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Table 7 Final Composite Measure Integrating Survey and Observation Components

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

Measurement Psychological Safety Towards Team Leader Psychological Safety Towards Other Team Members Psychological Safety in Relation to Team as a Whole
Survey Results Mean s.d. Mean s.d. Mean s.d.
6.789 1.867 6.469 .986 5.987 .876
Total Observed Behaviours Displayed by: Team Members Team Leader Team Members Team Leader Team Members
Voice Behaviours 15 27 10 29 3
 Communicating opinions to others even if they disagree 2 5 2 5  
 Asking questions 5 3 5 10  
 Providing information 5 10   5 2
 Providing feedback 3 3 2 6 1
 Providing help or solutions   5   3  
 Correcting others   2 1   
Defensive Voice Behaviours 2 2 3 1  
 Denying faults or blame others    2   
 Showing aggression    1   
 Evading confrontation by focusing only on positives 2 2   1  
Silence Behaviours 3   2   5
 Facial expression or body language indicates fear      
 Facial expression or body language indicates disengagement 3     2
 Closed body language    2   3
Supportive Behaviours 10 19 7 17 1
 Sharing procedures, knowledge and experience 4 2   8  
 Sharing future plans 2 3   2  
 Active listening      
 Use of inclusive language such as “we”   8   5  
 Agreeing/Responding positively or enthusiastically to input 4   5   
 Acknowledging achievements/ congratulating    2 2 1
 Delegating tasks   6    
Unsupportive Behaviours   3 4   
 Interrupting   3    
 Discussions within small sub-groups    4   
 Reacting cold/ignoring a joke      
Learning or Improvement Oriented Behaviours 5 5 2 15 2
 Reviewing own progress and performance   2   7  
 Asking for feedback 2     
 Asking for help or solutions 1 3    
 Asking for input from all meeting participants    2 8 1
 Informing the team about issues or mistakes related to patient safety or staff safety      1
 Looking for improvement opportunities and speaking up with ideas 2     
 Acknowledging own mistake      
Familiarity Behaviours 3 4 11 3 3
 Talking about personal, non-work matters   1 6   
 Laughing about a joke 3 3 5 3 3
Total Observed Behaviour      
 Categories indicating high psychological safety:
(voice behaviours, supportive behaviours, learning or improvement behaviour and familiarity behaviours)
33 55 30 64 9
 Categories indicating lower psychological safety:
(defensive voice behaviours, silence behaviours and unsupportive behaviours).
5 5 9 1 5