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Effect of Psychological Safety Education on Psychological Safety Knowledge among Healthcare Workers in Nigeria

Abstract

Psychological safety is an important component of a healthy healthcare work environment because it enables healthcare workers to communicate concerns, ask questions, report errors, provide feedback, seek assistance, and participate in teamwork without fear of humiliation, retaliation, or unfair punishment. Healthcare workers in Nigeria may encounter hierarchical organizational structures, demanding workloads, staff shortages, communication difficulties, workplace conflicts, and fear of negative consequences when raising concerns. Limited understanding of psychological safety may prevent workers from recognizing its importance and from identifying behaviours and organizational practices that promote a safe and supportive work environment. Psychological safety education provides an opportunity to improve healthcare workers' knowledge of psychological safety, including its principles, benefits, barriers, communication practices, error reporting, speaking-up behaviours, teamwork, respectful interactions, leadership support, and appropriate mechanisms for raising workplace concerns. Against this background, this study investigates the effect of psychological safety education on psychological safety knowledge among healthcare workers in Nigeria. The study will be anchored on Social Cognitive Theory, Organizational Culture Theory, and the Job Demands–Resources Model. Social Cognitive Theory emphasizes the roles of knowledge, self-efficacy, observational learning, interpersonal interactions, and organizational environment in developing behaviours that support psychological safety. Organizational Culture Theory explains how shared values, norms, communication patterns, leadership practices, and organizational expectations influence employees' perceptions and understanding of safety within the workplace. The Job Demands–Resources Model explains how demanding work conditions may affect healthcare workers' wellbeing, while workplace resources such as supportive leadership, teamwork, autonomy, feedback, and effective communication may promote a healthier work environment. Collectively, these theoretical perspectives provide a suitable framework for explaining how psychological safety education may influence psychological safety knowledge among healthcare workers in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise healthcare workers, including doctors, nurses, pharmacists, medical laboratory scientists, physiotherapists, community health professionals, and other healthcare personnel working in selected public and private healthcare facilities across Nigeria. A multistage sampling technique will be used to select states, healthcare institutions, departments, units, and eligible healthcare workers. Psychological safety education will be measured using indicators such as exposure to structured educational sessions, training frequency and duration, understanding of psychological safety, speaking-up behaviours, respectful communication, teamwork, error reporting, feedback, conflict management, leadership support, workplace inclusion, non-punitive responses to mistakes, confidentiality, peer support, and mechanisms for raising workplace concerns. Psychological safety knowledge will be assessed using indicators such as understanding the meaning and principles of psychological safety, recognition of behaviours that promote or undermine psychological safety, knowledge of appropriate communication practices, understanding of speaking-up and error-reporting procedures, awareness of respectful teamwork, knowledge of leadership responsibilities, recognition of workplace barriers, understanding of appropriate feedback mechanisms, and awareness of available organizational support systems. Data will be collected using structured questionnaires and appropriately validated psychological safety knowledge instruments administered before and after the educational intervention where a quasi-experimental design is used. Descriptive statistics will be used to summarize healthcare workers' demographic and professional characteristics, exposure to psychological safety education, and psychological safety knowledge levels. Inferential statistical techniques, including paired or independent sample tests, chi-square tests, correlation analysis, and multiple regression analysis where appropriate, will be used to determine the effect of psychological safety education on psychological safety knowledge. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that psychological safety education has a significant positive effect on psychological safety knowledge among healthcare workers in Nigeria. Healthcare workers exposed to structured psychological safety education are expected to demonstrate improved understanding of psychological safety principles, speaking-up behaviours, respectful communication, teamwork, error reporting, constructive feedback, and available organizational support mechanisms compared with their baseline knowledge or healthcare workers without similar educational exposure. Education may increase workers' awareness of the importance of raising concerns, asking for assistance, reporting errors, sharing ideas, and communicating respectfully with colleagues and supervisors. Practical scenarios, role-playing, case discussions, and communication exercises may strengthen healthcare workers' understanding of how psychological safety can be promoted in real healthcare settings. Conversely, hierarchical workplace structures, fear of retaliation, inadequate leadership support, workplace conflicts, heavy workloads, limited training resources, and organizational cultures that discourage open communication may limit the effectiveness of psychological safety education. The study therefore expects structured, practical, workplace-oriented, and sustained psychological safety education to contribute significantly to improved psychological safety knowledge among healthcare workers in Nigeria. The study is expected to contribute to the literature on psychological safety education, psychological safety knowledge, healthcare workers, workplace mental health, healthcare teamwork, organizational culture, patient safety, occupational health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, hospital administrators, healthcare professional bodies, occupational health units, healthcare managers, quality improvement teams, public health practitioners, development partners, and policymakers regarding strategies for strengthening psychologically safe healthcare workplaces. The study will also provide evidence-based recommendations for integrating psychological safety education into healthcare worker orientation and continuing professional development, strengthening leadership training, improving communication and error-reporting systems, promoting non-punitive approaches to workplace mistakes, strengthening teamwork, protecting workers who raise legitimate concerns, and establishing sustainable psychological safety initiatives across healthcare facilities in Nigeria.

Keywords: Psychological safety education, psychological safety knowledge, healthcare workers, workplace mental health, healthcare teamwork, organizational culture, patient safety, occupational health, speaking-up behaviour, error reporting, Nigeria, public health.