The Role of Psychological Safety in Enhancing Medical Students' Engagement in Online Synchronous Learning.

Background: The COVID-19 pandemic instigated a global change in the delivery of undergraduate medical education, with an eminent shift from in-person to online teaching. The virtual methods that were utilised to a limited extent previously have now become the mainstay in education. The concept of psychological safety has been studied previously within medical education, but not in the distance learning context. The aim of the study was to explore students' experiences of online learning and to gain an understanding of the factors affecting psychological safety and its subsequent impact on their learning. Methods: A qualitative, social constructivist approach was adopted in this research. Data collection involved semi-structured interviews with 15 medical students from the University of Dundee. There was a representation from each year group on the undergraduate medical course. Data was transcribed verbatim and analysed thematically. Results: Five key themes were identified as motivation for learning, engagement with learning, fear of judgement, group learning and adjustment to online learning. Each of these comprised of interlinked subthemes related to peer and tutor interactions. Conclusions: Drawing on students' experiences, the paper presents the significant interplay of group interactions and tutor attributes operating in the virtual synchronous learning environment. The relevance of psychological safety in student learning and experience, and strategies to foster it in online classrooms are discussed in the context of existing literature and proposed future developments.