Psychological Safety Research Articles

How can we measure psychological safety in mental healthcare staff? Developing questionnaire items using a nominal groups technique.

There have been growing concerns about the well-being of staff in inpatient mental health settings, with studies suggesting that they have higher burnout and greater work-related stress levels than staff in other healthcare sectors. When addressing staff well-being, psychological safety can be a useful concept. However, there is no measure of psychological safety that is suitable for use in inpatient mental health settings. Edmondson (1999) is the most commonly used measure of psychological safety, but it was designed for use in general physical healthcare settings. As inpatient mental health settings are unique environments, transferability of knowledge from physical to mental healthcare settings cannot be assumed. We sought to develop questionnaire items that capture psychological safety among healthcare staff working in acute inpatient mental healthcare settings. We used the nominal group technique, a consensus method involving rounds of discussion, idea generation, and item rating/ranking to identify priorities. Twenty-eight stakeholders participated, including 4 who had lived experience of mental health problems, 11 academics and 18 healthcare professionals (8 participants identified with more than 1 category). The study involved a workshop with three parts: (i) an overview of current research and limitations of the Edmondson (1999) measure as outlined above, (ii) discussion on what items should be retained from the Edmondson (1999) measure, and (iii) discussion on what items should be added to the Edmondson (1999) measure. Twenty-one items were generated and retained to capture psychological safety in inpatient mental health settings. These measure professionals' sense of being valued by their team and organization, feeling supported at work, feeling physically safe and protected from physical harm, and knowing they can raise concerns about risk and safety. This is the first study to generate questionnaire items suitable for measuring staff psychological safety in mental health settings. These have been generated via a consensus method to ensure stakeholders' views are reflected. Further research is needed to evaluate factor structure, internal reliability, and convergent validity.

Inclusive Leadership and Employee Voice Behaviour: Serial Mediating Effects of Psychological Safety and Affective Commitment

Inclusive Leadership and Employee Voice Behaviour: Serial Mediating Effects of Psychological Safety and Affective Commitment

Team Factors in Ethical Decision Making: A Content Analysis of Interviews with Scientists and Engineers

The ethical decision making of researchers has historically been studied from an individualistic perspective. However, researchers rarely work alone, and they typically experience ethical dilemmas in a team context. In this mixed-methods study, 67 scientists and engineers working at a public R1 (very high research activity) university in the United States responded to a survey that asked whether they had experienced or observed an ethical dilemma while working in a research team. Among these, 30 respondents agreed to be interviewed about their experiences using a think-aloud protocol. A total of 40 unique ethical incidents were collected across these interviews. Qualitative data from interview transcripts were then systematically content-analyzed by multiple independent judges to quantify the overall ethicality of team decisions as well as several team characteristics, decision processes, and situational factors. The results demonstrated that team formalistic orientation, ethical championing, and the use of ethical decision strategies were all positively related to the overall ethicality of team decisions. Additionally, the relationship between ethical championing and overall team decision ethicality was moderated by psychological safety and moral intensity. Implications for future research and practice are discussed.

Enhancing the Graduate Medical Education Clinical Learning Environment Through Community of Practice Forums.

An optimal clinical learning environment (CLE) is associated with improved learning and patient care outcomes. Significant concerns exist about the state of the CLE in graduate medical education (GME). Research suggests GME programming falls short in interpersonal aspects of training that promote trainee engagement and psychological safety. Furthermore, published educational interventions in the CLE lack adequate theoretical backing to inform a rational approach to interventions in the CLE that could address these important problems.The authors apply the 2002 work of Etienne Wenger on communities of practice (COP) to address these GME CLE concerns. To distinguish this COP intervention from earlier theoretical work on COPs, the authors refer to this management concept as "COP forums." COP forums favorably influence the GME CLE through effects that complement experiential learning in patient care. COP forums support trainee psychological safety, mentorship from near peers, and opportunities to innovate-effects that can serve as a counterbalance to the time pressures, hierarchy, and compliance culture often experienced in the clinical environment. Deliverables of COP forums, including practice innovation and trainee self-efficacy, can favorably impact organization-wide performance and engagement.This article describes the historical position of COP forums in the evolution of COP theory and outlines the basic structure and function of COP forums. It contrasts COP forums to other COP-related concepts to explain their relevance to the GME CLE. Examples of innovative GME COP forums illustrate the structure and function of these interventions. Finally, the authors call for more research on the impact of COP forums on the GME CLE. To avoid confusion, such scholarship must account for the ongoing evolution of the larger COP framework and target specific dimensions of the theory most pertinent to the medical education research question at hand.

Our House Won't Rebuild Itself: Peace, Love, and Hope as Tools to Transform Graduate Medical Education.

Graduate medical education (GME), the period of specialty and subspecialty training following attainment of a medical degree, is the final step in a continuum of medical education culminating in independent physician practice. This manuscript uses the metaphor "our house" to describe all aspects of the GME environment in which health care professionals and trainees learn and work. Our house's inhabitants have unequivocally stated that our house is in a state of disrepair. While physicians-in-training inevitably face challenges on their journey to independent practice, those from historically marginalized backgrounds face these challenges compounded by the disproportionate impact of identity-based harms. The authors use critical and liberatory theories to explore dominant power dynamics in GME, classifying identity-based harms as silence, pain, and despair. To strive for true transformation, the authors advocate for a new set of house rules, a different way of co-existing based on the principles of liberatory design. The authors call on readers to rebuild the house of GME by drawing parallels between the foundational human values of peace, love, and hope and the educational principles of psychological safety, identity safety, and belonging. To transform GME, our community must make space in our house for all individuals to join, and indeed, to rebuild together.

The Joy Factor: Redefining Leadership Excellence at Black in Marine Science through Joy-Centered Leadership Practices.

At Black in Marine Science (BIMS), the integration of joy-centered leadership principles has emerged as a transformative blueprint for empowering leaders and fostering inclusive environments. This article explores the integration of the Formula for Joy (F4J) model within BIMS, providing a comprehensive overview of its principles and practices. It presents the model as an adaptable leadership approach suitable for a diverse range of leaders and organizational contexts. The F4J model, uniquely designed for the challenges and opportunities within BIMS, specializes in leaders' personal joy and wellness. It encourages leaders to embark on a journey of self-discovery, embracing their true identities and finding fulfillment within their roles. By fostering an authentic exploration of self and nurturing continuous growth, leaders can cultivate meaningful connections within their teams, promoting collaboration and unity. Moreover, the F4J model highlights the significance of psychological safety and balanced well-being in creating environments where individuals feel valued and culturally supported. By championing an ethos of iterative joyfulness, leaders engage in ongoing self-reflection and improvement, enhancing their well-being while fostering resilience in navigating organizational challenges. This article underscores the practical benefits of joy-centered leadership within BIMS, offering a roadmap for leaders to infuse joy into their practices and drive positive change. By embracing the principles of F4J, leaders within and around BIMS can foster environments of empowerment where diversity is celebrated, and individuals thrive.

Exploring the relationship between coach-initiated motivational climate and athlete well-being, resilience, and psychological safety in competitive sport teams

Exploring the relationship between coach-initiated motivational climate and athlete well-being, resilience, and psychological safety in competitive sport teams

"Because I Am a Female": Stigma and Safety Perspectives from Racially/Ethnically Diverse Women with Serious Mental Illnesses.

Individuals with serious mental illnesses (SMIs) face safety risks related to their mental health conditions that are often compounded by experiences of trauma, victimization, residence in impoverished neighborhoods, and histories of homelessness. Stigma and safety challenges significantly impact community integration for individuals with SMIs, particularly women, who often bear a disproportionate burden of vulnerability, gender-based stigma, violence, and other inequalities. This study investigates how women with SMIs engage in the meaning-making of their safety and stigma experiences that, in turn, influence their community integration. From a large multi-site study exploring community experiences of racially/ethnically diverse participants with SMIs, a subsample of 28 cis and trans-gender women, who reported experiencing gendered stigma and a lack of safety, were chosen for the current study. The interviews were analyzed using modified principles of Interpretive Phenomenological Analysis (IPA) to understand how women with SMIs made meaning of their safety and stigma encounters in their families, communities, and neighborhoods. IPA analysis resulted in the emergence of themes within a broad category of safety that represented participants' meaning-making about their physical safety and stigma experiences. Specifically, we used the broad themes from an existing framework of safety called 'Navigating Safety' model as sensitizing concepts for our analysis. Physical and psychological aspects of safety for this study were experienced in tandem whereby the women made sense of how their experiences of a lack of physical safety in multiple contexts shaped their sense of self, internalized stigma, and their social relationships. Within the broad theme of physical safety, participants described unsafe neighborhoods, exposure to domestic and intimate partner violence, and vulnerability to sexual violence. Additionally, under psychological safety, we identified how gender-based norms, race and ethnicity, sources of stigma (internalized, familial, and societal), and social isolation contributed to their mental health and social relationships (particularly with family). These findings highlight how the compounding influence of the intersection of multiple stigmatized identities exerts safety challenges on the lives and community experiences of women with SMIs. Focusing on access and affordability of appropriate gender-responsive resources for women, including trauma-informed care, could reduce hospitalizations, mental health symptoms, and stigma so they can safely integrate into their communities.

Lessons learnt from the implementation of the Covid-19 vaccination programme in the Southwest of England.

Vaccination remains one of the most successful public health interventions in preventing severe disease and death. The roll-out of Covid-19 vaccination programmes has helped protect billions of people around the world against Covid-19. Most of these programmes have been unprecedented in terms of scale and resources, and have been implemented at times of significant humanitarian crisis. This study aims to outline the lessons learnt from the implementation of a regional Covid-19 vaccination programme. These will help inform emergency preparedness and future crisis management. This qualitative study sought to explore the key drivers to the successful implementation of the Covid-19 vaccination programme in a region in the Southwest of England, applying the Normalisation Process Theory lens (NPT) to examine multi-stakeholder perspectives. Data collection involved semi-structured interviews with 75 participants. Document analysis was also used to corroborate the findings emerging from the interviews. Inductive thematic analysis of the data was used to identify the key drivers for the successful implementation of the programme. The NPT lens was then applied to map the themes identified to the domains and constructs of the framework. Ten key drivers to the successful implementation of the Covid-19 vaccination programme locally were identified, including: the clarity and consistency of the programme's goal; the diverse representation of stakeholders within the programme leadership team and the mechanisms created by this team to ensure psychological safety, autonomy, operational flexibility and staff empowerment; Communication and data specialists' input, and collaboration with local communities to maximise the reach of the programme; and allocating funding to tackle health inequalities. This study highlights the lessons learnt from the implementation of the Covid-19 vaccination programme at a local level, and the mechanisms that can be used in future crises to respond efficiently to the needs of individuals, communities and governments.

The Art of Speaking Up: Supporting a Culture of Safety in the OR.

Considering the high-risk, stressful, and fast-paced nature of the perioperative environment and vulnerability of surgical patients, the quest for maintaining a safety culture in the OR is ongoing. Speaking up-an interaction between perioperative team members to address a concern-requires team member empowerment to advocate for patient safety when needed. Hierarchical gradients, lack of psychological safety, incivility, and a nonsupportive organizational culture can impede speaking-up behaviors. Strategies to improve speaking up include using multimethod education initiatives, enhancing psychological safety, and managing conflict. Perioperative nurses can experience barriers to speaking up, such as lack of team familiarity, normalization of deviance, and differing perceptions among team members. The logistics of whole-team training initiatives can be challenging; however, such initiatives can help participants improve their understanding of the perspectives and communication goals of all involved personnel. Perioperative nurses and leaders should collaborate to promote speaking up for safety whenwarranted.

The role of multidisciplinary collaborations in publishing innovation

Product innovation is crucial for the future of the publishing industry, and the objective of this study was to understand the role of multi-disciplinarity in publishing innovation teams, typical patterns of interaction between team members, and similarities and differences in multidisciplinary innovation teams across national boundaries (US, Canada, and Germany). This is an exploratory study from Portland State University, Stuttgart Media University and Toronto Metropolitan University based on twenty-one qualitative in-depth interviews with publishing employees involved in the innovation process. The study reveals that multidisciplinary innovation teams are common in all three countries. Using an input-process-output (IPO) model, researchers found three main things: 1) input from outside the company is helpful; 2) corporate culture, familiarity and psychological safety foster creativity during the innovation process; and 3) innovation output is often evaluated by low-cost prototypes presented to the target audience.

Mental Well-Being and Management Support of Quick Service Restaurant Employees in the 4 Cities of Batangas

The study aimed to assess the mental well- being and management support during the time of the pandemic among restaurant employees in quick-service restaurants (QSR) in the cities of Batangas Province. It presented the profile of the restaurant employees in terms of gender, length of service, and type of employees; determined the mental well-being of employees in terms of well-being, psychological distress, absenteeism/ presenteeism; and work engagement; assessed the management support in terms of supervision support at work and psychological safety climate management; tested the significant difference when grouped according to the profile. Descriptive research was used with 103 QSR employees weighted mean and ANOVA are the statistical tests utilized. Based on the result, the majority of the QSR employees were 20-30 years old, female, working for less than 6 months, in a full-time category, in a franchised quick service restaurant with 1 to 2 days missed shifts in 28 days. The mental well-being of the QSR employees was stable because they often felt that they are close to other people, though sometimes they experienced that working was an effort, and during their absence, they are contacted by their manager or supervisor and their supervisor was accessible and approachable to their team. With this supervisor attitude, they felt that time passed quickly when they working. The responses of the QSR employees with regard to well-being differed when grouped according to profile. Assessment of psychological distress differed in terms of age, length of service, and type of ownership while for absenteeism the assessment differed in terms of types of employment and number of days missed. As to management support, only the assessment of QSR employees differed in terms of supervision at work and work engagement when grouped according to age.

Mediating Effect of Transformative Learning Process on the Psychological Safety and Transformative Learning Outcome among Information Technology Firms in Beijing, China

This paper investigates the mediating effect of transformative learning processes on the relationship between psychological safety and transformative learning outcomes among information technology firms in Beijing, China. With the rapid evolution of the technology industry, fostering a conducive learning environment becomes essential for employee development and organizational success. Drawing on a sample of information technology firms in Beijing, this study explores how psychological safety influences transformative learning outcomes, and whether transformative learning processes mediate this relationship. The research employs a structured questionnaire survey to collect data from employees, focusing on variables related to psychological safety, transformative learning processes, and transformative learning outcomes. Preliminary findings indicate a significant positive association between psychological safety and transformative learning outcomes. Moreover, transformative learning processes, including social support, attitude toward uncertainty, and criticality, demonstrate a mediating effect on this relationship. Specifically, employees who perceive higher levels of psychological safety are more likely to engage in transformative learning processes, leading to enhanced transformative learning outcomes. These results underscore the importance of promoting psychological safety and facilitating transformative learning processes within information technology firms. By fostering a supportive and inclusive work environment, organizations can empower employees to embrace change, cultivate innovative thinking, and ultimately drive organizational success in the dynamic technology landscape of Beijing, China.

Psychological safety and psychosocial safety climate in workplace: A bibliometric analysis and systematic review towards a research agenda

Introduction: Research on workplace safety has seen significant growth in academic and industry-focused literature over the past 20 years. However, the extant literature on workplace safety tends to focus on safety outcomes of physical accidents and injuries while relegating its conceptual and theoretical development to the background. Psychological safety and psychosocial safety climate in the workplace are essential to workers’ health and safety. These concepts are crucial in enabling job satisfaction, work engagement, and performance productivity. Progressing the literature on this subject is necessary to keep abreast with the changing dynamics of the post-COVID challenges, such as working from home, isolation, and stress from AI, among others. A significant gap in the extant literature burrows in the lack of conceptual clarity of workplace safety from a psychological perspective and the poor understanding of its substantive effects on organizations. Hence, re-examining workplace safety's conceptual and theoretical foundations from a psychological lens offers a more nuanced understanding of its potential to contribute to employee well-being and organizational resilience, pursuing a better work-life safe and more comfortable working environment. Method: This study: (a) synthesizes the theoretical propositions and empirical findings from 990 research articles published between 2000 and 2023 to map the existing body of knowledge about psychological safety and psychosocial safety climate, including their theoretical underpinnings and mechanisms, to offer a state-of-the-art overview of the scope of workplace occupational health and safety research from a psychological perspective; (b) applied a data-based research design adhering to PRISMA; (c) compiled descriptive synthesis and textual narrative syntheses through bibliometric analysis and a systematic literature review; and (d) opens the black box of workplace safety research by presenting significant findings to inform future conceptual, theoretical, and methodological research as well as the practice of workplace safety through the lens of psychology. Results: This study’s findings further offer managerial implications to workplace safety policy-making and human resource management practices to enhance employees’ psychological safety and eliminate workplace psychosocial hazards.

Sea Voyage Interview as a conversational method for strengthening the sense of psychological safety and security

The Sea Voyage Interview is a new and original method grounded in attachment narrative therapy, which serves as a therapeutic metaphorical framework to enhance clients’ narratives relating to safety and security, and to cope with the latter’s loss. It encourages clients to introspect and enrich their narratives by integrating cognitive and affective information, thereby improving threat identification and response strategies. This interview process acknowledges the distortions people create in their stories to feel secure, without judging the veracity of these narratives. The method employs a systemic approach, emphasizing context in shaping a sense of security and incorporates a playful element with kinetic sand and figurines to facilitate expression. It is non-diagnostic, designed for adult therapy, and does not explore childhood safety experiences, leaving this to established instruments. The Sea Voyage Interview prioritizes flexible conversational guidance, focussing on perceived threats, coping mechanisms, and psychological resources to foster a strengthened sense of security.

Fostering Innovative Work Behavior: Ethical Leadership, Psychological Safety, and Proactive Personality

Fostering Innovative Work Behavior: Ethical Leadership, Psychological Safety, and Proactive Personality

Focus groups as counterspaces for Black girls and Black women: A critical approach to research methods

When researchers intentionally account for the complexities of gendered racism, focus groups can become spaces for healing, community building, information exchange, psychological safety, and support for Black girls and Black women. This approach, when situated within race, gender critical perspectives, presents opportunities for ascertaining Black girls and Black women’s onto-epistemologies in ways that coincide with their identities. Given the alternative possibilities of focus groups, in this paper we advance strategies for employing focus groups as counterspaces, an anti-racist and anti-oppressive research method that educational psychologists can utilize to challenge current methodological approaches related to Black girls and Black women. To transform how educational psychologists spotlight Black girls and Black women as knowledge producers in research, we draw upon guiding theoretical frameworks (Black Girl Cartography and Critical Race Feminism) that highlight their voices and intersectional perspectives. We will (1) explain the theoretical perspectives that center this method as a critical approach for the gendered racialized experiences of Black girls and Black women, (2) share insights from the field where focus groups provide psychological safety and group collectivism, serve as an adaptive coping mechanism, and provide space for authentic communication styles, (3) consider areas for improvement and best practices for focus groups in research design, data collection and analysis, and (4) provide ethical considerations related to focus groups as counterspaces. Implications for critical research methodology approaches centering Black girls and Black women and the broader impact on the field of educational psychology are discussed.

Safety first! Psychological safety as a driver of learning in functionally diverse, self-assembled teams

Purpose This study aims to explore psychological safety as a potential moderating mechanism for the relation between functional diversity and individual perceptions of learning, and functional diversity and team performance in self-assembled teams. Design/methodology/approach To test these relationships, the authors conducted a cross-level, time-lagged, quasi-experiment, using a sample of 143 self-assembled teams. In one condition, participants formed into functionally diverse teams, and in another condition, participants formed functionally homogeneous teams. Findings Results suggest that functional diversity and psychological safety have an interactive effect on both individual learning and self-assembled team performance, albeit in different directions. Specifically, low psychological safety was more deleterious for individuals on functionally diverse teams than functionally homogeneous teams when it came to perceptions of learning, but the opposite was true when it came to team performance. Originality/value The results of this study indicate that it is critical to train team members on developing psychological safety, both in traditional and functionally diverse contexts.

Probation fear in new starters: understanding and alleviating concerns

Purpose This “viewpoint” paper aims to explore the root causes of probation fear, including worries about job security, performance expectations, cultural fit and feedback. It seeks to examine the impact of these fears on employees’ mental health, job performance, work relationships and career progression, as well as the broader implications for employers, such as increased turnover and training costs. Leadership’s role in creating a supportive environment and encouraging feedback is emphasised. Design/methodology/approach This paper uses a combination of author observations and literature to explore the intricacies of probation fears faced by employees during the probation process. Findings Author observations and literature show that the impact of probation fear is not strictly limited to the employee who is going through the probation process. It is suggested that by addressing probation fear, a more inclusive, supportive and productive workplace can be created. In a collective effort, Employers can implement transparent communication, structured onboarding, supportive feedback, mentorship programs and foster psychological safety and employees can seek clarity, build relationships, prioritise self-care, focus on learning and engage in professional development. Research limitations/implications As this paper includes observations from the author the paper could suffer from the writer’s biases even though this is unintended. Originality/value To the best of the authors’ knowledge, as this paper includes observations by the author, this study is original. This paper also provides value to both HR and front-line managers involved in the employee probation journey where the exploration of probation fear is under-researched.

Developing critical enquiry, capacity, capability and confidence in the health and care workforce.

Health and care staff have limited opportunities to design, deliver and lead critical enquiry activities. To explore barriers and enablers of building capacity, capability and confidence of these practitioners who wish to undertake critical enquiry activity. A realist conceptual framework including the development of middle range theory allowed analysis of the scholarship process and outcomes. Data were collected through snap surveys, interviews (face to face and online) and project output (posters). Nine scholars completed the programme and all participated in the study. They all experienced an increase in capacity, capability and confidence in critical enquiry activity. Six overarching themes arose from analysis of the interviews and snap survey data: value; expertise; attitudes; meaningful, responsive support; brain space; and skill and knowledge acquisition. A combined focus on people and project while staff remained embedded in their work area was key for the growth of skills and knowledge and creating impact from projects. Guilt at having dedicated time to take part in the programme was a self-imposed barrier to building capacity and capability. Social capital (gained from bringing together individuals from different groups with shared values) facilitated bonding, which increased psychological safety and helped enable capability and confidence. The combination of theory and practice embedded in a real-world context led to positive outcomes for staff, patients, carers and the facilitation team as real-life changes were made in clinical environments.