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Since its renaissance in the 1990s, psychological safety research has flourished—a boom motivated by recognition of the challenge of navigating uncertainty and change. Today, its theoretical and practical significance is amplified by the increasingly complex and interdependent nature of the work in organizations. Conceptual and empirical research on psychological safety—a state of reduced interpersonal risk—is thus timely, relevant, and extensive. In this article, we review contemporary psychological safety research by describing its various content areas, assessing what has been learned in recent years, and suggesting directions for future research. We identify four dominant themes relating to psychological safety: getting things done, learning behaviors, improving the work experience, and leadership. Overall, psychological safety plays important roles in enabling organizations to learn and perform in dynamic environments, becoming particularly relevant in a world altered by a global pandemic.

This Element reviews the evidence for three workplace conditions that matter for improving quality and safety in healthcare: staffing; psychological safety, teamwork, and speaking up; and staff health and well-being at work. The authors propose that these are environmental prerequisites for improvement. They examine the relationship between staff numbers and skills in delivering care and the attainment of quality of care and the ability to improve it. They present evidence for the importance of psychological safety, teamwork, and speaking up, noting that these are interrelated and critical for healthcare improvement. They present evidence of associations between staff well-being at work and patient outcomes. Finally, they suggest healthcare improvement should be embedded into the day-to-day work of frontline staff; adequate time and resources must be provided, with quality as the mainstay of professionals' work. Every day at every level, the working context must support the question 'how could we do this better?' This title is also available as Open Access on Cambridge Core.

Using interviews, a national field survey, and an online laboratory study, we have examined teamwork in fluid cross-boundary teams. Across three studies, we qualitatively discovered and quantitativ...

We highlight conversations at work as an arena of change. Drawing on and extending the psychological safety literature, we offer a new framework to distinguish between productive and unproductive f...

Background Psychological safety, a shared belief that interpersonal risk taking is safe, is an important determinant of incident reporting. However, how psychological safety affects near-miss reporting is unclear, as near misses contain contrasting cues that highlight both resilience (“we avoided failure”) and vulnerability (“we nearly failed”). Near misses offer learning opportunities for addressing underlying causes of potential incidents, and it is crucial to understand what facilitates near-miss reporting. Methods A survey of radiation oncology department staff in an academic hospital assessed psychological safety and presented five scenarios with varying proximity to patient harm: “standard care” involving no harm, three near misses with varying proximity to harm (“could have happened,” “fortuitous catch,” “almost happened”), and one “hit” involving harm. Respondents evaluated each event as success or failure and reported willingness to report on a seven-point Likert scale. The analysis employed ordered logistic regression models. Results A total of 78 staff (61.4%) completed the survey. The odds of reporting “hit” (odds ratio [OR]: 1.96, 95% confidence interval [CI]: 1.19–3.23), “almost happened” (OR: 1.60, 95% CI: 1.07–2.37), and “fortuitous catch” (OR: 1.60, 95% CI: 1.10–2.33) improved with an increase in psychological safety. The relationship of psychological safety to reporting “standard care” and “could have happened” was not statistically significant. The odds of reporting were higher when a near miss was discerned as failure (vs. success). Conclusion Near misses are not processed and reported equally. The effect of psychological safety on reporting near misses becomes stronger with their increasing proximity to a negative outcome. Educating health care workers to properly identify near misses and fostering psychological safety may increase near-miss reporting and improve patient safety.

Novel forms of teamwork—created by rapid change and growing diversity among collaborators—are increasingly common, and they present substantial methodological challenges for research. We highlight two aspects of new team forms that challenge conventional methods. Factors pertaining to change (e.g., in membership) create entitativity challenges such as whom to count as team members, while factors pertaining to difference (e.g., in expertise) create concordance challenges such as how to interpret disagreement in groups. We review research methods that are well-suited to each of these specific challenges. We identify the particular challenges of studying teams that exhibit high difference and change simultaneously and call for adaptive methods that enable insight into how they work. Clarity about the dimensions of deviation from ideal team forms, along with shared terminology, will help researchers make and discuss tough methodological choices and assist reviewers in evaluating them.

"Near miss" events are valuable low-cost learning opportunities in radiation oncology as they do not result in patient harm and are more pervasive than adverse events that do. Near misses vary depending on the presence of a latent error of behavior or process, and the presence of an enabling condition predisposing the patient to harm. These nuanced distinctions across near miss types can elicit different cognitive biases affecting the recognition of near misses as learning opportunities. We define near miss types in radiation oncology and explore the differential perceptions among radiation oncology staff.Six event types were defined based on attributes of latent error and enabling conditions: "hit," "potential hit," "almost happened," "fortuitous catch," "could have happened," and "process-based catch." These events were illustrated with an example of a patient receiving pacemaker cardiac clearance before radiation treatment. A survey assessing (1) success versus failure of an event and (2) willingness to report the event was administered to a radiation oncology department using the pacemaker example. Mean scores for each near miss type were compared.Ninety-five staff members (74%) completed the survey. Perceived success scores and willing-to-report scores significantly differed by near miss type (P = .042 for success ratings; P.0001 for willingness to report). "Could have happened" events were viewed as less successful and were more likely to be reported than "almost happened" events (P.0001).Cognitive biases appear to influence whether and how near miss types are recognized as report-worthy. Education of near miss types and engaging staff for quality improvement may improve recognition.

Do teams with motivation to learn actually engage in the behaviors that produce learning? Though team learning orientation has been found to be positively related to team learning, we know little about how and when it actually fosters team learning. It is obviously not the only factor that may impact learning in teams. Team psychological safety, or the way team members feel about taking interpersonal risks, is another important factor associated with team learning. Team open-mindedness, or the degree of curiosity that teams have for new ideas, is also likely to impact team learning. So far, these factors have been investigated independently of each other. In this article, we draw from theory on team development and goal achievement to develop a model of team learning that includes them. We report the results from a time-lagged, survey-based study designed to test our model. We found that the relationship between team learning orientation and team learning is mediated by team psychological safety. Yet, this is only true when team open-mindedness is low, not when it is high. We thus reveal initial patterns of interaction and discrimination among key factors that are related to team learning in ways that contribute to both theory and practice.

Teaming across expertise boundaries, within and across organizations, is an increasingly popular strategy for innovation. Although membership diversity expands the range of perspectives that teams can draw upon to innovate, meta-analyses of the team-diversity literature have found weak or inconsistent support for that assumption. These studies also have typically examined effects of team diversity in relatively stable bounded teams, rather than in newly formed temporary groups. Drawing from two streams of research to unpack team diversity, this paper seeks to describe the complexity of cross-boundary teaming, while highlighting factors that may be central to its effectiveness. Past research on team diversity suggests numerous moderators that affect the diversity–performance relationship in teams, while research on knowledge and practice explores the situated activities and logics of diverse experts in great depth. Both streams thus shed light on team diversity, offering complementary insights. We develop a model of cross-boundary teaming that marries these streams and offers human resource management researchers and professionals insights and approaches for helping diverse teams tackle complex problems.

The benefits of voice for both individuals and organizations have been widely studied. However, research on the relational context of voice has focused on leader and follower interactions while oth...

Now more than ever it is critical for scholars to deepen their understanding of organizational learning in hospitals: a setting that enables us to explore conditioning factors that make organizatio...

There is a growing research interest in the concept of silence that is broadly understood as employees’ self-censorship in communication with their managers. Though the phenomenon is important for ...

This paper describes a relationship between legitimacy building and learning for a new firm in a nascent industry. Through a longitudinal study of a new firm in the nascent smart city industry, we found that the firm failed to make progress on important internal initiatives, despite notable external successes, including prestigious employees, well-known partner companies, and extensive positive media attention. Exploring these concurrent developments, we discovered a surprising relationship between the firm's external successes and its internal failures. We propose that the legitimacy building that helped the new firm establish external success gave rise to cognitive and emotional internal dynamics that inhibited organizational learning. We call this dynamic the advocacy trap. By suggesting a downside to legitimacy building and identifying a novel barrier to organizational learning - rooted in cognition and emotion, and especially salient in new firms and nascent industries - our discovery opens several new avenues for research in entrepreneurship and organizational learning.

Many scholars have proposed factors that inhibit or facilitate organizational learning, yet few of these claims have been tested empirically. To measure differences in learning across organizations or work units within the same organization, this chapters draws on existing perspectives in the organizational learning literature to create and test a Learning Organization Survey (LOS) in two studies. The LOS presents ten constructs in three clusters – learning environment, processes, and leadership. Study 1 examines the reliability and validity of the ten theory-based constructs comprising the learning organization. Study 2 provides further validation that the LOS is a reliable, stable instrument containing items that suit the theoretical criteria for components of learning organizations. Implications for research and practice are discussed.

Fascination with organizations that eschew the conventional managerial hierarchy and instead radically decentralize authority has been longstanding, albeit at the margins of scholarly and practitioner attention. Recently, however, organizational experiments in radical decentralization have gained mainstream consideration, giving rise to a need for new theory and new research. This paper reviews the literature on less-hierarchical organizing and identifies three categories of research: post-bureaucratic organizations, humanistic management and organizational democracy. Despite this extensive prior work, scholarly understanding of radical decentralization remains limited. Using the term self-managing organizations to capture efforts that radically decentralize authority in a formal and systematic way throughout the organization, we set forth a research agenda to better understand less-hierarchical organizing at its limits.