Clear and decisive actions have importance placed on them in any work environment. Healthcare is also no different in regards to this rhetoric. Historically conversations, expressions and discussions around staff emotions have been frowned upon in many professional environments. Some healthcare specialities can be more closed off to such conversations than others. However, more and more healthcare organizations understand that the lack of emotional expression and also psychological safety has a huge impact in regards to both staff wellbeing and also staff retention.This article by Erin Carn-Bennett, MN, RN will discuss psychological safety and what activities can be employed among healthcare simulation teams to maintain and improve this culture on a regular basis.
Psychological Safety is Hard, Particularly in Healthcare
Some staff members are more inclined to share personal experiences and raise ideas more than others. However, psychological safety is about the creation of an environment for staff to be able to speak up freely without fear of reprimand or professional risk. As staff within a healthcare simulation team, psychological safety and the ability to have hard conversations not only with clinical simulation participants but also with one another is of huge importance. Although important, maintenance of psychological safety is far from easy in any field of work. In healthcare where even more is at stake, arguably this makes psychological safety even more challenging for teams the world over.
Life in general, is challenging for most people currently in one way or another. Staff bring baggage to work with them arguably more now than ever before. There can be an instinct to judge behavior of others, however under incredibly challenged world circumstances the ability to constantly be at a personal best is not realistic. To not have human moments of not performing to perfection and to be a causation of errors has never been more front and center than now. The ability to reflect, forgive and to understand one another is at the core of psychological safety. Though our biggest mistakes can feel incredibly painful, this is the space where there are the most lessons to learn.
Psychological Safety is Never Just a Check Box Activity
Psychological safety is the creation of a safe space for staff which takes a lot of work, but technically doesn’t require much education. The key ingredients are an attention to care and consistency to constantly work at the psychological safety foundations. Prior to the global pandemic, many healthcare workplaces and also workforces were much more stable. Many healthcare organizations described themselves as psychologically safe or felt this box could be ticked without an ongoing strategy. Today, psychological safety is complex and needs constant work. Psychological safety goes up and down in teams and needs a constant central focus by all.
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Psychological safety is an environment and feeling that there is the ability to be open and honest in a team or other environment. Amy Edmondson, a Harvard Business School professor who discovered the definition, describes a psychologically safe workplace culture as a culture where the ability to speak up and learn from mistakes is encouraged and often even celebrated. As healthcare simulation staff and teams who deal with clinical simulation participants often at their most vulnerable, there is great importance for our own teams to work constantly on this skill. No one is immune from errors in the psychological safety space and constant reevaluation to improve should be considered in order to grow and move forward.
Psychological safety is not the end product of being nice. Amy Edmondson describes that psychological safety is dependent on a certain amount of healthy conflict in an organization. A free exchange of ideas and the ability to have productive and professional disagreements enables organizations to be able to propel themselves forward and have a high level of staff satisfaction in their role.Staff that feel empowered to take action and know their voices are heard and that their opinions can positively affect their ability to innovate. As healthcare simulation is a highly innovative and creative space, psychological safety is critical for an effective team.
All team members can assist to support psychological safety, not just leaders. Strategies to support and improve psychological safety can include: ask for input and opinions broadly, respond to questions or doubt, acknowledge all ideas and provide thanks for contributions. Forgive staff members’ mistakes and focus on positives such as that the error was captured and any learnings from the experience. Above all, a psychologically safe work environment protects employees from the fear of being wrong. Psychological safety comes down to the ability for team members to feel safe, to be vulnerable and to share.
Team Activities to Help Support Psychological Safety
Hold an “anxiety party” as a team to practice vulnerability. Team members can write down their biggest anxieties and then rank their concerns from most to least worrisome. After this process, ask to share them with teammates to then provide feedback and perspective. This assists to practice honesty and encourages team members to acknowledge insecurities, and the ability to discover how to move forward and prioritize when stuck.
A daily or regular check in with team members can be hugely impactful and also beneficial for individuals to reflect on their team members current frames of mind. On a more strategic level a check in can be a helpful strategy to plan the day or week ahead in terms of workload. If a team member has a lot of stress at home but others are in a better position to assist, job lists and tasks can be altered with this in mind. In terms of how much team members may wish to share a numerical value out of ten may also be all that is required in terms of mental and physical capacity for team members.
Icebreakers and team building exercises can be useful especially within a new team or when new team members have joined. Sessions of reflection for team members around experiences or events can be incredibly powerful. No interruptions and deep listening can be incredibly transformative among team members. Other activities include the use of sticky notes to speak up thoughts about a specific question, problem or project. After each team member has had adequate time to write their sticky notes a safe and growth centered conversation can assist to give both reassurance and also solutions to problems.Celebrations of the messenger who is brave and raises difficult topics and questions should occur as much as possible to reinforce and encourage psychological safety.
This article has discussed psychological safety in regards to the healthcare simulation team. As healthcare simulationists a number of communication, soft skills and emotional intelligence strategies are required to be able to set up, run and debrief clinical simulation courses. However, healthcare simulation educators are not immune from life and global workforce challenges. An allowance to not always be right in the psychological safety space but to evolve, grow and try again should be at the forefront for those in healthcare simulation. Failure needs to be reframed as an opportunity for growth and role modeled to the rest of healthcare as clinical simulation already does in many other healthcare topics.
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