Presented By: Kirsten Porter-Stransky, University of South Carolina School of Medicine Greenville
Co-Authors: Laura Bauler, Western Michigan University Homer Stryker M.D. School of Medicine
Kristine Gibson, Western Michigan University Homer Stryker M.D. School of Medicine
Christopher Haymaker, Western Michigan University Homer Stryker M.D. School of Medicine
Karen Horneffer-Ginter, Western Michigan University Homer Stryker M.D. School of Medicine
Maggie Rothney, Western Michigan University Homer Stryker M.D. School of Medicine

Purpose
Psychological safety refers to the ability to take interpersonal risks, such as speaking up, offering new ideas, or expressing concerns, without fear of punishment. Previous research shows that psychological safety predicts higher quality of healthcare, effective educational environments, and greater willingness to propose innovative ideas and admit mistakes. However, the hierarchical nature of academic medicine can hamper psychological safety, negatively impacting students, employees, and patients. There is a paucity of evidence-based ways to promote psychological safety. To fill this gap, the current project describes and evaluates a multi-year, medical school-wide psychological safety initiative. 

Methods 
An interdisciplinary team created and implemented educational training sessions, a psychological safety champions programs, and resources based on Tim Clark's stages of psychological safety. We purposefully focused on training leaders, faculty, and staff first, so that they could model psychological safety for learners. To assess the impact, employed faculty and staff were invited to complete annual surveys, which included the previously validated Psychological Safety Scale developed by Amy Edmondson. Data were analyzed with repeated measures ANOVA and descriptive statistics. This study was approved by the Institutional Review Board. 

Results 
The initiative is in its third year, with successful implementation of educational training sessions, departmental champions, and a variety of resources. Ninety-seven faculty and staff completed both annual surveys. Within 1 year after implementation of the initiative, psychological safety significantly improved at the departmental level (p < 0.05). Participants rated their psychological safety as higher at the departmental level than institutional level (p < 0.01). 

Conclusions 
The present study describes an effective school-wide program to improve psychological safety among faculty and staff at the departmental level. Training leaders and employees first is important to promote a psychologically safe learning environment for medical students and residents. This project serves as a template for other health professions schools seeking to improve psychological safety.