Effects of Psychological Safety Within Allied Health Clinical Education

Abstract

Introduction: Psychological safety impacts learning in various settings, including healthcare. Though the construct has been investigated in medical and nursing education, less is known within athletic training (AT) and physical therapy (PT) education, particularly clinical education.
Clinical education is an opportunity for students to develop clinical reasoning skills, which are central to success as a healthcare provider. Inadequate clinical reasoning may lead to poor diagnostic accuracy, misdiagnosis, and inappropriate treatment or referral decisions, resulting in poor patient outcomes, poor provider outcomes, and unnecessary costs. Little original research exists on the role of clinical education environments and psychological safety within AT and PT education.
Methods: A quantitative, cross-sectional survey assessed individuals’ perceptions of psychological safety via the Psychological Safety Scale (PSS) and clinical reasoning via the Self-Assessment of Clinical Reflection and Reasoning (SACRR) scale. Participants included current students and recent graduates from Doctor of Physical Therapy (DPT) and Master of
Athletic Training (MAT) programs. Survey measures indicated good reliability through Cronbach’s Alpha: .83 for the PSS and .85 for the SACRR. Data were analyzed with descriptive statistics, Pearson’s correlation, and linear regression.
Results: The survey collected 338 viable responses, 169 from each profession. Pearson’s correlation revealed a weak relationship between psychological safety and clinical reasoning overall, r = .27 at p < .001. Further analysis stratified by profession and student versus graduate
status found weak to moderate correlations. Linear regressions assessed if the variance in SACRR scores was explainable by PSS scores, with 5 of 6 categories showing statistical significance.
Conclusion: Perception of psychological safety is remarkably similar between AT and PT students, and is higher for these groups compared to findings in the literature for nursing and medical students. Data analysis indicates a positive relationship exists between the constructs,
and some of the variance in perception of clinical reasoning is explainable by perceived of psychological safety.
Learning Objectives: 1) understand the benefits of psychological safety within learning environments, 2) understand the current state of psychological safety within athletic training and physical therapy clinical education, and 3) understand the relationship between students'
perceptions of psychological safety and clinical reasoning development