Eve Purdy Profile picture
Feb 5 11 tweets 8 min read
The sim community are leaders in the understanding of psychological safety...but its time we take the theory beyond it's "safe container"...

Expand the way you think about psychological safety by reading our new work in the area!

advancesinsimulation.biomedcentral.com/articles/10.11…

thread...
Psychological safety - a shared belief that the team is safe for interpersonal risk taking – has been a focus for sim facilitators. Giants have shown how psych safety can be fostered in the confines of the simulation space.

journals.lww.com/simulationinhe…

@GetCuriousNow
But psychological safety is even more critical in real workplaces. It is central to how teams accomplish complex work, how they learn together, and how they grow.



@AmyCEdmondson @RoisinODonovan4
We wanted to better understand whether there was a link between psych safety in simulation and psych safety in the real working environments...

So...we studied an existing simulation program @GC_Health - years of weekly sims with registrars and nurses.
74 participants completed narrative surveys and we conducted 19 interviews.

We coded all this data using @RoisinODonovan4's powerful framework for psychological safety in healthcare.

academic.oup.com/intqhc/article…
What did we find???

Convincing evidence that workplace psych safety impacts the simulation experience AND experience in simulation impacts workplace psych safety.

Simulation is NOT a safe container...it is a bidirectional leaky construct.
What else did we find?

Simulation was an incubator of familiarity and acted as a magnifying glass on leader behavioral integrity. It was clear that participants viewed simulation as a place where relationships are forged, with both positive and negative consequences.
The implications of the bidirectional nature of psych safety and simulation cannot be understated. It presents both opportunity and risk.

The opportunity - a sacred place to build the magic stuff that makes teams work.

The risk - a frighteningly easy place to destroy it.
So...

We must be mindful of what leaks INTO the sim space.

Consider the dynamics of the team entering, your relationship with them, and how sim fits in the broader ethos of the organization.
We should also aim to shape what leaks OUT.

STOP saying what happens in simulation stays in simulation...it just isn't true.

Instead aim to make that leak out one of increased psych safety for teams when they head back to work by tailoring your approach and debriefings.
There's lots more to the story...

Read it all here advancesinsimulation.biomedcentral.com/articles/10.11…

or get in touch with @purdy_eve @socraticEM @WarwickIsaacson

Thanks to @emfresearch @GC_Health @BondUniversity

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More from @purdy_eve

Oct 5, 2021
After studying ED teams, I am thrilled to share insights about how they work and some simple hacks to make them even better.

Spoiler alert: psychological safety is what it’s all about - thanks @amyCEdmondson @RoisinODonovan4

#RCEMasc @RCEMevents @SocraticEM

A thread…
Emergency medicine is basically just navigating uncertainty together.
Patient after patient.
Shift after shift.

We are quite familiar with good team behaviours that allow us to do so.
We train for things like…

Closing the loop
Recaps
Graded assertiveness
Communication
But as a community we have spent less energy on understanding and deliberately supporting the type of organizational and team culture that is a necessary pre-requisite for those good behaviours to happen.
Things like…

Trust
Familiarity
Feeling valued
Read 16 tweets
Jul 28, 2021
The acute phase of COVID-19 was a time of cultural magnification and transformation in emergency medicine. It was a time when we could see who we are, recognized what aligned with those values and identified what conflicted with them. #ACEMWS21 @Qemerg
A group of clinicians @Qemerg @KingstonHSC engaged in a rapid cycle collaborative ethnography by gathering >50,000 words in field notes and >40 interviews with staff during 12 week period (March-May 2020). Weekly we reported the "pulse" of the ED to department + hospital leaders.
This work highlighted aspects of pandemic reality that aligned with our core values, beliefs, and practices. For example, managing uncertainty is core to emergency medicine. Many thrived in doing so in the early days.
Read 7 tweets
Nov 24, 2020
Moments of crisis, like #COVID19, are moments of cultural compression...Moments when values and beliefs of a group are more easily identified and then shaped.

Moments that can tell organizations an awful lot about who we are, what matters most, and who we might become. #EDAC2020
It turns out that psychological safety, the ability for team members to take interpersonal risks, is critical for groups to do their work. In moments of crisis we can clearly see when psychological safety is intact....and...when it is not.

@AmyCEdmondson:
web.mit.edu/curhan/www/doc…
So...how might we shape an organizational culture that fosters psychological safety so that we can be our best during crisis, but perhaps even more importantly during normal times??? #EDAC2020
Read 8 tweets

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