Characterizing the Relationships Amongst Psychological Safety, the Learning Environment, and Well-Being in Surgical Faculty and Trainees

IF 2.6 3区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Surgical Education Pub Date : 2025-02-01 DOI:10.1016/j.jsurg.2024.103375

Alyssa A. Pradarelli MD , Julie Evans MS , Niki Matusko MS , Norah N. Naughton MD , Roy Phitayakorn MD, MHPE , John T. Mullen MD , Lily Chang MD , Melissa Johnson MD , Thavam Thambi-Pillai MD , Jon Ryckman MD , Melissa Alvarez-Downing MD , Sebastiano Cassaro MD , Felicia Ivascu MD , David T. Hughes MD , Gurjit Sandhu PhD

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引用次数: 0

Abstract

Objective

Learning environments affect the well-being of surgical faculty and trainees. Psychological safety (PS) has been linked with learning behaviors and aspects of well-being within medicine; however, given the unique challenges inherent to the surgical learning environment, there is a need to more closely examine these concepts for surgical faculty and trainees. The objective of this study is to examine the relationships between learning environment and PS, as well as PS and well-being with surgery.

Design

Multi-institutional, cross-sectional survey study. The electronic survey included assessments of PS, professional fulfillment, and the learning environment. Exploratory and confirmatory factor analyses were performed to identify learning environment constructs. Index construct scores were generated. Multivariable multivariate regression analyses were used to examine the relationships between constructs in the learning environment and PS as well as PS and well-being.

Setting & Participants

The electronic survey was distributed to surgical faculty, fellows, and residents at 8 institutions across the United States.

Results

For faculty, higher levels of professional interactions and rapport/climate within the learning environment were significantly associated with higher levels of PS (β = 0.39, p < 0.01; β = 0.34, p < 0.01, respectively). Higher levels of PS were significantly associated with lower levels of interpersonal disengagement (β = -0.16, p = 0.04). For trainees, higher levels of disrespect/retaliation and personal performance worry within the learning environment were significantly associated with lower levels of PS (β = -0.45, p < 0.001; β = -0.11, p = 0.048, respectively). Higher levels of PS were significantly associated with higher levels of professional fulfillment (β = 0.24, p = 0.01) and lower levels of work exhaustion (β = -0.27, p < 0.01) and interpersonal disengagement (β = -0.36, p < 0.001).

Conclusions

This study identified factors within the learning environment that were positively and negatively associated with psychological safety for surgical faculty and trainees. In addition, it identified a direct relationship between psychological safety and elements of well-being and burnout.

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表征心理安全、学习环境与外科教师及受训人员幸福感之间的关系。

目的：学习环境对外科教师和学员幸福感的影响。心理安全（PS）与医学中的学习行为和健康方面有关；然而，鉴于外科学习环境固有的独特挑战，有必要更仔细地检查外科教师和学员的这些概念。本研究的目的是探讨学习环境与手术后心理状态的关系，以及心理状态与手术后幸福感的关系。设计：多机构、横断面调查研究。电子调查包括对个人能力、职业成就感和学习环境的评估。通过探索性和验证性因素分析来确定学习环境的构念。生成索引构造分数。本研究采用多元回归分析的方法，探讨学习环境构念与主观幸福感的关系，以及主观幸福感与主观幸福感的关系。设置和参与者：电子调查分布在美国8家机构的外科教员、研究员和住院医师中。结果：对于教师而言，更高水平的专业互动和学习环境中的融洽/气候与更高水平的PS显著相关(β = 0.39,p < 0.01；β = 0.34,p < 0.01)。高PS水平与低人际脱离水平显著相关（β = -0.16,p = 0.04）。对于学员而言，学习环境中较高水平的不尊重/报复和个人表现担忧与较低水平的PS显著相关(β = -0.45,p < 0.001；β = -0.11,p = 0.048)。高水平的PS与高水平的职业成就感（β = 0.24,p = 0.01）、低水平的工作倦怠（β = -0.27,p < 0.01）和人际脱离（β = -0.36,p < 0.001）显著相关。结论：本研究确定了学习环境中与外科教师和学员心理安全呈正相关和负相关的因素。此外，它还确定了心理安全与幸福和倦怠因素之间的直接关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Education EDUCATION, SCIENTIFIC DISCIPLINES-SURGERY

CiteScore

5.60

自引率

10.30%

发文量

261

审稿时长

48 days

期刊介绍： The Journal of Surgical Education (JSE) is dedicated to advancing the field of surgical education through original research. The journal publishes research articles in all surgical disciplines on topics relative to the education of surgical students, residents, and fellows, as well as practicing surgeons. Our readers look to JSE for timely, innovative research findings from the international surgical education community. As the official journal of the Association of Program Directors in Surgery (APDS), JSE publishes the proceedings of the annual APDS meeting held during Surgery Education Week.