11.2 A Safe Learning Environment

Creating a Safe Learning Environment

The most important success factor of video review is creating a safe learning environment. The chair of a video review session plays a crucial role in establishing an atmosphere where participants feel comfortable learning from both successes and challenges. Here's how:

Setting Ground Rules:

• Respect is Fundamental: Emphasize that the focus is on skill development and process improvement, not personal critique.

• Constructive Feedback: Frame feedback with specific observations (e.g., "At the 3:12 mark, I noticed..." ) and offer suggestions focused on solutions.

• Balance is Key: Actively encourage highlighting both positive aspects and areas for potential optimization.

• Confidentiality: Stress that discussions within the review session should remain within that group.

Fostering Psychological Safety:

• Leader as Model: The chair sets the tone. Model openness to your own learning, and acknowledge that even experienced providers have areas for improvement.

• Vulnerability Creates Space: Briefly sharing a time when you benefited from similar feedback builds trust.

• Acknowledge Effort: Recognize the effort that goes into both performing procedures and being willing to have them recorded for review.

• Redirect Negativity: If comments stray into judgmental or personal territory, gently redirect the conversation back to objective observations and learning.

Additional Techniques:

• "Pause" Power: Encourage participants to pause the video if they need a moment to gather thoughts or for clarification.

• Provider Input: Allow recorded providers to share their perspectives and what they might do differently next time.

Emphasis: A safe learning environment is not about avoiding difficult discussions but about having them in a way that promotes growth. The chair plays a crucial role in establishing norms that empower everyone to learn from the review process.

A safe learning environment during video review sessions fosters psychological safety, allowing providers to openly discuss successes and improvement areas without fear of judgment. This leads to deeper learning, reduced defensiveness, and a focus on system-level enhancements. Ultimately, a safe space maximizes the potential of video review to drive continuous improvement in medical care.

Without a safe learning environment for video review, providers may feel apprehensive and defensive, leading to hesitation in sharing their insights or raising concerns. Fear of judgment can stifle open discussions, limiting the potential for deep analysis and system-level improvements. The focus may shift to finding fault instead of identifying collaborative solutions. This can erode trust in the process, hinder participation, and ultimately diminish the effectiveness of video review as a tool for improving medical care.