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.
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.
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.
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…
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.
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.
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