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Record W2969991226 · doi:10.1136/bmjstel-2019-000470

Managing psychological safety in debriefings: a dynamic balancing act

2019· review· en· W2969991226 on OpenAlexaff
Michaela Kolbe, Walter Eppich, Jenny W. Rudolph, Michael Meguerdichian, Helen Catena, Amy Cripps, Vincent Grant, Adam Cheng

Bibliographic record

VenueBMJ Simulation & Technology Enhanced Learning · 2019
Typereview
Languageen
FieldMedicine
TopicSimulation-Based Education in Healthcare
Canadian institutionsUniversity of CalgaryAlberta Children's Hospital
Fundersnot available
KeywordsDebriefingPsychological safetyPatient safetyContext (archaeology)HumiliationConstrual level theoryPsychologyInterpersonal communicationPerceptionSocial psychologyApplied psychologyHealth care

Abstract

fetched live from OpenAlex

Debriefings should promote reflection and help learners make sense of events. Threats to psychological safety can undermine reflective learning conversations and may inhibit transfer of key lessons from simulated cases to the general patient care context. Therefore, effective debriefings require high degrees of psychological safety-the perception that it is safe to take interpersonal risks and that one will not be embarrassed, rejected or otherwise punished for speaking their mind, not knowing or asking questions. The role of introductions, learning contracts and prebriefing in establishing psychological safety is well described in the literature. How to maintain psychological safety, while also being able to identify and restore psychological safety during debriefings, is less well understood. This review has several aims. First, we provide a detailed definition of psychological safety and justify its importance for debriefings. Second, we recommend specific strategies debriefers can use throughout the debriefing to build and maintain psychological safety. We base these recommendations on a literature review and on our own experiences as simulation educators. Third, we examine how debriefers might actively address perceived breaches to restore psychological safety. Re-establishing psychological safety after temporary threats or breaches can seem particularly daunting. To demystify this process, we invoke the metaphor of a 'safe container' for learning; a space where learners can feel secure enough to work at the edge of expertise without threat of humiliation. We conclude with a discussion of limitations and implications, particularly with respect to faculty development.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.203
metaresearch head score (Gemma)0.332
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Qualitative · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: none
Teacher disagreement score0.203
Threshold uncertainty score0.983

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.2030.332
Meta-epidemiology (narrow)0.0020.002
Meta-epidemiology (broad)0.0010.002
Bibliometrics0.0030.002
Science and technology studies0.0100.010
Scholarly communication0.0110.013
Open science0.0030.012
Research integrity0.0050.010
Insufficient payload (model declined to judge)0.0070.003

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.057
GPT teacher head0.472
Teacher spread0.415 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

Study designQualitative
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations291
Published2019
Admission routes1
Has abstractyes

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