Purpose:
Serious illness and breaking bad news (BBN) conversations are high-stakes
clinical encounters that can challenge learners’ confidence, emotional
readiness, and communication skills. Psychological safety is essential for
enabling learners to engage fully, ask questions, and practice complex
communication behaviors without fear of judgment. This concept describes an
educational model designed to foster psychological safety through a
structured, interactive session that integrates case-based discussion,
targeted instruction, and applied practice.
Methods:
The session uses a just-in-time teaching framework delivered over a
structured 90-minute format. Learners first engage in small-group analysis of
a realistic serious illness/BBN scenario to surface challenges and prior
experiences. A facilitated whole-group synthesis identifies recurring
barriers that affect psychological safety. A focused teaching segment
introduces evidence-based principles of psychological safety and common
pitfalls that arise in communicating in emotional settings. Participants then
revisit the case scenario in small groups to apply newly learned strategies,
developing specific techniques to support learner engagement in real clinical
settings. A closing debrief reinforces key concepts and models effective
facilitation behaviors. Materials include visual prompts, reflective
questions, and digital tools for capturing group insights.
Results:
The session structure may produce several outcomes: identification of
common psychological safety challenges in serious illness/BBN encounters;
increased awareness of educator behaviors that shape learning climates; and
generation of concrete, transferrable strategies including explicit role
framing, structured pre-briefing, supportive debriefing, and modeling
vulnerability. Participants may report greater confidence in facilitating difficult
conversations and enhanced ability to support learner participation during
emotionally intense encounters.
Conclusions:
A structured, interactive session grounded in psychological safety
principles may provide an effective approach to preparing educators for
supporting learners during serious illness and BBN conversations. By
integrating case analysis, focused instruction, and applied practice, this
model creates a replicable framework that can strengthen communication
training, improve learner confidence, and ultimately enhance patient-centered
care.