Psychological Safety Newsletter #37: Performance Reviews and Emergency Medicine

Training, Workshops, Exercises and Tools

Psychological Safety Newsletter #37: Performance Reviews and Emergency Medicine

trans awareness week

Welcome to the psychological safety newsletter and thanks for subscribing. You are awesome. This week includes performance reviews, emergency medicine, mentoring, the future of work, kindness and affective vs cognitive trust..Enjoy, and have a wonderful day.

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This newsletter is sponsored by Conflux.

Conflux is the leading business consultancy worldwide helping organisations to navigate fast flow in software. We help organisations to adopt and sustain proven, modern practices for delivering software rapidly and safely.

We’ve recently been reading ‘The Fearless Organization’ by Amy C. Edmondson, and Sophie Weston, Principal at Conflux, has put together some key takeaways from the book in this article

This week is Transgender Awareness Week, so this newsletter begins with this excellent article from McKinsey, on Being Transgender At WorkBeing transgender today often means facing not only stigma but also increasing threats to safety and existence, whether it’s record-high levels of deadly violence or a higher-than-typical likelihood of encountering employment or housing discrimination. Transgender people suffer from far lower levels of psychological safety in the workplace and are often prevented from bringing their true selves to work. But creating a trans-inclusive workplace, through inclusive policies, benefits, languages and practices will reap benefits for everyone. And it can start with small steps, such as normalising the declaration of pronouns, eliminating gender-specific dress codes, or ensuring that health insurance plans cover gender-affirmative surgery and hormone therapy. 

Psychological Safety In the Workplace:
Congratulations go to Dr Amy Edmondson for taking the number 1 spot in this year’s Thinkers50 list. Very well deserved indeed. I certainly owe Dr Edmondson a lot and I’m incredibly grateful for her research and insights into psychological safety, teaming and organisational learning.

This has me so conflicted. On one hand, performance reviews are awful. Especially performance reviews that are linked to financial incentives. But I guess, if you have to carry out performance reviews (maybe your organisation has a fixed policy on them, for example), then is considering psychological safety of everyone involved at least a step in the right direction, or is it layering a veneer of progressive leadership on top of an outdated and regressive practice?

Dr Eve Purdy has featured in the newsletter previously, and for good reason. Here, Eve is on the Mind Full Medic Podcast, talking about team culture and cultivating psychological safety in healthcare and emergency medicine. There are so many takeaways here for clinical teams, including team huddles, after-action reviews and an onus on senior clinicians to set the tone.

Mentoring programmes are powerful, and this piece from Christopher Stanton at Harvard Business School (based on this paper) makes a great point that broad-based mentoring programs, with no opt-out provision, are likely to generate more impressive results than opt-in programmes, because “no matter what the cause, those who need help most are not seeking help.

Two pieces on the future of work and organisations follow:

I know Joe Fay, and he’s a lovely guy. He’s also just written this excellent piece about the future of work and organisations, that aligns with my belief that organisational change is only ever successful through experimentation and learning: “Scenario planning and constant experimentation works for delivering software and services. Applying it on a societal scale might be a daunting prospect, but is probably our best option.”

I also know Andrew Doran, who is also a great guy, and he’s written this excellent piece (actually a follow up piece) about his experience of how work has changed, continues to change, and may look in the future. Really worth a read, and I want to highlight his prediction on how high performing organisations will:

  • Hire the best people;
  • Set some ground rules about what is expected, e.g. be where the client wants them to be, and to participate in-person on team-wide/company-wide event days;
  • Have an understanding that being in an open-plan office is more about relationship building than getting work done;
  • Provide a variety of activity-based workspaces in their offices;
  • Let staff decide where the best place is to be productive on any given day.

Psychological Safety Theory, Research and Opinion:

This episode of Calm Edged Rebels podcast talks about how much factors like industry, culture and hierarchy impact on levels of psychological safety, what kind of behaviours can crush people’s confidence, and what role does belonging play? 
This is fascinating: “The enhanced levels of anxiety and stress are perceived to be functional by a section of parents who view it as a prerequisite for enhanced effort and better consequent performance in standardised examinations.” – an article by Dr Debarshi Roy at Oxford University:  Encouraging an Intolerance to Failure: Psychological Safety in Indian School Systems.

Here’s an article by Dr Bob Klaber at Imperial College NHS trust: How acts of kindness can improve care and strengthen teams. It’s a great piece that emphasises the importance of kindness not only to patients but to colleagues, particularly in the face of what could be a challenging winter for the NHS in the UK.

This piece in Binghampton University News argues that affective trust may be more important to team members than cognitive trust: “Research: People prefer friendliness, trustworthiness in teammates over skill competency.” I’ve written about the different kinds of trust in relation to psychological safety previously.

Things to do and try: Thanks to Mark Eddleston for signposting me to this excellent resource that he’s put together. This is a fab collection of practices to enable new (and better) ways of working, from Lean Coffee to Loomio’s conflict process.

This week’s poem:

A Word is Dead, by Emily Dickinson

A word is dead
When it is said,
Some say.

I say it just
Begins to live
That day.


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