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Psychological Safety: simple, important, and fragile

10/18/2018

 
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References
(1) Edmondson, Amy C. et al Psychological Safety: The History, Renaissance, and Future of an Interpersonal Construct          Annu. Rev. Organ. Psychol. Organ. Behav. 1: 23 – 43, 2014
(2) 
Perlow, Leslie et al Is Silence Killing Your Company? Harvard Business Review May 2003
(3) 
Raemer, Daniel B. et al Improving Anesthesiologists’ Ability to Speak Up in the Operating Room Acad Med. 91:530–          539, 2016

(4) Salazar, Marco J. Barzallo et al Influence of Surgeon Behavior On Trainee Willingness to Speak Up: A Randomized           Controlled Trial J Am Coll Surg 219:1001-1009, 2014

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In this article you will learn what psychological safety is and why it is simple, important, and  fragile. 
Definition of psychological safety
Psychological safety means that people feel safe to speak up about concerns, new ideas, negative feelings, and disagreements. People can trust what they say will be understood and explored, not attacked or discounted. Psychological safety is not a separate program. It is how we talk together to get work done. It is the way we define problems, create solutions, make decisions, and give and receive feedback. 


How to create it
Creating psychological safety is conceptually relatively simple. It requires inviting participation including explicitly asking for and exploring different viewpoints as opposed to arguing back and forth. For example, a leader might say multiple times during a meeting: “No one has all the answers including me. It is very easy to get off on the wrong track. We need to hear from all of you, especially when you disagree or have concerns.”

What makes it important
Psychological safety is very important as studies have shown it enables performance.(1) Particularly with complex problems, the best results arise from collaborative learning which requires openness and honesty. Also, inviting people to say what they really think facilitates intrinsic motivation which enhances outcomes because it means approaching work out of genuine interest and commitment. 

Why it is so difficult to develop and sustain
Despite the conceptual simplicity of psychological safety, it is quite difficult to develop and sustain. Our brains were hard-wired early in our evolution for quick reactions for survival. Even minor stresses in team interactions can activate this hard-wiring causing leaps to biased conclusions, often outside of awareness. This diminishes curiosity and openness which are already hard to sustain in the midst of the usual, constant pressure for quick solutions. 

Also, multiple studies have also shown that it is inherently difficult in group situations for people to speak up with views contrary to others.(2) For example, in healthcare it is surprisingly common for experienced professionals to not speak up even when surgical patients are about to be harmed.(3, 4) This tendency to silence is magnified when work is fast-paced and by the presence of power differentials. Ultimately, even highly experienced professionals need repeated, explicit invitations and support to consistently speak up.

The fragility of psychological safety
Perhaps the most difficult aspect of psychological safety is that it demands leaders who cultivate their own self-awareness, vulnerability, and humility: self-awareness because our minds can so easily be hijacked by the survival brain; vulnerability because we have to ask for and carefully listen to disagreements about things we really care about; and humility because we must admit when we are wrong and that we need advice and help. 

All of these issues make psychological safety quite fragile. Developing and sustaining it is a matter of life-long commitment and practice.   

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