By Mardi O’Keefe
As an intern, you spend your year moving between teams, specialties and supervisors. In each rotation you will quickly get a sense of how a team works and, importantly, whether it feels safe to speak up.
Can you ask a question without feeling foolish? Can you say you don’t know? Can you clarify an instruction you don’t understand? Can you raise a concern about a patient? Can you tell someone you think you may have made a mistake?
These are all examples of psychological safety.
Psychological safety is the shared belief that members of a team can speak up, ask questions, raise concerns, contribute ideas or acknowledge mistakes without fear of being embarrassed, humiliated or punished. In healthcare this matters, because good patient care depends on people sharing information and expertise – particularly when something doesn’t look or feel right.
What does psychological safety feel like?
You will probably recognise it when you experience it.
It is the registrar who responds to your question with interest rather than irritation. The consultant who asks, “Does anyone see this differently?” The nurse who feels comfortable telling the medical team they are worried about a patient. The intern who can say, “I’m not sure. Can you check this with me?”
It is also what happens after someone speaks up.
Are they listened to? Is their concern considered? Are questions treated as a legitimate part of the work? If someone makes a mistake, can the team discuss what happened and learn from it while still maintaining appropriate standards and accountability?
Psychological safety does not mean everyone agrees. It does not mean being nice all the time or lowering standards. In fact, psychologically safe teams are better able to have difficult conversations, question decisions and address problems because people feel able to contribute honestly.
But I’m an intern. What can I do?
Quite a lot.
You may be the most junior doctor in the team, but you are still a team member. Psychological safety is influenced by the everyday behaviour of everyone in the group, not only those with formal leadership roles.
Start with the interactions you can influence:
Ask questions. Being willing to say “I’m not sure” helps normalise learning and uncertainty.
Speak up when something concerns you. You may have noticed something others haven’t.
Listen when others speak. Don’t dismiss, interrupt or talk over someone because they are junior or from another profession.
Respond well when someone asks you a question. This includes medical students, other interns and colleagues who may know less about a particular task than you do.
Acknowledge mistakes early. Hiding mistakes makes teams less safe. Raising them allows the team to respond, correct and learn.
Invite others in. A simple “What do you think?” can make it easier for someone else to contribute.
You won’t be able to create psychological safety across an entire department on your own. There will also be teams in which speaking up feels harder than it should.
But you can pay attention to the kind of colleague you are becoming.
Internship is not only about developing your clinical skills. It is also where you begin developing the behaviours you will carry into future teams and eventually into your own leadership.
Start now. Ask. Listen. Speak up. Make it easier for others to do the same.
Want to learn more about psychological safety?
Explore other AMA Victoria resources on Creating psychological safety in your teams, What psychological safety sounds like at work and Psychological safety is not about being nice.
Mardi O’Keefe is the Director of Engagement & Professional Growth at AMA Victoria.