Developing CLOUT: A Longitudinal, Cross-Program Chief Resident Curriculum to Increase Psychological Safety in the Clinical Learning Environment

Psychological safety in the clinical learning environment is essential for learning and thriving. The authors aimed to leverage the leadership position and influence that chief residents hold and invited them to participate in a longitudinal professional development curriculum designed to provide them with the tools to promote psychological safety. A total of 66 chief residents from 25 residency programs, along with 18 faculty allies, participated in 5 workshops, which were designed to increase their understanding of and effective responses to workplace mistreatment or bias directed toward trainees. These skills-based workshops focused on effective coaching, conflict management, and self-regulation of emotions for themselves and their trainees. There was a significant improvement in self-reported efficacy in these domains at the completion of the curriculum and evidence of behavior change as assessed by baseline and final case scenario responses. Additionally, the relationship building that resulted by bringing all chief residents together further enhanced the curriculum's impact as assessed qualitatively. Providing chief residents with skills and resources to become change agents through a longitudinal curriculum in a cohort model improves individual self-efficacy and responses to exemplar cases. Assessment of the overall impact on individual programs and institutional climate is planned.