Not just ‘what you say’ but ‘how you say it’: co-creating psychological safety through micro-communication skills in simulation-based education

This essay builds on a previous editorial in which we posited that psychological safety is not something a simulation-based educator can ‘create’ or ‘ensure’ alone; that psychological safety is a relational concept. While simulation-based education often has critical technical elements, it has also been described as essentially a social practice. In this essay, we explore how micro-communication skills can contribute to shaping this social practice, and how simulation educators can use these practices to foster psychological safety and optimize learning. We argue for the use of micro-communication skills by simulation educators to shift from that notion of faculty ‘creating’ psychological safety to a position of ‘co-creating’ psychological safety with learners through mutual, responsive interactions. We propose how the social dynamic can be influenced through phatic communication, emotional pace setting, humour, physical/gestural communication, empathic communication, conversational pauses and turn-taking. By foregrounding the social dimensions of simulation-based education, we highlight how everyday communication choices shape learners’ experience, trust and growth.