Key tips to providing a psychologically safe learning environment in the clinical setting

Abstract

Having psychological safety embedded in preceptorship relationships facilitates positive interpersonal and educational experiences for students. Psychological safety refers to a student’s belief as to whether or not it is safe for them to take interpersonal risks, such as asking questions, sharing an idea for improvement or speaking up to maintain patient safety. Having psychological safety leads to collaboration, positive student learning experiences and effective patient care. This article presents key guidelines for preceptors to provide a psychologically safe learning environment for their students. Guidelines fall under four categories 1) before meeting students, 2) first meeting students, 3) continued relationship with students, and 4) general rules. These guidelines are informed by current literature on psychological safety and preceptorship and the author's clinical expertise in nursing preceptorship. We conceptualise psychological safety in a nursing preceptorship for preceptors to denote the experience of inclusivity, empowerment, and well-being of students within the social, cultural and physical clinical learning environment. A crucial attribute to cultivating a psychologically safe environment involves being an accessible and approachable preceptor.

Validation of the Italian version of the Neuroception of Psychological Safety Scale (NPSS)

“…In addition, in order to measure, and enhance, psychological safety in mental health services, team-level surveys are administered that comprises proposed indicators of psychological safety as perceived compassion, as well as perceived institutional and managerial help [ 81 ]. Finally, it has been shown that among the key-points for ensuring a psychologically safe learning environment in a clinical context kindness represents a fundamental component [ 82 ]. Taken together, it may be hypothesized that these findings indicate that in order to develop, and maintain, psychological safety both self-compassion and self-kindness may be needed.…”

Motivators and barriers for rural community preceptors in teaching: A qualitative study

“…53 However, in the context of a busy clinical setting with many potential distractors, creating this learning environment is difficult and requires a skillful preceptor who can balance autonomy and supervision, encourage open communication and provide constructive feedback. 54 Additionally, both the community preceptor and student need to be aware of the expectations from the clinical experience.…”

Navigating power dynamics between pharmacy preceptors and learners

“…This begs the question, are preceptors creating a psychologically safe space for our learners? 27 The learner should be comfortable asking questions, making reasonable mistakes, and providing feedback as well as receiving feedback. Preceptors may be unaware of their own nonverbal cues that occur during student discussions such as eye rolling, looking away frequently, or distracting behavior.…”

“…Some preceptors may compare one student to another in abilities, which may be a biased comparison that is not conducive to a positive learning environment. 27 All of these may give the impression to the learner that they are performing poorly or are not deserving of their preceptor's time and attention. Thus, they may not feel comfortable sharing this feedback and the preceptor's growth will be limited and the precepting patterns will continue.…”

“… 4 Preceptors who are mindful of this perception can help students understand where they are in their stage of learning and collaborate on actionable goals for rotation progression when appropriate. 27 …”