What’s in a leader? Association of perceived leadership effectiveness and psychological safety among clinical physician faculty

Objective To identify leadership qualities associated with psychological safety among physician faculty in a large medical centre in New York City. Patients and methods An anonymous, institution-wide cross-sectional survey was sent to all physician faculty with clinical responsibilities between July and September 2022. Demographic and occupational characteristics were assessed. Perceived leadership effectiveness was measured with the nine-item Mayo Leadership Index and psychological safety was measured using the seven-item Fearless Organisation Questionnaire. Multivariable logistic regression analyses were conducted to determine associations between leadership, psychological safety, and demographic and occupational correlates of psychological safety. Results Of 3086 eligible clinical faculty members, 867 (28.1%) physicians with clinical responsibilities participated. On average, 57.6% of physicians reported that their workplace was psychologically safe and the majority agreed with items on the Mayo Leadership Index (60.0%–84.5%), the most prevalent being ‘treats me with respect and dignity,’ ‘employs me to do my job’ and ‘encourages employees to suggest ideas for improvement.’ In a multivariable model, higher overall leadership index scores were positively associated with psychological safety scores. Conclusions Greater perceived leadership effectiveness was positively associated with psychological safety among clinical physician faculty at a large, urban hospital. These results suggest that organisational investment in promoting leadership effectiveness may have positive downstream effects on healthcare delivery, burn-out and attrition rates.