Psychological Safety Research Articles

Culturally-aligned clinical leadership competencies for effective teamwork in Japanese healthcare.

Clinical leadership competencies for effective teamwork differ between Western cultures, where an independent self-construal prevails, and Japanese society, where the self-construal is rooted in interdependence. Although 27 out of 82 Japanese medical schools have 'leadership' as an educational outcome, specific competencies are poorly described, hindering the development of contextually-relevant leadership education. This study aimed to identify clinical leadership competencies and articulate the attributes and skills fundamental to leadership as perceived by Japanese physicians. The 80 items of the UK clinical leadership competency framework (CLCF) formed the stimulus in a modified Delphi. Participants, comprising 26 Japanese physicians, rated the importance of each item using a 5-point Likert scale with free-text comments regarding the modification of competencies and suggestions for new items. Items were eliminated if the Likert mean was less than 4.0 and if fewer than 70% of participants considered them to be important. Newly described or modified items derived from free-text comments were rated for importance in a second round with reflective thematic analysis of the free-text descriptions. A CLCF of 84 items, reflective of Japanese clinical leadership, was created by eliminating three items describing tasks rarely involving Japanese physician leaders, revising seven items to emphasize understanding of members, and adding seven items to maximize feelings of team comfort. Seven skills and attributes emerged to construct Japanese clinical leadership from thematic analysis. "Humility" was viewed as a fundamental to leadership. Humility-driven "self-discipline" and "attentive listening", "supporting members" and "guiding members" with humility-based compassion, were essential elements to create "psychological safety" for freedom of expression. Achieving "unity" through emotional integration was identified as the overall goal of leadership. The reorganized CLCF has embedded more member-centered behaviors that build rapport and comfort for the members than the original CLCF. Modeling the Confucian virtue of humility and building unity by acting with compassion toward members are characteristics of Japanese clinical leadership that reflect an interdependent social context. These findings are a step toward the development of leadership education aligned with a Japanese context.

“If you haven’t got trust, they’re not going to come to you with anything:” Qualities of positional leader and early childhood teacher relationships that support agency

Leadership is a relational practice that influences early childhood teachers’ (ECTs) capability for agency. Agency contributes to the job satisfaction, wellbeing, and retention of ECTs-which are of pressing importance in a climate of global early childhood workforce sustainability challenges. Empirical insights presented in this paper explore the qualities of supportive relationships between positional leaders and ECTs which afford agency. Findings from a qualitative multiple case study that analysed the relationship between ECT agency and retention are provided. Data were collected from six ECTs, five service leaders, and two policy agents working in Victoria, Australia. Through the theoretical lens of Sen’s Capability Approach and Gramsci’s theory of hegemony, it is argued that positional leaders must cultivate supportive relationships with ECTs despite the neoliberal hegemony that fosters a culture of managerialism. Supportive relationships involve leaders who recognise ECTs’ personhood, cultivate encouragement, trust, and respect, and prioritise emotional and psychological safety.

Unlocking Job Involvement: Helping New Employees Navigate using Uncertainty Reduction Theory with Psychological Safety as a Mediator.

Organizational socialization (OS) is a critical process that all employees go through. In addition to the job characteristics, the efficiency and effectiveness of the OS process impact the individual's ability to adjust and be involved in the job. This study proposes and tests a new model in which psychological safety mediated the effects of OS and job characteristics on the job involvement of 313 newly recruited health-care professionals' working in 10 private hospitals in South India. Researchers used Uncertainty Reduction Theory to explain the relationship between the variables under study. The results indicate that newcomers' job involvement is predicted positively by OS and job characteristics, and that psychological safety mediates these relationships. These findings as well as their implications in the health-care professional arena are discussed within the Eastern cultural contexts of organizational behavior research.

Examining the relationship between perceived organizational support and teachers’ resistance to change: the mediating effects of climate for initiative and psychological safety

Examining the relationship between perceived organizational support and teachers’ resistance to change: the mediating effects of climate for initiative and psychological safety

The development of an online-based rural community of practice framework for addressing health issues among rural citizens: a grounded theory approach.

Health literacy facilitates an individual's ability to interpret and utilize medical information, thereby influencing their quality of life. Despite the benefits, the current oversaturation of information necessitates the support of healthcare professionals. Help-seeking behavior (HSB) is a term that describes the actions taken to assuage health concerns, and timely medical consultations are critical, especially for older individuals in rural areas who often face barriers to accessing care. These challenges are exacerbated by the perceived psychological distance from medical services in rural settings due to past negative experiences; however, the emergence of social media has helped form a bridge, allowing for direct communication with physicians. While consultations with artificial intelligence (AI) do occur, interaction with human physicians remains the gold standard. Thus, this study sought to understand social media's role in facilitating health consultations in rural areas and the implications for primary care education among physicians. This qualitative study, conducted from September 2022 to June 2023, employed a grounded theory approach to analyze information about a social network-based consulting system that utilized the LINE application. Residents posted anonymous health-related concerns, and comments were extracted. Two researchers coded and assessed the data; another specialist reviewed the findings. A total of 621 citizens participated, generating 10,432 posts. The grounded theory approach identified five major themes regarding health-related social networking in rural settings: (1) mutual exploration for information sharing highlighted distrust toward primary care physicians; (2) temporary collaboration resulted in superficial health discussions and relationship-building through empathy; (3) conflicts arising from differing health perspectives and misinformation sharing led to intense debates; (4) anxiety was resolved through shared illness experiences and increased empathy, enhancing psychological safety; and (5) a mutual assistance community was created, characterized by improved health dialogues and HSB among participants. The high engagement with the social network-based consulting system in rural Unnan City highlights technology's pivotal role in facilitating health dialogue and community engagement, despite challenges related to misinformation and health literacy complexities. As a reflection of the community's health perceptions and dynamics, future adaptations should incorporate strategies to combat these challenges while preserving collaboration and support.

The impact of workplace bullying on employees’ work withdrawal behavior and the significance of psychological safety in China’s multi-ethnic regions

In China's multi-ethnic regions, the phenomenon of workplace bullying can be compared to a mental shackle, which inhibits the work enthusiasm of the bullied, makes the bullied feel depressed, frustrated, and other negative feelings, and makes many employees miserable. This study aimed to develop a correlation between workplace bullying, employees' work withdrawal behavior, and psychological safety in China's multi-ethnic regions. The data collection for this study primarily involved gathering information. through questionnaires from 357 employees within 42 Yunnan-listed enterprises in China's multi-ethnic regions. All statistical data, including frequency, proportion, average, and variability measures, were analyzed using a software tool designed to process statistical information. The finding indicated there exists a direct correlation amongst workplace bullying and employees' work withdrawal behavior in China's multi-ethnic regions. Incorporating psychological safety into the model, subsequent mediation effect testing reveals that there is a partial mediating role of psychological safety in the correlation among workplace bullying and employees' work withdrawal behavior. This research contributes to the existing theoretical investigation on the correlation among workplace bullying, employees' work withdrawal behavior, and their psychological safety in China's multi-ethnic regions. Additionally, it explores how psychological safety can mediate these effects. Furthermore, this study offers valuable insights for enterprises operating in China's multi-ethnic regions by providing practical strategies for human resource management and conflict reduction within organizations.

Change-oriented Leadership in the Context of Transitioning to Strategic Autonomy

Growing geopolitical tensions have transformed the business landscape , driving domestic firms toward an era of strategic independence (Yale School of Management, 2024). This research examines a well-known Eastern European consulting firm that, after transitioning to an independent entity, was confronted with a new personnel assessment system. This shift necessitates a comprehensive understanding of employee readiness and resistance — fundamental concepts in change management literature (Armenakis et al., 1993). Our study incorporated quantitative methods to divide employees according to their readiness for the new system (k-means clustering, factor analysis, and discriminant analysis). At the same time, it employed qualitative research methods to explore motives and attitudes behind employee resistance or readiness (Choi & Ruona, 2011). Based on their adaptability to the new system, we identified three distinct clusters of employees: “Active Supporters,” “Cautious Appraisers,” and “Conservative Skeptics,” allowing us to pinpoint specific non-readiness factors and formulate tailored strategies to address them. The findings suggest that emotional involvement, openness to change, and previous experiences with similar practices significantly influence employee readiness. To mitigate these issues, the paper proposes a strategy rooted in psychological safety and differentiated error management, as advocated by Edmondson (2023), to enhance the organization's learning capability and adaptability. Our results align with previous research indicating that stronger attitudes, often based on personal experience, significantly predict behavior (Eagly & Chaiken, 1993). We found that the initial uncertainty of organizational changes served as a major stressor, underscoring the importance of understanding and conceptualizing changes (Kramer, 2015). Unlike Schwartz (1994), the value orientation of “Tradition” did not exert significant influence, but values of “Autonomy,” “Stimulation,” “Achievement” (consistent with Sortheix & Lönnqvist, 2014), “Hedonism,” and “Power” positively impacted employee openness to changes. The implications of this study extend to other Eastern European companies undergoing similar transitions, providing guidance on how change can be managed effectively in the context of transitioning to strategic autonomy.

Nurse Leader Perspectives and Experiences on Caregiver Support Following a Serious Medical Error

OBJECTIVE This study explored nurse leaders' perspectives and experiences in supporting nurses following a serious medical error. BACKGROUND Appropriate support is crucial for nurses following an error. Authentic leadership provides an environment of psychological safety and establishes a patient safety culture. METHODS A cross-sectional survey research design was conducted to determine nurse leader's (NLs') perspectives on supporting nurses following a medical error. RESULTS NL training on handling serious medical errors varied. NLs indicated experiencing a variety of formal support programs: peer support, education, error examination, employee assistance, and just culture. Following an error, NLs reported these interventions were helpful, including education/retraining, psychological safety, time off the unit, identifying system failures, nurse involvement in disclosure, and peer support. CONCLUSION This study illuminates how NLs support nurses following an error. It provides insight into the education of NLs on assisting nurses and the need to implement formal caregiver support programs.

Bolstering the initiative of construction project members: a self-determination lens combining project social media use

PurposeIn today’s turbulent and complex era, initiative behavior is becoming more drawn to construction projects but challenging to arouse as it is free of the established regulations in project practice. Given the prevalence of social media (SM) in modern workplaces, this study is thereby motivated to investigate whether and how SM use can act to drive initiative behavior of construction project members (PMs) in this context.Design/methodology/approachThis study sharply examines two distinct types of SM use – work-related and social-related – to explore their roles in driving the initiative behavior of construction PMs. Additionally, self-determination theory is employed to explore their underlying translation mechanisms and associated boundary conditions. A survey dataset collected from 229 construction PMs is used to empirically test the proposed theoretical model.FindingsEmpirical results show that role-breadth self-efficacy, psychological safety and project identification, by satisfying basic psychological needs respectively, act as crucial bridging roles in translating SM use into initiative behavior of PMs. Such mediation effects are applied to both work-related and social-related SM use with varied mechanisms. Besides, prevention focus is found to be a contingent moderator on these relationships, with a strengthening role toward role-breadth self-efficacy and a weakening role toward project identification.Originality/valueThis study digs into the nuanced mechanisms of how SM use benefits construction projects, especially in terms of PMs’ initiative. The findings of this research afford new insights into effectively invigorating the initiative behavior of construction PMs under the current digital momentum.

What are the priorities of consumers and carers regarding measurement for evaluation in mental healthcare? Results from a Q-methodology study.

The purpose of this study was to identify and describe common views of people with lived experience of mental health challenges - consumers and carers, families and supporters - of what they consider the most important measures to include in health economic evaluations which assess the incremental value of competing options in mental health care. Participants (n = 111) were people living in the state of Victoria, Australia, who identified as consumers of mental healthcare (n = 38); carers, family members and/or supporters (n = 43); or both (n = 30). Factor analysis based on Q-Methodology was used to identify clusters of people who hold similar viewpoints. Common viewpoints were described in terms of the characteristics of the group, and a qualitative interpretation was conducted on the basis of distinguishing statements and quotes provided in participants' own words. We identified four common views: (1) safety before all else, prioritizing physical, sexual and psychological safety; (2) hope and partnership in processes of care; (3) physical and emotional health and wellbeing; and (4) care access, continuity and partnership with families. Although different priorities were identified for each viewpoint, key priority areas that were common to all views were having an environment in the health service that fosters respect and dignity, and that consumers feel heard and listened to. In sub-group and qualitative analyses, differences were observed regarding the likelihood of consumers and carers holding each of the views, as well as by age group. While some differences were noted between the views of consumers and carers and different age groups, there was also common ground regarding what outcomes are of most importance to measure. Including these measures in evaluation frameworks would provide a way of focussing mental healthcare decisions on the aspects of mental healthcare that are of most value to consumers and carers, thereby addressing an important shortcoming of current approaches to decision-making in mental healthcare.

Rapid review of facilitating reflective practice groups with staff in adult inpatient mental health settings

ABSTRACT Reflective practice is poorly defined and often lacks distinction from other practices, such as clinical supervision. In the UK, the National Health Service (NHS) faces unparalleled challenges within the context of chronic underfunding, high staff attrition, and the recent global pandemic. Frontline staff are desperately trying to meet the demands of their roles and services are struggling to prioritise their professional development and wellbeing, further exacerbating these problems. This rapid review of the evidence sought to identify barriers and facilitators of Reflective Practice Groups (RPGs) within adult inpatient mental health services, using three databases. Two-hundred and one unique references were retrieved, yielding eight papers meeting the inclusion criteria. Barriers to facilitating RPGs included: practicalities; individual and team expectations; needs and competencies of facilitators; and organisational issues. Studies suggested solutions including facilitating RPGs off-ward to reduce disruptions and protect the space; increasing psychological safety by incorporating clear guidelines and expectations for attendees; and organisational support. The review highlighted universal challenges faced by healthcare professionals and organisations in facilitating and accessing RPGs. The review illustrates the paucity of research in this area, which may be due to nebulous definition and inconsistencies between different organisations. Implications for practice are discussed.

“That Percentage of Safer”: A Mixed-Methods Analysis of Homeschool Parents’ Perspectives of School Safety

ABSTRACT School safety has been widely studied from the perspectives of administrators, teachers, and students in traditional education settings. However, parents’ perceptions of school safety have been largely overlooked. Moreover, it is unknown how homeschool parents conceptualize safety in educational settings despite school safety being a known motivator for homeschooling. This mixed-methods study uses two years of national-level survey data from 2,124 respondents and four focus groups with thirteen participants to investigate homeschool parents’ school safety concerns. Supporting existing literature, we find that homeschool parents are likely to also be parents of special-needs learners. Findings suggest homeschool parents are not concerned with physical as much as psychological and academic safety. Moreover, homeschool parents tend to frame the concepts and concerns of school safety through the lens their own or their children’s prior traditional school experiences. Study limitations, practitioner implications, and future directions for research are discussed.

Exploring the Interplay Between Self-Confidence and Emotional Intelligence in College-Level Educators: Implications for Teaching Effectiveness and Student Engagement

This study explores the relationship between self-confidence and emotional intelligence in college-level educators and examines their combined impact on teaching effectiveness and student engagement. As modern educational demands evolve, educators are increasingly recognized for their role in not only delivering content but also in fostering an inclusive, emotionally supportive learning environment. Self-confidence enables educators to present material with clarity, maintain authority, and adapt to diverse classroom challenges, while emotional intelligence equips them with empathy, self-awareness, and social skills essential for connecting with students on a personal level. The interplay of these traits contributes to a balanced teaching approach that supports both academic and emotional needs in students, thereby promoting active engagement, participation, and a positive classroom climate. This study utilizes a mixed-methods approach, combining quantitative self assessments and qualitative interviews to capture the nuanced ways in which self-confidence and emotional intelligence interact and influence teaching dynamics. Findings indicate that educators who possess both high self-confidence and emotional intelligence create classrooms that encourage open communication, foster psychological safety, and inspire student motivation. However, several limitations are noted, including the subjective nature of self-reported data and the influence of cultural and contextual factors on perceptions of confidence and emotional intelligence. Additionally, the study's cross-sectional design limits insights into the long-term development of these traits in educators. Despite these limitations, the study underscores the critical role of emotional and interpersonal skills in effective teaching, suggesting that professional development programs should integrate training in self-confidence and emotional intelligence to enhance educators’ overall impact. These findings contribute to a growing body of literature advocating for a holistic approach to educator preparation, one that values emotional acumen and self-assuredness alongside academic expertise. By emphasizing the importance of these traits, institutions can better support educators in creating enriching, engaging, and resilient learning environments that prepare students for both academic success and personal growth.

Agile Practices and IT Development Team Well-Being: Unveiling the Path to Successful Project Delivery

Agile methods have become popular in the field of software development, offering improved efficiency and product quality. Despite this widespread use, fewer studies have explored in one model their effect on job stress, psychological safety, job engagement, and enhanced job and career satisfaction, which are all the factors that can impact project success delivery. Our study surveyed software development teams with extensive agile experiences. The findings showed that agile practices have a positive influence on job and career satisfaction, better job engagement, improved psychological safety, and project success delivery. However, there are high levels of job stress reported that negatively affect job satisfaction and project results. Therefore, successfully implementing agile methods depends on maintaining sustainable development practices and improving the level of motivation in the agile teams.

Connecting individual-level creativity to strategic management processes

PurposeThis study examines how structured procedures and psychological safety can enhance six sigma processes’ effectiveness and foster individual creativity within an organization.Design/methodology/approachThis study employs a novel methodological approach, combining structural equation modeling (SEM) and multi-value qualitative comparative analysis (mvQCA).This combination gave us a unique lens through which to view the complex connections between the constructs that were the subject of the investigation.FindingsThe results substantiate that a well-structured six sigma approach, paired with a psychologically safe environment, fosters knowledge exploration and exploitation as well as triggering conducive learning behaviors. These elements, in turn, augment individual creativity, which is found to be instrumental in boosting six sigma performance.Originality/valueThis study is one of the first to combine mvQCA and SEM to investigate the complex interplay between structured methods, psychological safety and individual creativity in enhancing six sigma performance. This research highlights the importance of fostering creativity in strategic management processes and the unrealized potential of combining these methods.

THE DIPLOMAT WITHIN: LEADING WITH UNITY IN A MULTIPOLAR WORLD

AbstractThe authors, who have varied and extensive experience in areas such as business and law, note that their “article leverages our collective experiences worldwide as leaders, lecturers, coaches, and speakers, that underscore the increasingly urgent need for diplomacy skills in everyday human interactions.” They further discuss the importance of diplomacy and diplomatic skills in modern workplaces. The authors “introduce the following three‐tiered Personal – Organizational ‐ External Diplomacy Framework, inspired by modern diplomatic thought. It cuts through dense literature on diplomacy and provides a navigational tool on how to add diplomacy skills into the organization’s DNA to nurture peaceful coexistence and achievement of goals, from interpersonal to global engagements.” They discuss three steps in detail, which in their words are (1) Mastering Personal Diplomacy, (2) Developing Organizational Diplomacy, (3) Developing External Diplomacy. For instance, core skills in step 1 are, in their words, self‐awareness, emotional intelligence, systems thinking, positive regard for others, effective communication, and trust building skills. Step 2 includes, in their words, Leadership Diplomatic Composure, Psychological Safety and Performance, Learning and Development, Engagement and Dialogue, Diversity and Teamwork, and Strategic Implementation. Step 3 includes, in their words, Engagement with External Stakeholders, Leadership in Global Challenges, and Public Diplomacy and Policy Advocacy.

Promoting Workplace Mental Health for Hospital Social Workers Using Compassionate Mind Training

Hospital social workers commonly experience empathy fatigue and burnout at work. However, empathic distress can be reversed by cultivating compassion as a skill and learning how to turn empathy into compassion. This report explores how 60 staff used Compassion Mind Training (CMT) to promote workplace mental health for hospital social workers. It recommends building a workplace culture of compassion through CMT using various ways to reinforce individual and organizational commitments. This helps create a sense of psychological safety that leads to positive ripple effects in the mental health of staff.

Sequenced co-design with stakeholder communities to support the development of spaces for mental health recovery and healing

This research reports on a sequenced co-design process to engage lived experience consumers, carers, healthcare professionals, sector advocates and government representatives in co-designing spatial and experiential inputs to a residential eating disorders facility. The stakeholder community was enabled to co-design a model of care and, building on this, shape the functional brief for the design of health spaces. The stakeholder community input provided architects and designers with a more expansive understanding of user needs regarding specific architectural qualities including psychological safety, flexibility, social connection, and sensory experiences. Our approach yields insights across three interlinked areas: capacity building in the stakeholder community to develop the design language to contribute to design discussions; co-design processes to question pre-existing design assumptions; and subsequently, the development of a more nuanced brief for health spaces. The research supports designers, architects, health organizations and health planners to meaningfully engage with future users of complex healthcare environments.

Cultivating a Culture of Trust: The Key to Unlocking Team Potential

This article examines the research behind psychological safety and provides practical recommendations for how leaders can cultivate it within their teams. Psychological safety refers to shared beliefs among team members that the team is safe for interpersonal risk-taking and idea sharing. Studies show that psychological safety positively impacts team innovation, collaboration, learning, and performance. However, few organizations consistently foster it. The article discusses the origin and key findings of psychological safety research, including Edmondson's early work and follow-up studies showing its relationship to various organizational outcomes. It then offers advice for leaders, such as modeling vulnerability, focusing on growth over blame, promoting inclusive decision-making, providing constructive feedback, and celebrating learning from failures. Industry examples from Netflix, Google, and Southwest Airlines illustrate how applying these practices helps maintain psychological safety. The article argues that proactive leadership is needed to establish psychological safety as a sustainable norm that allows teams to thrive and reach their highest potential.

Towards Safer Spaces: An Empirical Investigation of Trainee Psychological Safety Within Academic Medical Centers.

Psychological safety is critical for fostering well-being. Integral to the mission of academic institutions, trainees are among the most vulnerable to negative workplace experiences, calling for a need to understand factors that contribute to psychological safety in this population. Our objective is to empirically explore trainee psychological safety to inform best practices for training environments. A survey was used to capture organizational, interpersonal, and individual factors, as well as demographic information in graduate, postdoctoral, medical, resident, and fellow trainees. Descriptive statistics, multivariate ordinal logistic regression, and dominance analyses were used to understand psychological safety and the predictors that explained the majority of the variance in its statistical model. Gender minorities and those who suppressed their race information were less likely to feel psychologically safe. Psychological safety was predominately explained by senses of belonging, recognition, and respect. Notably, trust and confidence in supervisor emerged as a pivotal factor influencing belonging and respect, whereas organizational support played a crucial role in fostering recognition and belonging. Intriguingly, clarity in role expectations and autonomy were positively correlated with recognition. Our findings highlight the interplay between organizational, interpersonal, and individual dynamics shaping psychological safety. Importantly, those who suppress their race as well as female or gender minorities are disproportionally prone to feeling unsafe. We further elucidate role clarity and autonomy as important factors in achieving a sense of recognition. We suggest programs prioritize development beyond technical competencies, recognizing trainees as key stakeholders in the cultivation of positive culture within academic environments.