Journal of general internal medicine
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Psychological safety is the feeling that one can take interpersonal risks without fear of negative consequences including retaliation, intimidation, or rejection. The literature base on psychological safety in medical education is increasing. Despite increasing recognition in the medical literature, many medical practitioners and educators are uncertain about the background and effects of psychological safety on medical education. ⋯ While it is recognized that higher psychological safety is important, creating better psychological safety is a complex challenge analogous to patient safety, well-being, and healthcare disparity. The challenges for environments with lower psychological safety are understanding what to fix and how to fix it, and recognition that quick fixes are elusive. Moving forward, medical educators must have a better understanding of how to enhance psychological safety.
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There has been a growing disconnect between learners and educators within medical education. As the landscape of medical education has been altered post-pandemic and cultural shifts favor "safe spaces," we sought to explore the tension that exists between a sense of safety and the discomfort inherent within the learning process. Through separate focus groups conducted with trainees and faculty, a common theme emerged: a sense of vulnerability. ⋯ Educators feel a sense of vulnerability that their feedback will be interpreted as "retaliatory teaching." This sense of vulnerability was heightened in situations that emphasized the tension between personal well-being vs altruism, safe spaces vs accountability to high standards, and advocacy for system change vs power hierarchy. We must acknowledge this vulnerability and the resulting tensions that can ensue due to the competing commitments of medical training. By cultivating a culture of mutual growth and respect, we can create a learning environment that embodies the highest standards of medicine.
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Editorial
Combatting Fragmentation: Lessons Learned from an Integrative Approach to Teaching Health Equity.
While social medicine education is a long-established field of study within medical education,1 implementation has historically been through elective coursework making integration, assessment, and evaluation challenging. The launch of the novel Washington University in St. ⋯ Additionally, the Gateway HEJ curriculum presented an opportunity to explore novel ways of assessing medical students, as well as illuminating additional opportunities for faculty development to ensure fidelity to the HEJ content. This paper includes the process of development as well as the lessons learned, limitations, and future plans for iterative improvements to the curriculum.