Towards Safer Spaces: An Empirical Investigation of Trainee Psychological Safety Within Academic Medical Centers.

Purpose: Psychological safety is critical for fostering well-being. Integral to the mission of academic institutions, trainees are among the most vulnerable to negative workplace experiences, calling for a need to understand factors that contribute to psychological safety in this population. Our objective is to empirically explore trainee psychological safety to inform best practices for training environments. Design: A survey was used to capture organizational, interpersonal, and individual factors, as well as demographic information in graduate, postdoctoral, medical, resident, and fellow trainees. Descriptive statistics, multivariate ordinal logistic regression, and dominance analyses were used to understand psychological safety and the predictors that explained the majority of the variance in its statistical model. Findings: Gender minorities and those who suppressed their race information were less likely to feel psychologically safe. Psychological safety was predominately explained by senses of belonging, recognition, and respect. Notably, trust and confidence in supervisor emerged as a pivotal factor influencing belonging and respect, whereas organizational support played a crucial role in fostering recognition and belonging. Intriguingly, clarity in role expectations and autonomy were positively correlated with recognition. Originality: Our findings highlight the interplay between organizational, interpersonal, and individual dynamics shaping psychological safety. Importantly, those who suppress their race as well as female or gender minorities are disproportionally prone to feeling unsafe. We further elucidate role clarity and autonomy as important factors in achieving a sense of recognition. We suggest programs prioritize development beyond technical competencies, recognizing trainees as key stakeholders in the cultivation of positive culture within academic environments.