Psychological safety in debriefing

Psychological safety (PS) has emerged as a key factor in simulation-based medical education, particularly during debriefing sessions, where reflection and feedback are essential for meaningful learning. This narrative review explores the role of PS in facilitating effective debriefing, emphasizing how it influences learners’ confidence, emotional regulation, and engagement in reflective dialogue. A literature search was conducted in PubMed and Google Scholar for articles published between 2020 and 2025, using the terms “psychological safety,” “debriefing,” “medical simulation,” and “assertive communication.” Findings suggest that establishing PS before and during debriefing fosters inclusion, open communication, and emotional support– conditions that enhance both technical and non-technical skill development. Facilitators play a central role by promoting respectful interactions, empathy, and assertive communication, which strengthen group trust and reduce stress-related barriers to learning. Moreover, structured debriefing models such as PEARLS, Diamond Debrief, and LEARN provide frameworks that sustain PS by integrating reflection, emotional expression, and shared meaning-making. The creation of psychologically safe environments contributes to reduced error incidence, improved teamwork, and the development of resilient, self-aware healthcare professionals. This review underscores the need to integrate PS training into simulation facilitation to ensure reflective, humane, and effective learning experiences in medical education.