Evidence map›Paper›PMID 41878668›Full record

ReviewJournal of healthcare leadership2026

An Umbrella Review of Relational Enablers of Psychological Safety and Identity-Related Gaps in the Evidence: Implications for Healthcare and Organizational Settings.

Miriam Gonzalez, Farhin Chowdhury, Michelle Kee, Brooke MacLeod, Becky Skidmore, Roberta L Woodgate

Abstract readReview
In one paragraph

Review in Journal of healthcare leadership, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Miriam GonzalezCollege of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.ORCID 0000-0002-2020-0531
Farhin ChowdhuryCollege of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.
Michelle KeeCollege of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.ORCID 0000-0001-9538-1691
Brooke MacLeodDepartment of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.
Becky SkidmoreSkidmore Research & Information Consulting Inc., Ottawa, Ontario, Canada.ORCID 0000-0001-8293-9238
Roberta L WoodgateCollege of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.ORCID 0000-0002-7176-2390

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We examined published reviews on psychological safety to synthesize key relational enablers and assess whether gaps related to culture, race, or ethnicity have been identified. Psychological safety is critical for authentic and effective teamwork. Although many reviews explore its antecedents, a synthesis of relational enablers is lacking. Identifying significant gaps related to minority identities is also essential for determining whether the evidence base applies across diverse contexts. An umbrella review was conducted using five databases (Ovid MEDLINE ALL, Embase, APA PsycInfo, Web of Science, and ABI/INFORM) and Google Scholar. Following the JBI approach, screening, data extraction, and critical appraisal were performed. Published reviews were included if they addressed antecedents of psychological safety in workplace settings, without language or date restrictions. The final search was completed on July 24, 2025. Review characteristics and findings were summarized descriptively, and qualitative content analysis was used to synthesize relational enablers. Eleven reviews met inclusion criteria, including a meta-analysis, an evidence synthesis, and systematic, scoping, integrative, and structured narrative reviews. Reviews originated from healthcare or organizational psychology and management disciplines. Participants included employees and healthcare workers, teams, and professionals. Overall quality was acceptable, though transparency regarding appraisal and data extraction varied. Four categories of relational enablers emerged: leadership (behaviors, characteristics), team dynamics (cooperation, inclusive climate), interpersonal factors (trust, open communication), and individual capacities and beliefs (emotional intelligence, experience). Most reviews acknowledged cultural limitations, while only a minority addressed race or ethnicity explicitly. This umbrella review provides a synthesized account of relational enablers of psychological safety and highlights identity-related gaps. We provide evidence-based actionable strategies to strengthen psychological safety by targeting leadership behaviors, team dynamics, interpersonal trust and communication, and individual characteristics. Lastly, the findings emphasize the need for future research to consider race, ethnicity, and culture to ensure applicability across diverse contexts.

Indexed as

cultureethnicitypsychological safetyracerelational enablersreview of reviews

Identifiers

PMID41878668
PMCPMC13006558

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.