Psychological Safety is Critical to the Success of All Medical Teams

Psychological safety refers to a team environment where team members are comfortable with being vulnerable, asking questions (no matter how silly), and speaking up without fearing judgement, embarrassment, or rejection from their colleagues. In high-stakes professions such as medicine and healthcare, these ‘safe’ conditions can foster high-quality communication, decision-making, and patient care. So, what are some of the benefits of psychological safety? And how can we enable it?

Benefits of psychological safety

Research demonstrates that teams with high psychological safety outperform teams with low psychological safety, especially in innovation (Bynum & Haque, 2016). In medicine and healthcare teams, psychological safety can help to instil a continuous quality improvement mindset, willingness to learn from mistakes, and increased knowledge sharing between team members (Nembhard & Edmondson, 2006). It can also encourage medical team members to generate new ideas, challenge others, and report and debrief about errors. In turn, team members are more engaged, experience greater job satisfaction, and are likelier to stay with their workplace (Frazier et al., 2017).

“Better teams [in the medical industry] — as measured by a team diagnostic survey — reported higher error rates, not lower ones. That made me think: Maybe better teams don’t make more mistakes. Maybe they’re more willing and able to talk about them.” – Amy Edmondson at the Learn Serve Lead 2019: The AAMC Annual Meeting

Fostering Psychological Safety

Undoubtedly, several deep-rooted challenges within the healthcare industry may hinder psychological safety. These challenges include to name a few: rigid and hierarchical reporting lines, large power differentials, a competitive culture, and negative behaviours that intensify the impulse to avoid speaking up (i.e., shaming, humiliation, judgement and bullying; Bynum & Haque, 2016).

While there is some way to go before high psychological safety is a norm in this industry – the good news is that team members and leaders can enact particular behaviours that can foster psychological safety at work:

To foster psychological safety, team members can:

• Show curiosity: Openly share your interest in learning new skills, experiment and iterate, and willingness to make mistakes. For example, when you know something interesting, make it a regular habit to share your insights with at least one other team member.
• Provide peer support: Be a supportive and considerate team member. Look out for each other and aim to build high-quality relationships at work to build trust. For example, regularly schedule time to chat about non-work matters.

Leaders can demonstrate the following:

1. Leading by example: Be open, sharing your visions and plans but try not to be afraid of showing your true self. This gives more authentic signposts and enables people to model your openness and Growth style.
2. Encourage intrapersonal risk-taking: ‘Intrapersonal risks’ refers to behaviours that, in the absence of high psychological safety, would typically result in discomfort and avoidance behaviours (e.g. showing vulnerability, being comfortable not knowing the answer or admitting mistakes/errors.) As a leader, you can encourage interpersonal risk-taking by suspending judgement and actively inviting questions. Share your war stories and lessons learned to promote the same from your team.
3. Be inclusive: Being an inclusive leader means encouraging your team members to bring their authentic selves to work. You can do this by being available to your team, being open to listening and considering all diverse perspectives; this purposefully creates a sense of belonging for all team members.
4. Foster a Growth culture: Latest psychosocial research identifies that creating an environment of growth is the most beneficial for team structure and outcome. This is more relevant than pushing performance criteria alone. Having goals and targets is crucial to any business. However, people need to see that creativity, innovation and being able to fail are central to High Performance.
5. Encourage Focus: Great products come from ensuring people know precisely where they are going and what they should do.
6. Take Responsibility for your Team: Great leaders are accountable. They carry the team, and the team learns to carry each other. That’s what fundamental safety in teams does.

As high psychological safety becomes more common in the medical industry, so will various positive outcomes for practitioners and their patients. Leaders and individual team members have roles in creating a culture where colleagues feel safe using their voices.