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Abstract
Healthcare professionals who feel psychologically safe believe it is safe to take interpersonal risks such as voicing concerns, asking questions and giving feedback. Psychological safety is a complex phenomenon which is influenced by organizational, team and individual level factors. However, it has primarily been assessed as a team-level phenomenon. This study focused on understanding healthcare professionals' individual experiences of psychological safety. We aim to gain a fuller understanding of the influence team leaders, interpersonal relationships and individual characteristics have on individuals' psychological safety and their decisions to engage in voice or silence behavior. Thirty-four interviews were conducted with healthcare professionals from across five teams working within an acute, suburban hospital. Hybrid inductive-deductive thematic analysis focused on identifying themes which captured the complexities of individuals' varied experiences of psychological safety. The themes identified were: “Personal Characteristics,” “Past Experiences,” “Individual Perceptions of Being Valued,” and “Judged Appropriateness of Issues/Concerns.” These themes are explored within the context of motivating and inhibiting factors associated with the influence of leadership, interpersonal relationships and individual characteristics on experiences of psychological safety and voice behavior. These results extend existing theoretical frameworks guiding our understanding of psychological safety by accounting for the variation in individuals' experiences and studying these significant influences on voice behavior. Important considerations for the development of interventions to enhance psychological safety are discussed.
Highlights
Psychological safety concerns an individual’s perception of whether it is safe to take interpersonal risks (Kahn, 1990; Edmondson, 1999)
We address the following research questions: What are individuals healthcare professionals’ experiences of psychological safety? how do these experiences relate to their individual dispositions, their team leader or their relations with co-workers? These questions are explored and discussed within the context of informing the development of interventions to improve psychological safety in healthcare teams
Healthcare professionals’ experiences of psychological safety are grouped according to the motivating and inhibiting effects that leadership, interpersonal relationships and individual characteristics have on voice and silence
Summary
Psychological safety concerns an individual’s perception of whether it is safe to take interpersonal risks (Kahn, 1990; Edmondson, 1999). Past studies have demonstrated that educational and simulation-based interventions showed some improvements in psychological safety and/or speaking up behavior (Coyle et al, 2005; Dufresne, 2007; Pian-Smith et al, 2009; Johnson and Kimsey, 2012; Sayre et al, 2012; O’Connor et al, 2013; Raemer et al, 2016). Many of these interventions have shown mixed results or no significant change post intervention (O’Donovan and McAuliffe, 2020a). These lived experiences are complex and highly nuanced and we adopt a qualitative approach to gain an in-depth understanding of lived experiences of psychological safety
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