Proceed with Caution: Assessing for and Increasing Psychological Safety in Obstetrics and Gynecology Residency Teaching and Learning Environments

OBJECTIVE: The primary objective of this study was to understand resident perspectives on psychological safety in a large Obstetrics/Gynecology program in Ontario, Canada. The secondary objective was to describe the impact of an educational session on psychological safety. DESIGN: A nine-question survey was sent to all residents to assess perspectives on psychological safety during training. Fischer's exact test was used to explore associations between resident year (junior and senior) and associated perspectives on psychological safety. Based on perspectives expressed in the first survey, an educational session discussing the concept of psychological safety, strategies for increasing psychological safety, and links to resources was designed. SETTING: The survey was sent to all Obstetrics/Gynecology residents at McMaster, University, the third largest training program in Canada. The training session was presented at a virtual grand round; a pre- and post-session survey was distributed to attendees. RESULTS: Nineteen residents (56%) completed the first survey. A significant association was found between year and belief that the learning environment was psychologically safe. Results suggested that juniors tended to disagree more with this statement than senior residents. No other significant associations were found; however, there was a pattern suggesting that junior residents had lower perceptions of psychological safety. Eighteen (43%) grand rounds participants completed the pre-intervention survey. The education session resulted in a higher percentage of people claiming knowledge of psychological safety, feeling psychologically safe in their work environment, and knowledge of resources related to psychological safety. CONCLUSION: Overall, results suggest that junior residents may have lower levels of psychological safety than senior residents. In addition, an education session can increase awareness of educational concepts and where to access resources.