A cross-sectional study of psychological safety: Barriers and facilitators in a non-western clinical setting

Residents' experiences of psychological safety were linked to more proactive feedback-seeking, which was in turn associated with higher self-perceived competence. However, more passive feedback strategies appeared less sensitive to psychological safety, likely reflecting cultural norms and hierarchical barriers. These safety perceptions were shaped by interpersonal relationships, leadership accessibility, workload pressures, and broader institutional culture, with hierarchy emerging as a dominant concern. Multi-level interventions, including leadership training, faculty development, and structural reforms, are needed to foster psychologically safe learning environments that promote resident growth, team functioning, and patient safety.