Physicians' Perceptions of Psychological Safety and Peer Performance Feedback

J Contin Educ Health Prof. 2018 Fall;38(4):250-254. doi: 10.1097/CEH.0000000000000225.


Introduction: For continuous professional development, it is imperative that physicians regularly receive performance feedback from their peers. Research shows that professionals are more proactive in learning and knowledge sharing with peers in teams with more psychological safety. Psychological safety has however not been studied in relation to peers' performance feedback. This study investigated the association between physicians' perceptions of psychological safety and performance feedback received from their peers.

Methods: We invited physicians of cardiology, gastroenterology, obstetrics and gynecology, otorhinolaryngology, pulmonology, neurology, and neurosurgery departments of an academic medical center to participate. Physicians evaluated psychological safety using Edmondson's seven-item validated scale and performance feedback using the adapted four-item feedback subscale of the validated System for Evaluation of Teaching Qualities, including corrective and positive feedback, explanations of feedback, and suggestions for improvement from peers. We analyzed the data using multilevel linear regression analyses adjusted for physicians' sex, years since being certified a medical specialist, and months working in the clinic under the study.

Results: This study included 105 physicians (86.8% participated). Psychological safety was positively associated with physicians' perceptions of performance feedback from peers (B = 0.54, 95% confidence interval = 0.34-0.73, P-value <.001).

Conclusions: Physicians who experienced more psychological safety were more likely to receive corrective and positive performance feedback from peers, explanations of feedback, and suggestions for improvement. Medical teams should consider investing in psychological safety to encourage performance feedback from peers, and thus support physicians' continuous professional development and their efforts to provide high-quality patient care.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Feedback*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Peer Group*
  • Perception*
  • Physicians / psychology*
  • Psychometrics / instrumentation
  • Psychometrics / methods
  • Staff Development / methods
  • Surveys and Questionnaires
  • Work Performance / standards