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BMC Medical Research Methodology
Published in: BMC Medical Research Methodology 1/2020

Open Access 01-12-2020 | Research article

Measuring psychological safety in healthcare teams: developing an observational measure to complement survey methods

Authors: Róisín O’Donovan, Desirée Van Dun, Eilish McAuliffe

Published in: BMC Medical Research Methodology | Issue 1/2020

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Abstract

Background

Psychological safety is a dynamic team-level phenomenon which exists when team members believe that it is safe to take interpersonal risks. In healthcare teams, the presence of psychological safety is critical to delivering safe care. Scholars have highlighted a need for alternative measures which compliment survey-based measures of psychological safety in healthcare teams.

Methods

The exploratory phase of this study raised concerns about whether current survey measures could provide a sufficient understanding of psychological safety within healthcare teams to inform strategies to improve it. Thus, previously validated psychological safety surveys and a meeting observation measure were adapted for use in healthcare teams. First, two group feedback sessions were held with 22 healthcare professionals, as well as a systematic literature review. Then, the members of eleven healthcare teams in Ireland and The Netherlands (n = 135) took part in the pilot test of the adapted composite measure.

Results

The final composite measure has two parts: a team meeting observation measure and an adapted survey. The observation measure has 31 observable behaviours fitting seven categories: voice, defensive voice, silence behaviours, supportive, unsupportive, learning or improvement-oriented and familiarity type behaviours. The survey part consists of 19 items in three sub-dimensions related to; the team leader, other team members and the team as a whole. Three additional items capture the perceived representativeness of the observed team meeting compared to other similar meetings. Final adaptations were made in order to integrate the observation and survey measure.

Conclusions

The resulting composite measure combines the strengths of observational and survey measures and is tailored for use in healthcare teams. It is uniquely co-developed with healthcare professionals and grounded in the psychological safety and healthcare literature. This composite measure can enable longitudinal research on psychological safety and inform future research to develop and test interventions to improve psychological safety.
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Metadata
Title
Measuring psychological safety in healthcare teams: developing an observational measure to complement survey methods
Authors
Róisín O’Donovan
Desirée Van Dun
Eilish McAuliffe
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Medical Research Methodology / Issue 1/2020
Electronic ISSN: 1471-2288
DOI
https://doi.org/10.1186/s12874-020-01066-z

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