Delphi Study on Psychological Safety Competencies in Healthcare Training Curricula
Condition: Psychological Safety; Knowledge, Attitudes, Practice
Study type: Observational

Summary: 
      Psychological safety refers to the shared belief that a work team can face complex challenges
      when there is an environment of mutual respect and trust. Thus, healthcare professionals
      provide safer care when causes and ways to avoid clinical errors can be discussed and
      analyzed without fear of criticism or sanctions. A psychological safety climate can be a
      determinant of patient safety. In this way, this provides safer care when it is possible to
      discuss and analyze the causes and how to avoid clinical errors without fear of criticism or
      sanctions.

      This study aims to explore the mentors' opinion on what psychological safety competencies are
      being acquired by future generations of healthcare professionals (students and residents,
      hereafter "trainees") through current training programs and what actions should be taken to
      promote such competencies in clinical settings.
    

Detailed description: 
      Consensus study based on the Delphi technique. To develop the questionnaire 0 structured
      interviews will be conducted. This study step includes the development of a consultation
      instrument in questionnaire format to conduct the Delphi study. Only the legibility, face and
      content validity of the questionnaire will be assessed through interviews to ensure its
      correct completion by the participants.

      One member of the research team for each participating country will act as national study
      coordinator in that country.

      The study procedure will be structured in the following steps:

        1. Research team constitution.

        2. Request for study evaluation and approval by an Ethics Committee in each of the
           participating countries. This step is required only in the case of countries where
           ethical evaluation is mandatory to conduct this type of study. A common draft of the
           protocol will be available to support each national coordinator.

        3. Collect preliminary information for the subsequent questionnaire re-define for the
           Delphi study. For this purpose, the available literature on the topic of the study and
           the WHO Global Patient Safety Action Plan 2021-2030 (more specifically, objective 5) has
           been reviewed beforehand. Once the first version of the questionnaire has been drafted
           from the information collected, interviews will be conducted with 3 mentors from each
           participating country to assess the legibility, face, and content validity of the draft
           questionnaire (readability, comprehension, clarity, coherence, relevance, and
           appropriateness). A template will be available to conduct it.

        4. Revision and improvement of the initial version of the questionnaire based on the
           information gathered through the interviews to ensure the face and content validity of
           the instrument.

        5. Approval of the questionnaire by the research team based on the information collected in
           steps 3 and 4. The questionnaire will be translated from English into the local
           languages of the participating countries by two native experts independently.
           Inconsistencies will be resolved with the participation of a third researcher.

        6. Recruitment of participants. The national coordinator will be responsible for contacting
           the teaching units of healthcare institutions in their country to establish, through
           them, contact with trainees' mentors. A minimum of 20 participants from each country is
           expected. They will be working in family medicine, midwifery, pharmacy, surgery, and
           medicine departments.

        7. Invitation to the study. The questionnaire will be designed on a web platform, property
           of the research team, hosted on a secure server, and specifically designed for
           conducting Delphi studies. The responses given to the questionnaire will be treated as
           fully confidential. However, given the nature of the study (Delphi with several rounds),
           each participant will access the web platform through personalized credentials to allow
           continuity in data collection and analysis. Personal information (username and password)
           will be deleted, and the responses of the same person to the different rounds will be
           linked by a unique double-blind code. The questionnaire will be disseminated by e-mail.
           Three reminders are foreseen to ensure an adequate response rate.

        8. First round and successive rounds up to expert consensus. A minimum of two rounds will
           be carried out, and the maximum will be determined by reaching a consensus among the
           participants.

        9. Data analysis and interpretation of the results. Preparation of an article for
           publication in a scientific journal.

       10. Dissemination of the results. The results will be translated into practice to improve
           the training programs of next generations of health professionals through schools and
           faculties, ministries of health, and other agencies and scientific societies involved in
           curricula design. The results will also be disseminated through the usual scientific
           media (journals, conferences, etc.) and social networks.
    

Intervention name(s): Delphi study
Intervention type(s): Other
Intervention description(s): A Delphi study will be conducted with several rounds up to expert consensus.
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Trainees' mentors who would be working in inpatient or outpatient settings or community or
        social care centers mentoring residents in the fields of family medicine, midwifery,
        pharmacy, surgery, and medicine department.
      
Keywords: Psychological Safety; Healthcare students; Delphi study; Knowledge, attitudes, skills; Trainee mentors