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Table 1 Behaviours Identified for Inclusion in Observation Measure

From: Measuring psychological safety in healthcare teams: developing an observational measure to complement survey methods

Source Category Behaviour
Hoenderdos [12] 1. Good Environment
2. Defensive or Evasive Behaviour
3. Responsibility
4. Feedback
5. Knowledge Sharing and Work Procedures
6. Extra behaviour Present in Meetings
1. Relaxed behaviour (make jokes, whistle, singing), Personal attention (talk about personal, non-work related matters), Enthusiasm (Greet, compliment), Agree (say yes, nod)
2. Aggression (raise voice, large gestures), Closed body posture (arms closed over each other, lean backwards), Evade confrontation (do not react to addressed problems or confrontations), Resistance against task (React negatively towards the execution of a task)
3. Point towards responsibility, Give fault to others (blame others as the source for own failure), Deny fault (deny any shortcoming of the alleged), Fail to meet or delay previous agreements (take responsibility and acknowledge own fault)
4. Active listening (Verify, confirm, paraphrase etc), Interrupting, Provide or ask for feedback, Do not make eye-contact during feedback. Joke about disagreements (about previous feedback, procedures or issues), React cold to enthusiasm.
5. Asking open questions, Ask or offer help, Brief consultation, Look for improvement opportunities (address own work method, look for solutions together), Discuss and compare results, Share procedures, knowledge and experiences, Negatively react towards ideas (ideas or opinions of other team members), Re-divide Tasks (of routine or previously divided tasks)
6. Not present of unprepared at the meeting (come late, read or work during meeting), Chatting or singing in sub-group, Give the same people the attention (with every new agenda topic)
Edmondson [1] Learning behaviour 1. This team asks its internal customers for feedback on its performance
2. This team relies on outdated information or ideas
3. This team actively reviews its own progress and performance
4. This team does its work without stopping to consider all the information team members have
5. This team regularly takes time to figure out ways to improve its work performance
6. This team ignores feedback from others in the company
7. This team asks for help from others in the company when something comes up that the team members don’t know how to handle
Le Pine and Van Dyne [31] Voice behaviour 1. Team member develop and make recommendations concerning issues that affect the work group
2. Team members speak up and encourage others in the group to get involved in issues that affect the group
3. Team members communicate opinions about work issues to others in the group even if they disagree
4. Team members keep well informed about issues where opinions might be useful to this work group
5. Team members get involved in issues that affect the quality of work life in the group
8. Team members speak up in the group with ideas for new projects of changes in procedures
Van Dyne et al. [32] 1. Acquiescent Silence
2. Acquiescent Voice
3. Defensive silence
4. Defensive voice
5. Prosocial Silence
6. Prosocial Voice
1. Remaining silent because of being disengaged or feeling unable to make a difference in the team. This may include; not speaking up or displaying disengaged non-verbal behaviour (e.g. no eye contact or closed body language)
2. Voicing passive support for ideas based on resignation or agree with the group due to low self-efficacy to make a difference. May include; expressing agreement without offering new ideas, not making effort to communicate own ideas.
3. Withholding information based on fear or self-protection. Not speaking up and displaying non-verbal behaviour which indicates fear (e.g. no eye contact, evades confrontation, closed body language)
4. Expressing ideas to shift attention away from self, based on fear. May include emphasising positive features and diverting attentions away from problems.
5. Withholding information based on cooperation or to benefit the team. Refusing to divulge information that might harm the organisation/team
6. Expressing solutions to problems based on cooperation or suggesting ideas for change to benefit the team. Speaking up about projects or ideas that might benefit the organisation and expressing ideas even if others disagree.
O’Donovan & McAuliffe [33] 1. Priority for safety
2. Improvement or Learning Orientation
3. Support
4. Familiarity with colleagues
5. Status, hierarchy and inclusiveness
1. Safety Culture: Conversations and discussion during meetings focused on safety.
Leader Behavioural Integrity for safety: Team leaders words and actions aligned.
Professional Responsibility: Individuals on the team refer to their responsibility for patients as a reason for disagreeing/speaking up.
2. A Culture of Continuous Improvement: The team is focused on continuous improvement- addresses areas related to improvement- asks questions related to improvement.
Change Oriented Leaders: The team leaders behaviour shows that they encourage innovative thinking, change. The leader facilitates open discussion.
3. Organisational Support: Meetings are structured in a way that supports speaking up such as allowing time for questions and discussion.
Supportive Leadership: Leader responds to employee input positively, gives freedom, autonomy, personal control to other team members, teaches and communicates strategic intent to their team, provides instruction, feedback and explanations about the procedure, makes sense of unexpected events and updates the status and progress of procedure.
Support from Peers: In general, team members share decision making, speak up, show strong teamwork.
4. Familiarity between Team Members: Familiarity between team members evident- talking about personal issues, relaxed behaviour etc.
Familiarity across Teams: Team members link information from other teams, suggest helpful collaboration with other teams and communicate with those outside the team to gain knowledge and expertise that they can report back to their group.
Familiarity with Leader: Familiar relationships- talk personal, relaxed behaviour.
5. Individual Knowledge and Experience: Domination from one or a group of team members or sharing of power across team.
Leader Inclusivity: Leader invites and appreciates input from other team members. Uses inclusive language such as “we”.