Amy Edmondson

The Fearless Organization

Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth



  • “I have defined psychological safety as the belief that the work environment is safe for interpersonal risk taking. The concept refers to the experience of feeling able to speak up with relevant ideas, questions, or concerns.”       — Edmondson, A.C. “Psychological Safety and Learning Behavior in Work Teams.” Administrative Science Quarterly 44.2 (1999): 350–83.
  • Psychological safety is the most important ingredient of organizational learning.
  • It means reducing fear, making the workplace safe for interpersonal risk-taking. Significantly improves the quality of communication, collaboration and exchange of information in general.
  • Enables learning, enhances creativity, significantly improves decision-making, helps to improve organizational processes boosts innovation, enables exploring new market opportunities.
  • Creates employee engagement, enables fully utilizing employee skills and capabilities.
  • Increases team performance. Creates highly effective, high-performing groups, operating in an environment of mutual respect and deep trust.
  • Brings safety to the next level: helps to deal effectively with new and uncertain situations.
  • It directly contributes to the organization’s bottom line: increases profit, ROI (Return on Investment), ROA (Return on Asset).


  • “I have defined psychological safety as the belief that the work environment is safe for interpersonal risk taking. The concept refers to the experience of feeling able to speak up with relevant ideas, questions, or concerns.”       Edmondson, A.C. “Psychological Safety and Learning Behavior in Work Teams.” Administrative Science Quarterly 44.2 (1999): 350–83.
  • “Psychological safety describes a climate where people feel safe enough to take interpersonal risks by speaking up and sharing concerns, questions, or ideas.”
  • “a sense of confidence that the team will not embarrass, reject, or punish someone for speaking up.”
  • “a shared belief that the team is safe for interpersonal risk taking”
  • it is very much shaped by local leaders
  • “blends trust and respect” – when colleagues trust and respect each other
  • not a personality trait, but a group phenomenon
  • “takes off the brakes that keep people from achieving what’s possible. But it’s not the fuel that powers the car. (…) Setting high standards remains a crucial management task.”
  • “(…) making the environment safe for open communication about challenges, concerns, and opportunities is one of the most important leadership responsibilities in the twenty-first century.”
  • “In any organization (…) that requires integrating knowledge from diverse areas of expertise – psychological safety is a requirement for success.”
  • “psychological safety leads to, among others, creativity, error reporting, and knowledge sharing, as well as behaviors that detect the need for change or that help teams and organizations make change”
  • feeling able, even obligated to express opinions
  • “Today’s employees, at all levels, spend 50% more time collaborating than they did 20 years ago.”
  • teamwork is dynamic —> occurring in constantly shifting configurations of people rather than in formal, clearly-bounded teams
  • only 3 in 10 employees strongly agree with the statement that their opinions count at work (Source)
  • “psychological safety leads to, among others, creativity, error reporting, and knowledge sharing, as well as behaviors that detect the need for change or that help teams and organizations make change”
  • it is not about being nice – allows productive disagreement and free exchange of ideas
  • not being polite on meeting only to disagree later
  • it’s about candor and honesty – learn from different point of view
  • not same as trust – psychological safety is an immediate experience, trust is an expectation about the future
  • not about lowering performance standards
  • Psychological safety does not imply excessive talking and over-processing. Psychologically safe meetings do not have to take longer.
  • “(…) the fearless organization is something to continually strive toward rather than to achieve once and for all. It’s a never-ending and dynamic journey.”
  • shared obligations and responsibility
    • workers are called upon to contribute their best to the company
    • the company is responsible for helping individuals develop and succeed
  • “uncouple[ing] fear and failure” – making possible for employees to fail and learn from their mistakes
  • creating an environment where psychological safety is high enough that a “making mistakes doesn’t strike terror into employees’ hearts.”
  • giving workers information to understand the whole context of the situation rather than giving top-down orders – good practice: using a white board


1. Apathy zone
  • Both psychological safety and performance standards are low
  • People show up at work, but their hearts and minds are elsewhere
  • They choose self-protection overexertion
2. Comfort zone
  • High psychological safety but low-performance standards
  • People generally enjoy working with one another
  • They don’t see a compelling reason to seek additional challenge
  • Not much much engagement or fulfilment
3. Anxiety zone
  • High-performance standards, low psychological safety
  • Employees are anxious about speaking up
  • Interpersonal anxiety – having a question or an idea but not feeling able to share it
  • Both work quality and workplace safety suffer
  • Confused setting high standards with good management
  • High standards with uncertainty
  • Recipe for disaster
4. Learning zone (high-performance zone)
  • High-performance standards with high psychological safety
  • People can collaborate, learn from each other
  • Ability to get complex, innovative work done
  • In the last century when people were treated as cogs in the machine motivating by fear worked pretty well. Repeated tasks were performed in a standardized manner, micro-management was quite an effective way to get things done and keep people motivated. HOWEVER, when 4 conditions are present in the work environment micro-management is the recipe for failure. In fact, these conditions can be found in almost every knowledge-work environment.
  • “In any company confronting conditions that might be characterized as volatility, uncertainty, complexity, and ambiguity (VUCA), psychological safety is directly tied to the bottom line.”
  • “psychological safety is mission critical when knowledge is a crucial source of value”
Further reading:
  • “Speaking up describes back-and-forth exchanges people have at work – from volunteering a concern in a meeting to giving feedback to a colleague.”
  • “It is clearly far better for people to ask questions or raise concerns and be wrong than it is for them to hold back”
  • Example: “raising a different point of view in a conference call, asking a colleague for feedback on a report, admitting that a project is over budget or behind schedule”
Implicit Theories of Voice – “the asymmetry of voice and silence”
  • “(…) a small set of common, largely taken-for-granted beliefs about speaking up at work (…) beliefs about when it is and isn’t appropriate to speak to higher ups in an organization”
Further reading:
  • 📄 Detert, J.R. & Edmondson, A.C. “Implicit Voice Theories: Taken-for-Granted Rules for Self-Censorship at Work.” The Academy of Management Journal 54.3 (2011): 461–88.
  • “Regret for the things we did can be tempered by time; it is regret for the things we did not do that is inconsolable.”
    —Sydney Harris
  • “Remaining silent due to fear of interpersonal risk can make the difference between life and death. Airplanes have crashed, financial institutions have fallen, and hospital patients have died unnecessarily because individuals were, for reasons having to do with the climate in which they worked, afraid to speak up.”
  • “The psychological experience of having something to say yet feeling literally unable to do so is painfully real for many employees and very common in organizational hierarchies (…).”
  • The conequences of not speaking up because of interpersonal fear are invisible. You can see just the spoken mistakes, you cannot see the consequences of missing a great innovation idea or being ignorant about an insight that affects your customers. Missed opportunities are invisible —> one cannot even estimate the real cost of interpersonal fear and a “silent” workplace.
  • “because not offering an idea is an invisible act, it’s hard to engage in real-time course correction”
  • Not speaking up should be considered as a system feature, not a character trait or individual act of courage. “Insisting on acts of courage puts the onus on individuals without creating the conditions where the expectation is likely to be met.”
  • “When people don’t speak up, the organization’s ability to innovate and grow is threatened.”
  • “Cheating and covering up are natural by-products of a top-down culture that does not accept “no” or “it can’t be done” for an answer. But combining this culture with a belief that a brilliant strategy formulated in the past will hold indefinitely into the future becomes a certain recipe for failure.”
  • “It is clearly far better for people to ask questions or raise concerns and be wrong than it is for them to hold back”
Quotes from psychologically  unsafe workplaces
  • “grow up in this culture and you’ll find that small mistakes are not tolerated” – Federal Reserve Bank of New York – regulatory team
  • “[you] don’t want to be too far outside where management is thinking” – Federal Reserve Bank of New York – regulatory team
  • “(…) a phenomenon identified by Anita Tucker in her remarkable ethnographic study of nurses in the early 2000s”
  • “shortcuts that people take at work when they confront a problem that disrupts their ability to carry out a required task”
  • “A workaround accomplishes the immediate goal, but does nothing to diagnose or solve the problem that triggered the workaround in the first place.”
  • “They seem to get the job done, but, in so doing, they create new, subtle, problems.”
  • Low psychological safety creates more on workarounds.
When does it occur?
  • “when workers do not feel safe enough to speak up and make suggestions to improve the system”
Further reading:
  • 📄 Tucker, A.L. & Edmondson, A.C. “Why hospitals don’t learn from failures: Organizational and psychological dynamics that inhibit system change.” California Management Review 45.2 (2003): 55–72.
How motivating by fear looks like?
  • “when workers do not feel safe enough to speak up and make suggestions to improve the system”
  • “What many people do not realize is that motivation by fear is indeed highly effective – effective at creating the illusion that goals are being achieved. It is not effective in ensuring that people bring the creativity, good process, and passion needed to accomplish challenging goals in knowledge-intensive workplaces.”
  • Motivating by fear only works in the case of a hierarchical structure and performing repetitive tasks. In the case of knowledge workers, it doesn’t work, when people are expected to do non-repetitive creative work.
    Motivating by fear only works in case of a hierarchical structure and performing repetitive tasks. In case of knowledge workers it doesn’t work, when people are expected to do a non-repetitive creative work.
  • “(…) jobs where learning or collaboration is required for success, fear is not an effective motivator.”
  • “Brain science has amply demonstrated that fear inhibits learning and cooperation.”  (Todes, D.P. Ivan Pavlov: A Russian Life in Science. Oxford University Press, 2014. Print.)
More on this topic:
    • Daniel Goleman explains the idea of emotional flooding in his book: Emotional Intelligence. When people are under the control of their emotions are not able to make rational decisions.
    • In his book, Talking to Strangers, Malcolm Gladwell tells a story about the struggles of the CIA to develop the “perfect” interrogation process, because of the same phenomenon.
  • “In psychologically safe environments, people believe that if they make a mistake or ask for help, others will not react badly.”
  1. Unreachable target goals. Not having regular employee conversationsm not knowing what is happening on the front line.
  2. A command-and-control hierarchy that motivates by fear. Management makes up hypothesizes, giving exact instructions for frontline workers.
  3. Putting pressure on people – not listening to objections. They are afraid of losing their jobs if they fail.
  4. Executing failure – If employees found speaking up impossible they execute the plan exactly how it has been said. The cost could be violating regulations, diying patients, accidents, airplance crushes, global financial crises.
  • “(…) no one wakes up in the morning excited to go to work and look ignorant, incompetent, or disruptive. These are called interpersonal risks, and they are what nearly everyone seeks to avoid (…)” “In fact, most of us want to look smart, capable, or helpful in the eyes of others (…)”
  • We reading social clues and dynamics all the time. When we have are in a group or having a conversation with someone we are managing not just the content of the message, but relationships as well. As we spend more time managing the status, deciding who is in charge and who is subordinate, we became less and less effective in working together on the actual job.
  • Looking smart and capable or helpful in the eyes of others
  • Roots in childhood: as children, we usually learn what matters to others to avoid rejection.
  • “Don’t want to look ignorant? Don’t ask questions. Don’t want to look incompetent? Don’t admit to mistakes or weaknesses. Don’t want to be called disruptive? Don’t make suggestions.”
Further reading:
  • high-volume repetitive work
  • occurs due to worker behavior, unsufficient skills, attention, deficiencies
  • the goal is the catch deviations from the norm and correct them
  • preventable failure: never good news
  • the most common form of doing work today (mostly services industries)
  • failue: still not good news
  • little is known about how to obtain a desired result
  • occurs due to uncertanty, experimentation and external risk factors and unforseen events
  • failure: not fun but must be considered because of the value they bring
  • The leader’s responsibility to reframe failure from a deadly sin to a learning opportunity.
  • Success occurs through course correction – not through magically getting it right the first time.
  • Pixar CEO: “uncouple fear and failure”, stunning success occurs only if you’re willing to confront the “bad” along the way to the “good.”
  • “What we’re trying to teach is that failure is not a bug of learning, it’s a feature,”


A Survey Measure of Psychological Safety
  • “Use a seven-point Likert scale (from strongly agree to strongly disagree) to obtain responses, but a five-point scale works as well.”
  • “Three of the seven items are expressed positively, such that agreement indicates greater psychological safety, and three are expressed negatively (represented in Figure 1.2 with an “R” for reverse), such that disagreement is consistent with higher psychological safety. In analyzing the data, therefore, it is important to “reverse score” data from the negatively worded items, where a 1 in the data set is converted to a 7, a 7 to a 1, a 2 to a 6, and so on.”
Further reading:
  • 📄 Edmondson, A.C. “Psychological Safety and Learning Behavior in Work Teams.” Administrative Science Quarterly 44.2 (1999): 350–83.
Tools of Extreme Candor
  • These ideas are originated by Ray Dalio, and are explained in his book: “Principles”
  • “create an environment in which…no one has the right to hold a critical opinion without speaking up about it.” – in other words: speaking up is neccessary
  • “if a person has a terminal illness, it’s better to know the truth, no matter how frightening, because only then can one figure out what to do”
  • framing silence as an unethical choice
  • you owe your colleagues the expression of your opinion or ideas; in a sense, those ideas belong to the collective enterprise, and you, therefore, don’t have the right to hoard them
  • “Every employee is required to keep an Issue Log, which records individual mistakes, strengths and weaknesses, and a “pain button,” which records the employee’s reaction to specific criticisms as well as their changes in behavior to remedy weaknesses, and whether those changes were effective.”
  • “prohibition on talking about people who are not present and thus cannot learn from what’s being said”
  • “ongoing assessment statistics for each employee are kept on “baseball cards,” publicly available to everyone in the firm, and used by managers for making decisions around compensation, incentives, promotions, and firing. No one at the firm, including Dalio, can hide behind opacity.”
  • “A “transparency library” containing videos of every executive meeting, is available for viewing in case employees want to see how policies or initiatives were discussed.”
  • “having task-based conversations about who will do what, as well as exchanging alternate points of view and overcoming differences or misunderstandings”
  • need for error and smart failures as a part of the learning process – “our society’s ‘mistakephobia’ is crippling”
  • to learn from mistakes as a pathway to innovative and independent thinking
  • “don’t try to ‘win’ the argument. Finding out that you are wrong is even more valuable than being right, because you are learning.”
  1. Debate – takes place between “approximate equals,”
  2. Discussion – an open exploration of ideas and possibilities and involves people with varying levels of experience and authority in the organization
  3. Debate – takes place between people with “different levels of understanding.”
Further material:
The Leader’s Tool Kit for Building Psychological Safety



Create a shared frame of understanding of everyday situations. You can shift the whole meaning of every situation by introducing new terminology which helps to interpret it differently.
  • Introduce new terminology – words to work by.
  • Help people think differently about the work.
  • “Frames consist of assumptions or beliefs that we layer onto reality.”
  • “Our prior experiences affect how we think and feel about what’s presently around us.” When we are under pressure or in any emergency situation we immediately shift back to our natural way of thinking and dealing with situations.
  • “We can shift our automatic frames and create a shared frame that more accurately represents reality.”
  • “We believe we’re seeing reality – seeing what is there.”
  1. Reframing failure from a deadly sin to a learning opportunity
  2. Framing the role of the boss
Further materials about framing:
  • Chapter 3 of Edmondson, A.C. Teaming: How Organizations Learn, Innovate, and Compete in the Knowledge Economy. San Francisco: Jossey-Bass, 2011. Print, pp. 83–113.
  • Malcolm Gladwell – Blink: The Power of Thinking Without Thinking
  • Daniel Coyle – The Culture Code: The Secrets of Highly Successful Groups
Every human being needs to feel a sense of purpose which gives life a meaning. If people have a shared purpose it is much easier to align their effort to accomplish a common goal.
  • “Leaders must take the time to emphasize the purpose the organization serves. This is because anyone can get tired, distracted, and frustrated and lose sight of the larger picture – of what’s at stake.”
  • “Helped people reconnect with the reasons they are here and the cause they are working on”
  • Find the common point, not the difference between people. They are all there to contribute to a common cause.
Further materials about framing:


  • “Realizing that self-protection is natural, the invitation to participate must be crystal clear if people are going to choose to engage rather than to play it safe.”
2 practice for inviting participation:
  • “Humility is the simple recognition that you don’t have all the answers, and you certainly don’t have a crystal ball.”
  • Practicing situational humility is the responsibility of the leader -> admitting that the leader is relying on workers as much as the workers relying on him or her.
  • “no one wants to take the interpersonal risk of imposing ideas when the boss appears to think he or she knows everything”
  • “A learning mindset, which blends humility and curiosity”
  • “(…) recognizes that there is always more to learn”
  • MIT Professor Ed Schein calls this “Here-and-Now Humility. (Humble Inquiry: the Gentle Art of Asking Instead of Telling)
  • Practice asking rather than telling.
  • “The greatest enemy of learning is knowing.” John Maxwell
  • Inquiry is purposeful probing to learn more about an issue, situation, or person.
  • Culture of telling: Naive Realism cognitive bias: gives us the experience of “knowing” what’s going on. We believe we are seeing “reality” – rather than a subjective view of reality. We fail to be curious.
  • Ross, L. & Ward, A. “Naive Realism: Implications for Social Conflict and Misunderstanding.” In Values & Knowledge. Ed. T. Brown, E.S. Reed, & E. Turiel. Lawrence Erlbaum Associates (1996): 103–35.
  • Asking good questions:
    • Generates curiosity in the listener
    • Stimulates reflective conversation
    • Is thought-provoking
    • Surfaces underlying assumptions
    • Invites creativity and new possibilities
    • Generates energy and forward movement
    • Channels attention and focuses inquiry
    • Stays with participants
    • Touches a deep meaning
    • Evokes more questions
  • implement structures designed to elicit employee input. Teams are the real competitive advantage. If every member of the team can contribute his or her best you can build much better product and can provide much greater services.
  1. Google
  • A good example: “g2g” (Googler-to-Googler) network, consisting of more than 6000 Google employees who volunteer time to helping their peers learn.
  • article 
  1. Groupe Danone
  • The global food company Groupe Danone created structured conference events called “knowledge marketplaces”


“To reinforce a climate of psychological safety, it’s imperative that leaders – at all levels – respond productively to the risks people take.”
Use the practice of three Cs:
  • Curiosity -> which leads us to ask questions. “When we ask genuine questions, people feel they matter (whether boss, peer, or subordinate), especially when we listen and respond thoughtfully to their answers.”
  • Compassion -> “the self-discipline to imagine and remember that everyone faces hurdles.” Understand and care about others. “People don’t care how much you know until they know how much you care.” John Maxwell
  • Commitment -> “matters because if you demonstrate your dedication to achieving the organization’s goals, it can be contagious.”
Further materials about framing:
  • 📖 Edgar Shine: Humble Inquiry: the Gentle Art of Asking Instead of Telling
  • 📖 Carol Dweck – Mindset: The New Psychology of Success
Use the practice of three Cs:
  • “Failure is a necessary part of uncertainty and innovation (…)”
  • “Leaders who respond to all failures in the same way will not create a healthy environment for learning. When a failure occurs because someone violated a rule or value that matters in the organization, this is very different than when a thoughtful hypothesis in the lab turns out to be wrong. Although obvious in concept, in practice people routinely get this wrong.”
  • studies show: when leaders don’t respond productively to failure “many failures go unreported and their lessons are lost”
  • to answer differently to different types of failures see the TYPOLOGY OF FAILURE explained above
  • “But won’t this kill the psychological safety? No. Most people are thoughtful enough to recognize (and appreciate) that when people violate rules or repeatedly take risky shortcuts, they are putting themselves, their colleagues, and their organization at risk.”


VW diesel emission scandal
Company goal in 2007
  • triple the company’s US sales within 10 years
The challenge
  • create clean diesel for the US market
  • VW manager-engineer Wolfgang Hatz admitted in 2007: “The CARB [California Air Resources Board] is not realistic. We can do quite a bit, and we will do quite a bit. But impossible we cannot do.”
The attitude
  • “a reign of terror and a culture where performance was driven by fear and intimidation.”
  • Ferdinand Piech, VW’s former chairman, CEO, and top shareholder (…) offered up an explanation that might serve as a textbook example of how to create a psychologically unsafe environment while seeking to motivate: I’ll give you the recipe. I called all the body engineers, stamping people, manufacturing, and executives into my conference room. And I said, “I am tired of all these lousy body fits. You have six weeks to achieve world-class body fits. I have all your names. If we do not have good body fits in six weeks, I will replace all of you. Thank you for your time today.”
The outcome
  • VW installed cheating devices into 11 million diesel vehicles worldwide. A software detected if a car was tested in the lab or used on the road. “On the road, the so-called clean diesel engines spewed into the atmosphere as much as 40 times the level of NOx permitted by regulations.”
Wells Fargo
  • Most valuable US bank, in 2015, with over 6000 local branches across the US.
Company goal
  • Implement a cross-selling growth strategy: selling existing customers additional products, increase the profit earned by customer.
  • “do whatever it takes” to sell
  • Metrics tracking was strict and unforgiving
  • At some branches, employees reportedly could not leave until they reached their daily sales goal.
  • Those who did not do well enough were publicly criticized or fired.
  • It was averaging 6.11 products per customer, compared to the industry average of 2.71. — Wells Fargo, 2015 annual report
  • By September 8, 2016, it was all over. The ticking time bomb had exploded from within.
  • The company fired over 5300 employees for ethics violations between 2011 and 2016.
Federal Reserve Bank of New York (FRBNY)
  • “Before and during the 2008–2009 global financial crisis: failure to effectively regulate the excessive financial risk-taking of several of the big US banks.”
  • “Real decision-making was stymied by groupthink or “striving for consensus”.
  • “Fear of speaking up as a frequent theme that characterized FRBNY meetings and employee experiences in all aspects of their job.”
  • “regulatory officers tasked with monitoring individual banks like Goldman Sachs felt: “intimidated and passive”
  • “the regulators “just followed orders.”
  • 2008-2009 global financial crisis
  • “In 1995 Toy Story, the first computer animated feature film released by a company named Pixar. That year, Toy Story would become the highest grossing film and Pixar the largest initial public offering.”
  • “Pixar co-founder Ed Catmull credits the studio’s success, in part, to candor. His definition of candor as forthrightness or frankness.”
  • “Leadership that creates the conditions where both creativity and criticism can flourish.”
  • Braintrust meetings:
    “(…) a group of directors and storytellers watches an early run of the movie together, eats lunch together, and then provides feedback to the director about what they think worked and what did not. But the recipe’s key ingredient is candor. And candor, though simple, is never easy.”
  • feedback must be constructive – and about the project, not the person
  • the filmmaker cannot be defensive or take criticism personally, must be ready to hear the truth
  • Second, the comments are suggestions, not prescriptions.
  • feedback must come from a place of empathy
  • making the final decision is always the filmmaker’s responsibility
Further reading
  • 📖 Amy Wallace and Edwin Catmull: Creativity, Inc.: Overcoming the Unseen Forces That Stand in the Way of True Inspiration
Company situation
  • Nokia had become, by the 1980s, a pioneering telecom company in the world
  • 1990s Nokia was the world’s leading mobile phone manufacturer, with a 23% market share — Nokia Corporation, 1998 annual report
The challenge
  • Answering to the growing market share of the iPhone Nokia wanted to do the impossible: deliver touch-phones quickly to compete with the iPhone.
The attitude
  • “grounded in a culture of temperamental leaders and frightened middle managers, scared of telling the truth.”
  • “handicapped by a culture of fear”
  • People who could not comply with top managers’ unreasonable requests were “labeled a loser”
  • “(Nokia’s R&D team) (…) They wanted to give them good news…not a reality check”
  • former chairman and CEO of Nokia, was described as: “shouting at people at the top of his lungs”
  • “it was very difficult to tell him things he didn’t want to hear.”
The outcome
  • Nokia became another casualty of avoidable failure
  • by 2012, its market value had dropped by over 75%
  • In September 2013 Nokia announced the sale of its Device and Services business to Microsoft.
NASA’s Space Shuttle Columbia crush
  • “Reporting on the investigation, ABC News anchor Charlie Gibson asked Rocha why he hadn’t spoken up in the meeting. The engineer replied, “I just couldn’t do it. I’m too low down [in the organization]…and she [meaning Mission Management Team Leader Linda Ham] is way up here,” gesturing with his hand held above his head.”
  • “February 1, 2003, NASA’s Space Shuttle Columbia experienced a catastrophic reentry into the Earth’s atmosphere. All seven astronauts perished.”

Source: Wikipedia

Further material
  • 📄Roberto, M.A, Edmondson, A.C., &. Bohmer, R.J., Columbia’s Final Mission. Case Study. HBS No. 304-090. Boston, MA: Harvard Business School Publishing, 2004.
  • 📄National Aeronautics and Space Administration. Columbia Accident Investigation Board: Report Volume 1. Washington, D.C.: U.S. Government Printing Office, 2003.
The Tenerife disaster
  • “collision of two Boeing 747 jets on an island runway in the Canary Islands in March 1977”
  • Captain of the flight: Jacob Veldhuyzen van Zanten, one of the company’s most senior pilots, chief flight trainer of most of the company’s 747 pilots, and head of flight safety for Royal Dutch Airlines
  • (…) Zanten interrupted with an imperative: “We’re going.” Given the captain’s authority, it was in this moment that Meurs apparently did not feel safe enough to speak up. Meurs, in that split second, did not open his mouth to say, “wait for clearance!”
  • Flight Engineer Schreuder expressed his concern that Pan Am was not clear of the runway (…). Van Zanten emphatically replied, “oh, yes,” and continued with the takeoff.
  • And in this moment Schreuder did not say a thing. Although he had correctly surmised that the Pan Am jet might be blocking their way.
  • The KLM Boeing was going too fast to stop when van Zanten, Meurs, and Schreuder finally could see the Pan Am jet blocking their way.
  • The crash ignited two jumbo jets into flames, and 583 people died.
  • The KLM’s left-side engines, lower fuselage, and main landing gear struck the upper right side of the Pan Am’s fuselage, ripping apart the center. The KLM plane remained briefly airborne before going into a stall, rolling sharply, hitting the ground, and igniting into a fireball.
  • considered the worst accident in the history of civil aviation
  • “After Tenerife, cockpit training was changed to place more emphasis on crew decision-making, encourage pilots to assert their opinion when they believed something was wrong, and help captains listen to concerns from co-pilots and crews.”
  • Speaking up must become a routine. It should be institutionalized and systematized.
Further material


Google: project Aristotle
  • article by Charles Duhigg in the New York Times Magazine in 2016
  • “even the extremely smart, high-powered employees at Google needed a psychologically safe work environment to contribute the talents they had to offer”
Findings: 5 contributing factors to team effectiveness
  • clear goals
  • dependable colleagues
  • personally meaningful work
  • a belief that the work has an impact
  • psychological safety
“psychological safety was by far the most important…it was the underpinning of the other four.” —Julia Rozovsky, “The five keys to a successful Google team.
  • Researchers Markus Baer and Michael Frese
  • 47 mid-size German firms in both industrial and services industries
  • psychological safety increased company performance
  • increased return on assets, executive ratings  of company goal achievement
Further material:
  • 📄 Baer, M. & Frese, M. (2003), op cit.
  • What is engagement? The employee is feeling passionate about doing the job and committed to the organization.
  • study in a Midwestern insurance company
  • “psychological safety predicted worker engagement”
  • “psychological safety was fostered by supportive relationships with coworkers”
Further material:
  • 📄 Baer, M. & Frese, M. (2003), op cit.
  • a study of Turkish immigrants employed in Germany
  • psychological safety was associated with
    • work engagement
    • mental health
    • turnover intentions
Further material:
  • 📄 Ulusoy, N., Mölders, C., Fischer, S., Bayur, H., Deveci, S., Demiral, Y., & Rössler, W. “A Matter of Psychological Safety: Commitment and Mental Health in Turkish Immigrant Employees in Germany.” Journal of Cross-Cultural Psychology 47.4 (2016): 626–645.
  • University of Western Australia Professor Cristina Gibson and Rutgers University Professor Jennifer Gibbs
  • study of 14 innovation teams with members dispersed across 18 nations
  • remote teams felt less anxious about what others might think of them
  • enabled better communication
Further material:
  • 📄 Gibson, C.B. & Gibbs, J.L. “Unpacking the Concept of Virtuality: The Effects of Geographic Dispersion, Electronic Dependence, Dynamic Structure, and National Diversity on Team Innovation.” Administrative Science Quarterly 51.3 (2006): 451–95.
  • Amy Edmondson and Diana Smith
  • study of top management teams
  • psychological safety can enable
    • a candid discussion of strategic disagreement can be created
    • productive decision-making
  • 195 teams in a French university
  • expertise-diverse teams performed well when psychological safety was high and badly otherwise
Further reading:
  • 📄 Martins, L.L., Schilpzand, M.C., Kirkman, B.L., Ivanaj, S., & Ivanaj, V. “A Contingency View of the Effects of Cognitive Diversity on Team Performance: The Moderating Roles of Team Psychological Safety and Relationship Conflict.” Small Group Research 44.2 (2013): 96–126.
CRM (Crew Resource Management) APPLIED TO HEALTHCARE
  • “The goal has been to increase patient safety by promoting better communication and teamwork.”
  • “(…) a CRM-like training in communication and teamwork was shown to produce better outcomes”
  • “The program also led to greater patient and staff satisfaction.”
Further reading:
  • 📄 Shea-Lewis, A. “Teamwork: crew resource management in a community hospital.” Journal of Healthcare Quality. 31.5 (2009): 14–18.
  • 📄 Oriol, M.D. “Crew resource management: applications in healthcare organizations.” Nursing Administration 36.9 (2006): 402–6; McConaughey E. “Crew resource management in healthcare: the evolution of teamwork training and MedTeams.” Journal of Perinatal Neonatal Nursing, 22.2 (2008): 96–104.
  • medication error studies in a hospital setting across multiple teams
  • “significant correlation between the independently collected error rates and the measures of team effectiveness”
  • psychological safety if a group phenomenon
  • better teams are making more mistakes, not fewer than less strong teams
  • ” teams had a climate of openness that made it easier to report and discuss error” —> “good teams (…) don’t make more mistakes; they report more”
  • psychological safety is one of the most important factors of open communication and developing trust
Further reading:
  • 📄 Edmondson, A.C. “Learning from Mistakes Is Easier Said Than Done: Group and Organizational Influences on the Detection and Correction of Human Error.” The Journal of Applied Behavioral Science 32.1 (1996): 5–28.
Study of Employee Silence
  • Investigating employee experiences with speaking up
  • “(…) 85% of respondents reported at least one occasion when they felt unable to raise a concern with their bosses, even though they believed the issue was important.”
Further reading:
  • 📰 HBR article
  • 📄 Milliken, F.J., Morrison, E.W., & Hewlin, P.F. “An Exploratory Study of Employee Silence: Issues that Employees Don’t Communicate Upward and Why.” Journal of Management Studies 40.6 (2003): 1453–1476.
  • Chi-Cheng Huang and Pin-Chen Jiang
  • 245 members of 60 Research and Development (R&D) teams – Taiwanese technology firms
  • “Without psychological safety (…) team members were unwilling to offer their ideas or knowledge because of the fear of being rejected or embarrassed.”
Further reading:
  • 📄 Huang, C., & Jiang, P. “Exploring the Psychological Safety of R&D Teams: An Empirical Analysis in Taiwan.” Journal of Management & Organization 18.2 (2012): 175–92.
  • investigating the relationship between employee trust in top management and employee engagement
  • 170 research scientists
  • “trust in top management led to psychological safety”
Further reading:
  • 📄 Chughtai, A. A. & Buckley, F. “Exploring the impact of trust on research scientists’ work engagement.” Personnel Review 42.4 (2013): 396–421.
  • survey of clinical staff at a large metropolitan hospital
  • psychological safety was related to
    • commitment to the organization, patient safety
    • a work environment in which workers felt safe to speak up is especially important in order to provide safe care to patients
Further reading:
  • 📄 Rathert, C., Ishqaidef, G., May, D.R. “Improving Work Environments in Health Care: Test of a Theoretical Framework.” Health Care Management Review 34.4 (2009): 334–343.
  • study of 117 student project teams
  • “conflict promotes better decision-making and fosters innovation because it ensures consideration of diverse views and perspectives” — Edmondson, A.C. & Smith, D.M. “Too Hot to Handle? How to Manage Relationship Conflict.” California Management Review 49.1 (2006): 6–31.
  • 2 kinds of conflicts
    1. conflict being put to good use
    2. conflict getting in the way of team performance
  • psychological safety moderated the relationship between conflict and performance
  • conflict led to good team performance when teams had high psychological safety and low performance otherwise
  • ability to express relevant ideas
  • critical discussions without embarrassment
Further reading:
  • 📄 Bradley, B.H., Postlethwaite, B.E., Hamdani, M.R., & Brown, K.G. “Reaping the Benefits of Task Conflict in Teams: The Critical Role of Team Psychological Safety Climate.” Journal of Applied Psychology 97.1 (2012): 151–58.
demographic diversity and team performance
  • study in a Midwestern mid-size manufacturing company
  • psychological safety could make or break a diverse team’s ability to put its different perspectives to good use
  • “psychological safety may be playing an especially crucial role for minorities in creating engagement and a feeling of being valued at work”
Further reading:
  • 📄 Singh, B., Winkel, D.E., & Selvarajan, T.T. “Managing Diversity at Work: Does Psychological Safety Hold the Key to Racial Differences in Employee Performance?” Journal of Occupational and Organizational Psychology 86.2 (2013): 242–63.



The end!