Barriers and Facilitators to Surgical Trainee Psychological Safety

What are potential barriers and facilitators to psychological safety for surgical trainees in the clinical learning environment?In this qualitative study of 25 surgical trainees across 9 residency programs, 4 barriers and 3 facilitators to psychological safety were identified. Barriers consisted of (1) public humiliation, (2) tension around questioning, (3) culture fostered by faculty, and (4) influence of flawed system factors; facilitators included (1) the work involved in promoting psychological safety, (2) trust, and (3) normalizing vulnerability in the clinical learning environment.Findings highlight 7 key individual, interpersonal, and system-level factors associated with psychological safety for surgical trainees, which may inform the development of future interventions.

Corresponding Author: Gurjit Sandhu, PhD, Department of Surgery, Center for Surgical Training and Research, University of Michigan, 1500 E Medical Center Dr, 2201 Taubman Center, Ann Arbor, MI 48109-5346 (gurjit@med.umich.edu).

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