
A majority of faculty physicians reported working in a psychologically safe environment. Greater PS was associated with lower odds of burnout and ILJ. Investment in gender and diversity equity training may be one concrete step in advancing PS in the workplace.
缺乏关于心理安全感（PS）对医生幸福感和满意度潜在保护作用的数据。
我们试图研究（1）心理安全感的患病率；（2）心理安全感、职业倦怠和离职意向（ILJ）之间的关系；以及（3）我们医生队伍中与心理安全感相关的人口统计学和职业因素。
参与者：2022年7月至9月期间，向我们八家医院医疗系统内的所有教职员工发送了一项全机构范围的调查。
使用七项无畏组织问卷评估心理安全感，使用马氏职业倦怠量表-2评估职业倦怠。评估人口统计学和离职意向指标。进行多变量逻辑回归分析，以确定心理安全感、职业倦怠、离职意向以及心理安全感的人口统计学和职业相关因素之间的关联。
在总计3086名估计临床教职员工中，共有867人（28.1%）参与了调查。大多数人年龄在40岁及以上（67.4%），女性（51.9%），白人（60.0%），已婚/有伴侣（80.4%）；在门诊护理部门工作（53.7%）；职级为助理教授或副教授（75.8%）。平均而言，57.6%的医生将他们的工作场所评估为心理安全（各项目范围为40.9%-69.9%），35.2%的人职业倦怠筛查呈阳性，13.4%的人报告有离职意向。在调整了人口统计学和职业特征后，心理安全感得分每增加一个标准差单位，职业倦怠筛查呈阳性的几率降低27%（优势比（OR）=0.73，95%置信区间（CI）=0.63-0.84），离职意向的几率降低38%（OR=0.62，95%CI=0.52-0.74）。女性与较低的心理安全感得分相关。
大多数教职医生报告在心理安全的环境中工作。更高的心理安全感与更低的职业倦怠和离职意向几率相关。投资于性别和平等多元化培训可能是在工作场所提升心理安全感的一个具体举措。
