Psychological Safety in Medical Education, Another Challenge to Tackle?

Psychological safety is the feeling that one can take interpersonal risks without fear of negative consequences including retaliation, intimidation, or rejection. The literature base on psychological safety in medical education is increasing. Despite increasing recognition in the medical literature, many medical practitioners and educators are uncertain about the background and effects of psychological safety on medical education. For learners (students and residents), having an environment with high psychological safety means being able to admit knowledge gaps and skill deficits. Psychological safety is recognized as an essential attribute for a positive learning environment and is associated with several positive behaviors. To benefit medical educators, we contextualize the benefits of improved psychological safety in medical education and highlight the limited data substantiating what interventions are known to enhance psychological safety in graduate medical education. While it is recognized that higher psychological safety is important, creating better psychological safety is a complex challenge analogous to patient safety, well-being, and healthcare disparity. The challenges for environments with lower psychological safety are understanding what to fix and how to fix it, and recognition that quick fixes are elusive. Moving forward, medical educators must have a better understanding of how to enhance psychological safety.