ArticleInternational journal for quality in health care : journal of the International Society for Quality in Health Care2025
Psychological safety, job satisfaction, and the intention to leave among German early-career physicians.
Article in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Satisfaction with clinical practice environments among early-career health professionals in South Africa: findings from the WiSDOM cohort study.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2026Article
- The impact of workplace violence on occupational well-being of nursing staff: the moderating role of coping styles.BMC health services research · 2026Article
- Psychological Safety of Critical Care Nurses in Finland.Nursing in critical care · 2026Article
- Patient safety culture in resource-limited healthcare settings: A multicentre survey.PloS one · 2025Article
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Abstract
backgroundHealthcare systems worldwide experience shortages of healthcare professionals. Retention of physicians is becoming an increasing problem. The psychological safety among physicians affects not only performance but also their emotional well-being and job satisfaction. This study aims to evaluate early career physicians' perception of psychological safety and its influence on job satisfaction and intention to leave.
methodsIn a cross-sectional study, early career physicians, currently in fellowship programs in Germany were invited to fill in an electronic survey. The instrument consisted of demographic variables and sections from validated and well-established questionnaires. Psychological safety was evaluated on three levels-in relation to the team leader, team as a whole, and peers. Also, job satisfaction was assessed with standardized measures, and participants were asked if they were considering leaving their current employer. Participants were recruited via a nationwide learning platform-an online educational portal for medical students and early career physicians. Data analyses included descriptive, correlation analysis, and regression analyses to determine univariate and multivariate associations with job satisfaction and intention to leave.
resultsThe study sample consisted of 432 early career physicians. Most were fulltime employed (85.6%), female (78.2%), and in first 3 years of their postgraduate education (77.5%). A total of 47.2% indicated intention to leave their current employment. On a Likert-10 agreement scale, with high scores indicating greater psychological safety, the mean scores for leader-related, team-related, and peer-related psychological safety were 6.01 [95% confidence interval = 5.81-6.21), 7.30 (7.11-7.49), and 7.95 (7.78-8.12), respectively. In correlation analysis, all dimensions of psychological safety showed significant associations with job satisfaction and the intention to leave. In the multiple regression analyses, female gender (B = -0.10; P = .04) and age group (B = -0.08; P < .01) were associated with lower job satisfaction. High leader and team-related psychological safety were significantly associated with higher job satisfaction (B = 0.18, P < .01; B = 0.10, P < .01), and negatively related to intention to leave (OR = 0.53, P < 0.01; OR = 0.77, P < .01).
conclusionThis survey enhances our understanding of the nuances of psychological safety among early career physicians. In Germany, they reported low-to-medium levels of psychological safety related to the leader and low job satisfaction. Almost every second participant indicated intention to leave the organization. Leader-related psychological safety had highest effect on job satisfaction and intention to leave. Our findings corroborate the eminent role of leadership, workplace, and safety culture for job satisfaction and retention of early career physicians, what consequently affects quality and safety of healthcare.
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