Name
Climbing the Rungs of Psychological Safety: Investigating Clark's Theory
of Psychological Safety within Academic Medicine
Date & Time
Sunday, June 7, 2026, 4:00 PM - 4:15 PM
Location Name
Walsh
Speakers
Authors
Chandini Patel, Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville
Kirsten A. Porter-Stransky, PhD, Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville
Karen Horneffer-Ginter, Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine
Kristine Gibson, Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine
Christopher Haymaker, Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine
Laura D. Bauler, Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine
Presentation Topic(s)
Other
Description
PURPOSE: Psychological safety refers to environments where individuals
can freely voice concerns, ideas, and mistakes without fear of punishment,
which is essential for medical education and patient safety. Edmonson and
Clark each proposed an influential model of psychological safety. Edmonson’s
scale has been extensively studied; however, there is a paucity of research
examining Clark’s model from a scholarly perspective. Clark’s framework
includes four levels: inclusion, learner, contributor, and challenger safety.
This current study investigates the relationship among these levels within
medical school faculty and staff to test the hypothesis that the levels
sequentially build upon one other.
METHODS: Faculty and staff voluntarily completed a survey including two
psychological safety scales and demographic data. Data were deidentified. To
assess the reliability and validity of Clark’s scale, a Cronbach’s alpha was
computed and a Pearson’s correlation was performed between psychological
safety measured by Clark’s scale and the well-validated Edmonson’s scale. We
then examined the proportion of participants whose responses reflected a
progressive order among Clark’s levels of psychological safety. We further
investigated this relationship by demographic characteristics including
gender, clinical staff/faculty, non-clinical staff/faculty, and those who
identified as a minority group.
RESULTS: The sample size for this study consisted of 462 participants.
Clark’s scale had high internal consistency (Cronbach’s alpha = 0.92) and
significantly correlated with Edmonson’s scale (p<0.0001). The four stages
of psychological safety were examined for every participant, and 92.9% of
participants’ self-reports followed a stepwise order across the four levels,
indicating an ordinal relationship among Clark's levels of psychological
safety. This effect was observed in each demographic group analyzed.
CONCLUSIONS: This study supports a progressive sequence of inclusion,
learner, contributor, and challenger safety. Understanding the hierarchal
nature of Clark’s levels provides insight for the development of future
psychological training initiatives to cultivate a psychological safe culture.
can freely voice concerns, ideas, and mistakes without fear of punishment,
which is essential for medical education and patient safety. Edmonson and
Clark each proposed an influential model of psychological safety. Edmonson’s
scale has been extensively studied; however, there is a paucity of research
examining Clark’s model from a scholarly perspective. Clark’s framework
includes four levels: inclusion, learner, contributor, and challenger safety.
This current study investigates the relationship among these levels within
medical school faculty and staff to test the hypothesis that the levels
sequentially build upon one other.
METHODS: Faculty and staff voluntarily completed a survey including two
psychological safety scales and demographic data. Data were deidentified. To
assess the reliability and validity of Clark’s scale, a Cronbach’s alpha was
computed and a Pearson’s correlation was performed between psychological
safety measured by Clark’s scale and the well-validated Edmonson’s scale. We
then examined the proportion of participants whose responses reflected a
progressive order among Clark’s levels of psychological safety. We further
investigated this relationship by demographic characteristics including
gender, clinical staff/faculty, non-clinical staff/faculty, and those who
identified as a minority group.
RESULTS: The sample size for this study consisted of 462 participants.
Clark’s scale had high internal consistency (Cronbach’s alpha = 0.92) and
significantly correlated with Edmonson’s scale (p<0.0001). The four stages
of psychological safety were examined for every participant, and 92.9% of
participants’ self-reports followed a stepwise order across the four levels,
indicating an ordinal relationship among Clark's levels of psychological
safety. This effect was observed in each demographic group analyzed.
CONCLUSIONS: This study supports a progressive sequence of inclusion,
learner, contributor, and challenger safety. Understanding the hierarchal
nature of Clark’s levels provides insight for the development of future
psychological training initiatives to cultivate a psychological safe culture.
Presentation Tag(s)
Student Presentation