In this assignment PGY 2s will go through the Safe Learning Environment slide set (see button) and then complete the PGY 2 Safe Learning Environment One Page Curriculum. You will write a brief reflection about a macro and'/or a microaggression that you have witnessed. Be prepared to discuss (preserving confidentiality) your reflection in the group debriefing.

This presentation focuses on creating safe learning environments in healthcare, addressing micro and macroaggressions, and emphasizing the difference between intent and impact. It draws heavily from the work of Jo Shapiro. The presentation begins by highlighting the pervasive issue of unprofessional behavior, using the example of "Dr. Demeaning," whose demeaning and hostile actions towards trainees create a toxic learning environment. Reasons for tolerating such behavior include fear of repercussions due to hierarchical power structures, tribalism, and justifications based on technical skill or tradition. Furthermore, a misconception that high stress leads to high performance, as depicted by the Yerkes-Dodson curve, contributes to this acceptance. However, the presentation argues against this notion.

The presentation then explores the reasons people avoid addressing unprofessional behavior. These include: perceived time commitment, insufficient data, fear of retaliation, potential demoralization of the offender, skepticism about change, desire to be liked, underestimation of the issue's importance, cultural unacceptability, lack of a safe/trusting environment, and emotional barriers. It emphasizes that not giving feedback is not a neutral action and can have detrimental effects on learning and patient care. The presentation cites research indicating that positive communication and collaboration correlate with lower patient morbidity, while respectful leadership improves physician satisfaction and reduces burnout. Conversely, disruptive behavior correlates with compromises in patient safety and quality of care. Communication failures are identified as a major contributor to negative outcomes.

The presentation advocates for fostering team psychological safety, defined as a shared belief in interpersonal safety that allows team members to speak up without fear. It stresses the high cost of not addressing unprofessional behavior, impacting patient safety, the learning environment, litigation risk, retention, morale, productivity, and well-being. Leaders are urged to model a growth mindset, create safe spaces for feedback, and hold everyone accountable. Managing conflict and giving/receiving feedback are identified as critical skills. The presentation introduces frame-based feedback as a method for conflict management, emphasizing understanding the perspectives of both the giver (Me) and receiver (You) of feedback, and exploring the gaps and overlaps (Us) between these frames. It underscores the importance of assuming positive intent while addressing the impact of behavior.

Frame-based feedback encourages starting with a short, open-ended question to understand the other person's perspective ("Get Curious"). The context of the situation should guide the response, and escalating consequences should be implemented for persistent unprofessional behavior. The presentation acknowledges potential accountability barriers, such as excusing unprofessional behavior based on the offender's perceived value to the department, their perceived good intentions, or blaming the individuals raising concerns. It emphasizes that addressing unprofessional behavior is not about punishing minor issues or avoiding conflict, but about creating a safe and healthy learning environment. Escalating consequences are presented as a complementary approach to promoting professionalism.

The presentation also touches upon microaggressions, defined as subtle interactions that convey negative messages about specific groups of people, often unintentionally. The impact of these microaggressions can be significant, even if the intent is not malicious. The final slide mentions "Microaggressions Responses," suggesting strategies for addressing these subtle but harmful interactions. The presentation concludes with a photograph by Jo Shapiro and a reminder that everyone can be both a source and a target of unprofessional behavior, encouraging self-reflection and responsibility for building positive relationships. It highlights the importance of trust in healthcare teams, linking it to higher satisfaction, lower stress, and decreased intention to leave among clinicians. The presentation emphasizes that addressing unprofessional behavior and fostering psychological safety are crucial for improving patient care, creating a positive learning environment, and promoting the well-being of all healthcare professionals.