Department of Health Psychology, Miguel Hernández University of Elche, Elche, Spain.
Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Šafárik University, Kosice, Slovakia.
JMIR Med Educ. 2024 Oct 7;10:e64125. doi: 10.2196/64125.
In the field of research, psychological safety has been widely recognized as a contributing factor to improving the quality of care and patient safety. However, its consideration in the curricula and traineeship pathways of residents and health care students is scarce.
This study aims to determine the extent to which health care trainees acquire psychological safety competencies during their internships in clinical settings and identify what measures can be taken to promote their learning.
A mixed methods observational study based on a consensus conference and an open-ended survey among a sample of health care trainee mentors from health care institutions in a pan-European context was conducted. First, we administered an ad hoc questionnaire to assess the perceived degree of acquisition or implementation and significance of competencies (knowledge, attitudes, and skills) and institutional interventions in psychological safety. Second, we asked mentors to propose measures to foster among trainees those competencies that, in the first phase of the study, obtained an average acquisition score of <3.4 (scale of 1-5). A content analysis of the information collected was carried out, and the spontaneity of each category and theme was determined.
In total, 173 mentors from 11 pan-European countries completed the first questionnaire (response rate: 173/256, 67.6%), of which 63 (36.4%) participated in the second consultation. The competencies with the lowest acquisition level were related to warning a professional that their behavior posed a risk to the patient, managing their possible bad reaction, and offering support to a colleague who becomes a second victim. The mentors' proposals for improvement of this competency gap referred to training in communication skills and patient safety, safety culture, work climate, individual attitudes, a reference person for trainees, formal incorporation into the curricula of health care degrees and specialization pathways, specific systems and mechanisms to give trainees a voice, institutional risk management, regulations, guidelines and standards, supervision, and resources to support trainees. In terms of teaching methodology, the mentors recommended innovative strategies, many of them based on technological tools or solutions, including videos, seminars, lectures, workshops, simulation learning or role-playing with or without professional actors, case studies, videos with practical demonstrations or model situations, panel discussions, clinical sessions for joint analysis of patient safety incidents, and debriefings to set and discuss lessons learned.
This study sought to promote psychological safety competencies as a formal part of the training of future health care professionals, facilitating the translation of international guidelines into practice and clinical settings in the pan-European context.
在研究领域，心理安全感已被广泛认为是提高护理质量和患者安全的一个促成因素。然而，在住院医师和医疗保健学生的课程和实习途径中，对其的考虑却很少。
本研究旨在确定医疗保健实习生在临床实习期间获得心理安全能力的程度，并确定可以采取哪些措施来促进他们的学习。
本研究采用混合方法观测性研究，基于共识会议和来自泛欧地区医疗机构的医疗保健实习导师的开放式调查样本。首先，我们专门设计了一份问卷，以评估他们对能力（知识、态度和技能）和机构干预措施在心理安全方面的获得或实施程度和重要性的认知。其次，我们要求导师提出措施，以培养实习生获得研究第一阶段平均获得分数<3.4（1-5 分制）的那些能力。对收集到的信息进行了内容分析，并确定了每个类别和主题的自发性。
共有来自 11 个泛欧国家的 173 名导师完成了第一份问卷（回复率：173/256，67.6%），其中 63 名（36.4%）参加了第二次咨询。获得程度最低的能力与警告专业人员其行为对患者构成风险、管理他们可能的不良反应以及向成为第二受害者的同事提供支持有关。导师们为改善这一能力差距提出的建议包括沟通技巧和患者安全培训、安全文化、工作氛围、个人态度、为学员提供参考人、将其正式纳入医疗保健学位和专业途径的课程、为学员提供发言权的特定系统和机制、机构风险管理、法规、指南和标准、监督以及支持学员的资源。在教学方法方面，导师们推荐了一些创新策略，其中许多策略基于技术工具或解决方案，包括视频、研讨会、讲座、工作坊、模拟学习或角色扮演（有或没有专业演员）、案例研究、带有实际演示或模型情况的视频、小组讨论、用于联合分析患者安全事件的临床会议以及设定和讨论经验教训的汇报。
本研究旨在将心理安全能力作为未来医疗保健专业人员培训的正式组成部分，促进国际指南在泛欧背景下的转化和临床环境中的实施。
