Workshop B

Fostering Psychological Safety in the Clinical Learning Environment

Linda Neville1, and Alyssa Peterkin, MD2

1Medicine, Boston Medical Center and 2Medicine, Chobanian & Avedisian School of Medicine

Room R108

Maslow’s hierarchy of needs consists of five levels: physiological, safety, belonging, esteem, and self-actualization. As educators it is our responsibility to cultivate a safe learning environment for all participants. Over the past 5–10 years, the educational landscape has evolved significantly, and so have learners, who now bring diverse expectations and learning styles. To promote a sense of safety, programs must prioritize psychological safety—a concept broadly defined as “the belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes… It’s feeling like you’re in an environment that’s safe for interpersonal risk-taking.” Creating this environment empowers learners to engage fully without fear of reprisal, which is fundamental to both participation and the ability to receive feedback.
Recognizing that each individual perceives the world differently and values different things is crucial. Mistrust can arise when one person believes they are communicating clearly while another receives mixed or conflicting signals, leading them to disengage. By acknowledging differences and respecting diverse perspectives, we can build bridges and establish a shared language—an essential component of psychological safety initiatives. Fostering psychological safety requires developing personal connections and creating an environment where everyone can thrive.
One effective strategy for establishing a psychologically safe environment is the use of social contracts. These agreements help reduce power imbalances, minimize fear of interpersonal interactions, identify biases, and ensure inclusivity within the clinical learning team. Social contracts provide a common foundation by setting clear expectations for collaboration, guiding individuals in navigating interdependence, and reinforcing the understanding that success relies on mutual support. Within the clinical learning environment, preceptors play a key role by modeling fallibility, offering and seeking feedback regularly, and explaining their reasoning transparently.

Target Audience:

Program Directors, Program Administrators, Preceptors, Medical Educators

Learning Objectives:

Upon completion of this workshop, learners will be able to:

  1. Describe Psychological Safety
  2. Complete a Social Contract
  3. Highlight the role preceptors play in promoting psychological safety
  4. Recognize effective strategies for delivering feedback

Session Outline:

    1. Introduction 10 min- large group.
    2. Small Group Breakout 15 min- create a social contract and discuss how they will promote psychological safety in their training environments.
    3. Precepting & Feedback 10 min- large group, review strategies for delivering feedback.
    4. Small Group Breakout 15 min- In groups of 3, review vignettes describing trainee performance and practice delivering feedback. The 3 roles will be trainee, preceptor and observer, with the opportunity to play each role.
    5. Wrap up 10 min- comments, ideas, thoughts.