Reflections and recommendations on psychological safety in undergraduate simulation-based education

Abstract

Objective: To propose recommendations for promoting psychological safety in simulation practice based on educators’ experiences and an analysis of the concept in simulation-based education. Development: Psychological safety originates as a concept meant for teamwork. Subsequently, models for individual and vertical relationships are identified, where personal safety is related to that of others and factors that influence it are recognized, along with their effects. In the educational context, psychological safety is understood as creating a safe environment for learning, which facilitates the development of conversations without fear of humiliation or mistreatment. An adaptation of Clark's four levels to undergraduate education is proposed. Individual student factors such as a proactive personality, emotional stability, and orientation to learning are identified, as well as contextual factors like high quality relationships and student support systems. The relevance of ‘Grit’ as a concept is highlighted, as well as its relation to psychological safety. Additionally, ruptures in psychological safety during debriefing are detected, and we present strategies to prevent and repair them. The importance of educator training and continuous improvement is emphasized. Conclusions: Managing psychological safety is a challenge that requires an understanding of the concept and relies on specific strategies that educators can access in advance, during a learning scenario, or in the debriefing process, for which training is a key element.