Perceptions of psychological safety in high-containment laboratories: Mixed method survey of community members and industry experts

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The interdependence between HROs and surrounding communities necessitates examining the perceptions of conditions for safe and transparent operation from both community residents and subject matter experts (SMEs). This study aims to understand community residents’ perceptions of psychological safety in the operation of A high-containment laboratory (HCL), how incident reporting reflects the psychological safety of a facility, and the alignment in community residents and SMEs’ assessments of psychological safety in these laboratories. Methods A mixed methods approach was used to collect data from community residents and a high containment laboratory SMEs. Community residents evaluated the potential impact of inadequate psychological safety on safe operations in high containment laboratories and two incident reporting formats for their association with PS. Both community residents and SMEs provided open-ended responses regarding the role of psychological safety in a high containment laboratory. Results Community members emphasized that psychological safety plays a key role for safe and reliable operations within High containment laboratories, and solution-oriented incident reports that focus on corrective actions appeared to indicate higher levels of psychological safety than problem-oriented reports focused on identifying the root cause of the incident. Thematic analysis showed overlap in key themes from community residents and SMEs, suggesting that psychological safety is important for safe operations, safety culture, and communication. Uniquely, SMEs offered more detailed insights into risk management, preparedness, and the impact on community and reputation. Conclusions Findings underscore the importance of psychological safety in promoting safety culture and effective communication within HROs, which is recognized by the surrounding community of residents. Transparent reporting with a focus on corrective action may be perceived as more indicative of psychological safety than reports centered on root cause analysis. Lastly, there is a shared understanding of the importance of psychological safety between community residents and SMEs, with SMEs providing a more nuanced perspective on improving psychological safety in HROs. Environmental health psychological safety biosafety level facilities high-reliability organizations community residents subject matter experts incident reporting Figures Figure 1 Background High-reliability organizations (HROs) are defined as organizations that operate in high-risk environments with low accident rates [ 1 – 2 ]. In these organizations, safety is paramount as critical incidents or failures can result in significant consequences, including severe occupational and environmental health impacts [ 3 – 4 ]. Notably, in high-containment laboratories, stringent safety protocols are imperative due to the potentially catastrophic consequences of safety lapses [ 5 ]. For example, an economic analysis of a food-and-mouth (FMD) outbreak, even with emergency protocols, estimates economic loss of $ 56 billion and even significant job losses [ 6 ]. Beyond endangering the health and safety of lab personnel, such lapses also pose significant risks to the surrounding community [ 7 – 8 ]. In this context, psychological safety is a critical factor for maintaining operational integrity and mitigating potential risks, especially where safety is a critical function [ 9 – 10 ]. Previous meta-analyses established significant links between psychological safety and key workplace factors, such as task performance, work engagement, and information/knowledge sharing [ 11 ]. Rooted in organizational and social psychology theories, psychological safety refers to the perception of an environment where individuals feel safe to express concerns, voice opinions, and take interpersonal risks without fear of reprisal or negative consequences [ 12 – 14 ]. This concept gained prominence through research conducted by Amy Edmondson, whose studies explored its effects on team performance and organizational learning [ 15 – 16 ]. Within high-containment laboratories, where personnel handle hazardous pathogens and adhere to complex protocols, the presence of psychological safety is paramount [ 1 , 12 , 17 – 18 ]. Workers must feel comfortable acknowledging errors, reporting incidents, and collaborating effectively to address safety concerns. Without psychological safety, there is a heightened risk of underreporting incidents, reluctance to disclose errors, and a breakdown in communication—all of which can compromise safety protocols and increase the likelihood of accidents [ 19 – 20 ]. For example, envision a scenario where a laboratory technician identifies a potential safety hazard but hesitates to report it due to concerns about negative repercussions from management. Without a culture of psychological safety, this technician may opt to remain silent, allowing the hazard to persist and potentially lead to a safety incident. Conversely, in an environment where psychological safety is fostered, the technician would feel empowered to voice concerns, enabling timely intervention and hazard mitigation. Theoretical Underpinning The synthesis of the Theory of Planned Behavior (TPB) [ 21 ] and Social Exchange Theory (SET) [ 22 ] offers a comprehensive framework for fostering psychological safety within high-containment laboratories, crucial for promoting trust, collaboration, and knowledge sharing among personnel. According to TPB, individual behavior within such environments is influenced by attitudes, subjective norms, and perceived behavioral control. Positive attitudes toward safety practices, coupled with a supportive organizational culture, are pivotal in cultivating psychological safety among lab personnel. Subjective norms, reflecting the perceived social pressure from peers and supervisors, shape employees' safety-related behaviors, emphasizing the importance of establishing norms that prioritize safety and encourage open communication. Perceived behavioral control, shaped by access to resources including supervision and training, directly impacts employees' sense of agency and control over their work environment, contributing significantly to psychological safety. Complementing TPB, SET underscores the importance of trust, collaboration, and knowledge sharing in fostering psychological safety within high-containment labs. Trust, as a cornerstone of social exchange, is cultivated through transparent communication, supportive leadership, and shared values, enabling employees to feel secure in expressing concerns and ideas [ 23 ]. Collaboration emerges as a natural outcome of trust, as individuals engage in cooperative behaviors when they perceive mutual benefit. Encouraging collaboration among lab personnel fosters a culture of reciprocity and mutual support, further enhancing psychological safety. Additionally, knowledge sharing, driven by the principles of social exchange, promotes organizational resilience by facilitating the dissemination of best practices and innovative solutions to safety challenges. This collective intelligence empowers the organization to adapt and respond effectively to safety threats, ultimately bolstering its resilience and safety response capabilities. By integrating TPB and SET principles, high-containment labs can establish a robust framework for fostering psychological safety, underpinning a culture of trust, collaboration, and knowledge sharing essential for organizational resilience and safety excellence. According to the organizational learning theory [ 24 ], psychological safety can advance the process of workplace safety management by efficiently identifying related problems and encouraging team-based learning that help members obtain knowledge, skills, and abilities to solve the identified problems [ 25 ]. These theories underscore psychological safety’s pivotal role in promoting safety, communication, and organizational learning within high-risk environments like high-containment laboratories. By cultivating an environment where individuals feel psychologically safe to voice concerns and contribute to safety improvement efforts, organizations can enhance their ability to operate safely. This helps mitigate the potential risks associated with handling hazardous materials and pathogens, thereby protecting human and animal health, and the surrounding environment. Diverse Voices, Unified Safety Standards Examining the perceptions of both community residents [ 7 , 26 ] and subject matter experts (SMEs) [ 27 – 28 ] regarding psychological safety within high-containment laboratories is paramount from a community psychology perspective due to the inherent interdependence between these facilities and the communities in which they operate. Transparency is a fundamental principle in fostering trust and collaboration between high-containment labs and their surrounding communities [ 7 , 26 ]. Community members' perceptions of psychological safety not only reflect their sense of trust in the safety measures employed by these facilities but also influence their level of engagement and cooperation [ 29 ]. Involving these residents in the assessment of psychological safety ensures that their voices are heard, and their concerns are addressed, promoting a sense of ownership and accountability for safety outcomes [ 30 ]. Additionally, by incorporating community perspectives, high-containment laboratories can better align their safety protocols with community values and priorities, enhancing overall community resilience and well-being. Furthermore, the safe operation of high-containment laboratories has significant public and animal health implications that extend beyond the laboratory walls. Community psychology emphasizes the importance of understanding the broader social, economic, and environmental factors that shape health outcomes within communities [ 29 – 31 ]. In the context of high containment laboratories, maintaining psychological safety is critical for the safety of laboratory personnel and for preventing potential public and animal health crises. Community members' perceptions of psychological safety can provide valuable insights into how safety lapses within these facilities may impact public health outcomes, such as the spread of infectious diseases or environmental contamination. By engaging with community residents, high-containment laboratories can enhance their responsiveness to community needs and concerns, strengthening the overall public and animal health infrastructure and promoting collaboration between stakeholders. Involving SMEs in the assessment of psychological safety within high-containment laboratories is equally crucial. SMEs bring a wealth of technical knowledge and practical experience that can identify potential risks and effective mitigation strategies that may not be apparent to community residents. Their insights can enhance the development and implementation of robust safety protocols, including risk assessments [ 32 – 33 ], ensuring that these facilities not only comply with regulatory standards but also exceed them. By integrating the expertise of SMEs with the perspectives of community residents, high-containment laboratories can foster a more comprehensive approach to safety that addresses both technical and community-based concerns, ultimately contributing to greater trust, transparency, and collaboration. Therefore, examining the perceptions of both community residents and SMEs regarding Psychological safety within high-containment laboratories is essential for promoting transparency, trust, and collaboration between these facilities and their surrounding communities. By incorporating community perspectives, high-containment laboratories can enhance their safety protocols, aligning them with community values and priorities to better protect public health and ensure the safe operation of these facilities. Methods Study Aims The current study aims to address three primary questions to enhance our understanding of the role of psychological safety in high-containment lab safety: RQ1. Do community members perceive psychological safety as essential for the safe operation of high containment laboratories? Understanding the perceptions of community members, who may be directly impacted by safety incidents originating from high containment laboratories, is crucial. Their perspectives can shed light on the broader societal implications of psychological safety within these environments and inform community engagement strategies aimed at promoting safety and transparency, which may help to increase community trust in the facility. RQ2. Which incident reporting approach better reflects psychological safety: solution-oriented approach focusing on corrective actions or problem-oriented approach focusing on risk and root cause identification? Incident reporting serves as a critical communication tool for informing community members about biotechnical hazards and risks within high containment laboratories [ 34 ]. Different incident reporting methodologies may prioritize different aspects of safety culture, which can, in turn, influence perceptions of psychological safety. By comparing approaches focused on corrective actions versus those emphasizing risk and root cause identification, this study seeks to elucidate how these methodologies align with the promotion of psychological safety within high-containment laboratories contexts. RQ3. Is there a discrepancy in the assessment of psychological safety between community members and SMEs in high containment laboratories? Examining potential discrepancies in the assessment of psychological safety between community members and SMEs provides insights into the alignment of perceptions and priorities regarding safety. Identifying any disparities can inform targeted interventions aimed at bridging gaps in understanding and fostering a shared commitment to promoting psychological safety and enhancing safety within high containment laboratories. This study addresses a significant gap in the literature by investigating the role of psychological safety in high-containment laboratories safety from multiple perspectives, including those of community members and industry experts. The findings have the potential to inform policies, procedures, and training initiatives aimed at cultivating a culture of safety and resilience within high-risk environments. Participants The study engaged two distinct groups: residents of a community adjacent to a high containment laboratory ( n = 147) and SMEs currently working in high containment laboratories ( n = 20). In justification of the sample size of high containment laboratory SMEs, for thematic analysis previous research has suggested 12 interviews adequately achieve data saturation [ 35 ]. Community residents were recruited from a midwestern public university located directly next to a high-containment lab facility. Their average age was 19.51 ( SD = 2.30) and the majority were female (62.6%). The average familiarity with high containment laboratories was low ( M = 1.30 out of 5, SD = .67) and they had modest familiarity with the concept of psychological safety ( M = 2.13 out of 5, SD = .87). SMEs were recruited from two different high containment laboratories, with sixteen SMEs from one high containment laboratory and four from the other. Specific demographic information was only collected from the four SMEs at one facility, while demographic data from the sixteen SMEs was not collected to maintain confidentiality in reporting qualitative results to upper management. The average tenure in the facility for these SMEs was 2.73 years ( SD = 1.49). They ranged in General Schedule levels from 7 to 14 and represented various facility units. The four SMEs (50% male, 50% female) had an average age of 44.75 years ( SD = 25.94). Their education levels ranged from some college to Doctorate or professional degree, and they were all familiar with both high containment laboratories ( M = 3.75, SD = 1.5) and psychological safety ( M = 3.75, SD = 1.5). Procedures A mixed methods approach was adopted to gain a richer understanding of community members and SMEs’ perceptions of psychological safety in a high containment laboratory. Questionnaires and qualitative interview questions varied between community members and SMEs since workers in high containment laboratories receive extensive training on safety protocols and psychological safety. To ensure consistent understanding of psychological safety, both community members and SMEs were provided with an operational definition of psychological safety. Community members were also provided with an example of high containment laboratories to inform their answers, in case they were unfamiliar with them. Community residents evaluated the potential impact of inadequate psychological safety on safe operations in high containment laboratories and two incident reporting formats for their association with psychological safety. The examples of incident reporting were obtained from the potential exposure incident quarterly reports ( https://www.bu.edu/neidl/safety-security/neidl-quarterly-incident-reports/ ) by the National Emerging Infectious Diseases Laboratories at Boston University. See Appendix A for survey materials and survey items. A paired t -test was conducted to compare within-subject ratings of incident reports. Finally, both groups of participants, community residents and SMEs, were asked to provide open-ended responses to the question “Do you think a high containment laboratory with low psychological safety can operate safely? Why?” Community residents were asked via an online survey, and SMEs were asked via an in-person interview. SME responses were transcribed, and all the qualitative responses were analyzed via semantic analysis to identify common keywords, phrases, and their relationships regarding psychological safety in participant responses. Key themes were derived from them using the thematic analysis framework. Individual differences (i.e., age, gender, education, HCL familiarity, and psychological safety familiarity) were assessed as control variables. Descriptive statistics and regression analysis (i.e., psychological safety implication = Age + Gender + Education + HCL familiarity + Psychological safety familiarity) were examined to ensure that psychological safety implication perceptions do not systematically differ across demographic factors and individual differences. See Table 1 . Table 1 Regression Results of Psychological Safety Implications Across Individual Differences Estimate SE t p (Intercept) 1.29 .75 1.72 .09 Age .03 .04 .75 .45 Female (vs. Male) − .18 .17 -1.02 .31 Education .01 .17 .04 .97 HCL familiarity .09 .12 .69 .49 PS familiarity − .05 .09 − .49 .63 Note. HCL = High-containment laboratory; PS = Psychological safety; SE = Standard error. Thematic Analysis Initially, the semantic analysis conducted using Python with the Natural Language Toolkit (NLTK) [ 36 – 37 ] library followed a systematic approach outlined in several key steps. First, text preprocessing was performed to prepare the data for analysis. This involved gathering relevant text data, such as interview transcripts or survey responses, and then cleaning the text by removing irrelevant information such as headers, footers, and punctuation. The text was then tokenized to break it down into individual words or meaningful units, followed by the removal of stopwords—common words that do not carry much meaning on their own (e.g., “ the ”, “ and ”, “ so ”. The next step in the process was Word Sense Disambiguation (WSD), which is essential for accurately understanding words with multiple meanings (polysemy). Techniques such as NLTK's WordNet and SpaCy were employed to identify the most likely meaning of ambiguous words based on context [ 38 ]. Following WSD, the analysis focused on identifying themes within the text. Named Entity Recognition (NER) tools provided by NLTK [ 39 ] were utilized to identify key entities such as high containment laboratories or researchers, aiding in pinpointing relevant actors and locations. OpenAI’s ChatGPT 3.5 [ 40 ] was leveraged to enhance the interpretation and develop custom algorithms to identify recurring themes based on keywords or phrases related to "psychological safety”, "operational safety”, "communication", etc. The accuracy of the identified themes was reviewed through an iterative process, with adjustments made based on initial findings to refine steps like WSD or theme identification algorithms for improved accuracy. Overall, this systematic approach allowed for a comprehensive analysis of the text data, providing valuable insights into the topics under investigation. In justifying the sample size, the analysis utilized a thematic framework to identify key themes and patterns indicative of data saturation. The consistency across responses in emphasizing the critical role of psychological safety in a high containment laboratory operation was notable. Participants recurrently emphasized themes such as communication, trust, and mistake reporting, indicating a shared understanding. Despite diverse perspectives, underlying themes remained consistent, reinforcing the significance of psychological safety. Moreover, the depth of insights provided by participants, coupled with the absence of novel insights after analyzing numerous responses, further affirmed data saturation. This comprehensive analysis suggests the sample size was adequate in capturing the breadth and depth of participant perspectives on psychological safety in the context of high containment laboratories. Results Community members emphasized the critical role of psychological safety in high-containment lab safety ( M = 1.67 out of 5, SD = 0.60). Despite demographic variations in terms of age, sex, education, familiarity with the HCL environment, and the concept of psychological safety, community members consistently recognized the link between inadequate psychological safety and unsafe operations within high containment laboratories ( F (6, 121) = 1.638, p = 0.14). In the context of a high containment laboratory, solution-oriented incident reporting focused on corrective actions appeared to indicate higher levels of psychological safety ( M = 3.34, SD = 1.18) compared to problem-oriented incident reporting centered on risk and root cause identification ( M = 3.09, SD = 1.09; t [128] = 2.27, p = 0.03), with a mean difference of 0.25 and a 95% confidence interval of 0.03–0.46 (see Fig. 1 ). Results from the sematic analyses identified the following key themes from the community residents and high containment laboratories SMEs (see Table 2 ). Table 2 Summary of Key Themes from Thematic Analysis by Group Theme and Definition Community Residents High Containment Laboratory Facility Subject Matter Experts Communication • Open & honest communication • Effective internal & external communication & transparency Trust • Positive team dynamics & collaboration • Trust and confidence •Loss of trust due to lack of communication Incident Handling • Enhancing learning from mistakes and feedback • Effective handling of incidents Risk Management • Mitigating risk of mistakes • Preparedness through drills, procedures, and continuous improvement Culture of Safety • Positive organizational culture • Positive safety culture Employee Well-Being • Mitigating stress and anxiety • Poor well-being from stress and frustration with working conditions Community Trust NA • Positive relationship with community & reputation Employee Turnover NA • Preventing high turnover & hiring challenges For community residents, several respondents emphasized the importance of open and honest communication for identifying and addressing safety concerns. They also indicated that psychological safety fosters trust and confidence among team members, which is essential for effective incident handling the high-risk environment of a high containment laboratory and allows for learning from mistakes and feedback and continuous improvement. Whereas fear of repercussions may discourage reporting errors, which could compromise safety and increases the likelihood of mistakes , which can be dangerous in a high-risk environment like a high containment laboratory. When psychological safety perceptions are low, this can lead to increased stress and anxiety, negatively impacting employees' well-being ability to perform their tasks efficiently and safely. Psychological safety also influences team dynamics and collaboration by fostering mutual support from team members, which is vital for maintaining a safe and effective working environment. At a higher level, a positive organizational culture (i.e., culture of safety ) that promotes psychological safety is seen as crucial for the well-being and performance of employees, especially in high-risk facilities. Overall, the responses suggest a consensus that psychological safety is important for operating a high containment laboratory safely, as it contributes to better communication, trust, and error handling. SMEs emphasized the importance of a workplace environment where employees feel comfortable speaking up about safety concerns. This is linked to physical safety, as an environment where employees fear speaking up can lead to dangerous situations or failures to follow procedures. Communication and transparency are vital for psychological safety, both internally (between employees and management) and externally (with the community). A lack of proper communication can lead to misunderstandings, fear, and loss of trust . They also emphasized the need for a strong culture of safety that prioritizes the safety of employees and the community. The absence of such a culture can lead to accidents, loss of trust, and even life-threatening situations. High employee turnover and hiring challenges are seen as a risk for safety and efficiency. Difficulties in finding and retaining qualified staff, as well as hiring constraints (e.g., regulatory-established hiring preferences) can impact the quality of the workforce. Effectively handling incidents , including quick and clear communication and involving all necessary parties, is important for maintaining trust and safety. The need for ongoing risk management and preparedness through drills, procedures, and continuous improvement in safety practices. Safety issues can have a significant impact on the community's trust and reputation in the facility and its operations. Negative events can harm the facility's reputation and potentially the wider agricultural industry. Poor employee well-being , including increased levels of stress and frustration among employees due to lack of communication, safety concerns, or work culture can lead to disengagement and mistakes. These themes are interconnected, with psychological safety underpinning the overall safety culture and affecting communication, employee well-being, and the handling of incidents. A lack of any of these components can lead to a breakdown in safety and trust both internally and with the community. The results presented focus on key themes related to the importance of psychological safety, communication, and organizational culture within a high-risk environment such as a high containment laboratory. There are some notable similarities between key themes derived from community residents and SMEs. Results from both groups highlight the importance of psychological safety in the workplace, where employees can speak up about safety concerns without fear of repercussions. This is crucial in a high-risk environment like a high containment laboratory. Open and honest communication was emphasized by both groups as essential for identifying and addressing safety concerns. Effective communication between employees and management, and with the community, helps build trust and transparency. Both groups stressed the need for a strong safety culture that prioritizes the well-being and safety of employees and the community. A positive safety culture is linked to effective handling of risks and incidents. Both results acknowledge low psychological safety can lead to increased stress and anxiety among employees, impacting their ability to perform tasks efficiently and safely. The importance of team dynamics, collaboration, and mutual support is acknowledged by both groups as vital for maintaining a safe and effective working environment. In addition to overlap in key themes, there were some notable differences between community residents and SMEs. Community members emphasize the role of organizational culture in promoting psychological safety, which contributes to better communication, trust, and error handling. SME results focus more on the impact of organizational culture on employee well-being and the handling of incidents. SMEs discuss the importance of properly managing incidents, including clear communication and involving all necessary parties. This aspect is less prominent among community members. SMEs emphasize ongoing risk management and preparedness through drills, procedures, and continuous improvement in safety practices, whereas community member results do not explicitly mention this aspect. The SMEs discuss the potential impact of safety issues on the community's trust in the facility and its operations, as well as the facility's reputation and the wider agricultural industry. This aspect is less prominent in community members’ results. SMEs mention high employee turnover and hiring challenges as risks to safety and efficiency, a theme not covered by community residents. In summary, while both results share common themes related to psychological safety, communication, and safety culture, the SMEs provided more specific insights into risk management, preparedness, and the impact on community and reputation. Discussion This study investigates psychological safety in high containment laboratories, which is crucial for maintaining safety standards in high-risk environments. By integrating the TPB [ 21 ] and SET [ 22 ] frameworks, it explores how psychological safety fosters trust and collaboration among personnel. Additionally, the study examines community and expert perceptions to inform safety protocols and community engagement strategies, aiming to enhance organizational resilience and public health outcomes. The findings presented in the results emphasize the critical role of psychological safety in the context of laboratory safety, particularly within high containment laboratories. The data suggests that community members (BSL novices) recognize the link between inadequate psychological safety and unsafe operations, highlighting its significance in fostering a safe working environment. Findings also suggest that incident analyses rooted in corrective action, rather than root cause identification may increase perceptions of psychological safety. Determining the root cause of an incident can be useful for mitigating future accidents and similar incidents [ 41 ], while corrective action provides insight into how follow-up with personnel was handled. These results are aligned with the tenets of the TPB [ 21 ], which posits that individuals' behavioral intentions are influenced by their attitudes, subjective norms, and perceived behavioral control. In this context, psychological safety influences employees' attitudes toward safety practices, norms regarding reporting safety concerns, and their perceived control over safety-related actions. Additionally, how incidents are reported may be important for community perceptions of safety and transparency [ 29 ]. Moreover, the emphasis on open communication, trust, and error handling underscores the importance of SET. According to this theory, individuals engage in relationships where they perceive benefits outweighing costs. In the workplace, employees are more likely to engage in safety behaviors when they perceive support from their organization (in the form of psychological safety) and anticipate positive outcomes such as trust and error learning. This aligns with the findings that psychological safety fosters trust and confidence among team members, encourages reporting of errors, and contributes to a supportive organizational culture [ 11 , 15 , 20 ]. Considering both community and experts' input on the importance of psychological safety in high containment laboratories offer invaluable insights from managerial and community health perspectives. From a managerial standpoint, integrating community feedback enhances transparency and fosters trust, vital for maintaining public support and cooperation [ 26 ]. Expert input ensures alignment with industry standards and best practices, optimizing safety protocols and operational efficiency [ 27 – 28 ]. From a community health perspective, understanding community perceptions informs tailored engagement strategies, promoting mutual understanding and collaboration between facilities and surrounding communities [ 7 , 31 ]. By incorporating diverse perspectives, organizations can enhance safety culture, mitigate risks, and safeguard both employee well-being and community health. Practical Implications Practical takeaways from the study's findings include the importance of promoting psychological safety through transparent communication, building a strong safety culture, and addressing stress and anxiety among employees. Organizations can implement strategies such as fostering open dialogue, providing training on error management, and creating support systems to enhance psychological safety. Additionally, the emphasis on risk management, incident handling, and community impact highlights the need for comprehensive safety protocols and preparedness measures within high containment laboratories. One of our key findings suggests that when communicating any incidents, providing examples of actions to mitigate or prevent incidents might contribute to the organizational context of open, transparent, and constructive sharing of ideas above and beyond the approach of analyzing and pinpointing reasons for the incidents. This strategic communication should avoid individual blame, instead emphasizing corrective action and fostering continuous feedback for organizational members [ 42 ]. In addition, results highlight that community members have a general awareness of the importance of psychological safety and the implications of low psychological safety in high containment laboratories. Practically, this highlights an area that may benefit from enhanced communication. Facilities that operate under high-risk have the unique opportunity to inform their surrounding communities about safety status, protocols in place for protecting the community, and the importance of maintaining safety in their organizations. A recent study on a relatively new high containment laboratory [ 6 ] found that transparency was positively associated with social support and approval from the community, which in turn was associated with positive public perceptions regarding trust, perceived benefits, and lower risk perceptions. Thus, engaging with the surrounding community can help build trust in high containment laboratory operations, increase transparency, and promote collaboration with the public, which would help address any perceived and actual health disparities in the community. This transparent communication may enhance the relationship between surrounding communities and high containment laboratories and ensure that health disparities are minimized for the surrounding area. Limitations The study has limitations which warrant consideration. First, the data are based on self-report measures, which may be subject to social desirability bias. Future studies could utilize objective measures or observational methods to corroborate findings. Second, the study primarily focuses on perceptions within a specific context (high containment laboratories), limiting generalizability to other settings. Future research could explore the applicability of these findings across different industries and organizational contexts. Moreover, longitudinal studies could assess the long-term effects of psychological safety interventions on safety outcomes and organizational performance, as well as community perceptions. Third, the sample size for SMEs was small, limiting the ability to conduct more advanced sematic analyses. Future studies are encouraged to recruit a larger sample with the goal of uncovering additional themes. Conclusion Findings of our study underscore the importance of psychological safety in promoting safety culture and effective communication within high-risk environments such as high containment laboratories. Theoretical implications for TPB and SET highlight the role of attitudes, norms, and perceived benefits in shaping safety behaviors. Practical implications suggest strategies for enhancing psychological safety and improving safety outcomes. Abbreviations HRO – High-reliability organization HCL – High-containment laboratory TBP – Theory of planned behavior SET – Social exchange theory SME – Subject matter expert Declarations Ethics approval and consent to participate: This research was approved by the Kansas State University Institutional Review Board (IRB-11728). Consent for publication: Not applicable. Availability of data and materials: De-identified data from community members are available from the corresponding author upon reasonable request. Competing interests: The authors declare that they have no competing interests. Funding: This study was sponsored by the United States Department of Agriculture (USDA), Grant Agreement Number: 58-3022-3-011. Authors' contributions: Moana Sargent: Writing – review & editing, Methodology, Investigation. Ashley Sylvara: Writing – review & editing, Methodology, Investigation. Leah Klos: Writing – review & editing, Methodology, Investigation. Jacob Gallagher: Writing – review & editing. Kutina Cabrera: Investigation. Molly Goff: Investigation. Jesica Luna: Investigation. Alfonso Clavijo: Writing - review & editing, Co-PI. Jin Lee: Writing – original draft, Methodology, Formal Analysis, Conceptualization, Supervision, Project administration, Funding acquisition. Acknowledgements: Not applicable. 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Annual Review of Organizational Psychology Organizational Behavior. 2014;1(1): 23-43. Mareedu-Boada S, Hopp TA, Mitra R. Development and validation of biosafety climate scale for biological and biomedical science laboratories in the United States. Applied Biosafety. 2021 Dec 1;26(4):221-31. Peters A. The global proliferation of high-containment biological laboratories: understanding the phenomenon and its implications. Rev Sci Tech. 2018 Dec 1;37(3):857-83. Edmondson AC, Bransby DP. Psychological safety comes of age: Observed themes in an established literature. Annual Review of Organizational Psychology and Organizational Behavior. 2023 Jan 23;10(1):55-78. Edmondson AC. The fearless organization: Creating psychological safety in the workplace for learning, innovation, and growth. John Wiley & Sons; 2018 Nov 20. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179-211. doi: 10.1016/0749-5978(91)90020-T. Cropanzano R, Mitchell MS. Social exchange theory: An interdisciplinary review. Journal of management. 2005 Dec;31(6):874-900. Podsakoff PM, MacKenzie SB, Bommer WH. Transformational leader behaviors and substitutes for leadership as determinants of employee satisfaction, commitment, trust, and organizational citizenship. Journal of Management. 1996;22(2): 259-298. Weick KE, Westley F. Organizational learning: Affirming an oxymoron. Ortega, Van den Bossche P, Sánchez-Manzanares M, Rico R, Gil F. The influence of change-oriented leadership and psychological safety on team learning in healthcare teams. Journal of Business and Psychology. 2014;29: 311-321. Zhang XA, Muturi N. Organizational legitimacy for high-risk facilities: Examining the case of NBAF. Public Relations Review. 2021 Nov 1;47(4):102087. Proctor RW, Vu KP. How psychologists help solve real-world problems in multidisciplinary research teams: Introduction to the special issue. American Psychologist. 2019 Apr;74(3):271. Lianov LS, Barron GC, Fredrickson BL, Hashmi S, Klemes A, Krishnaswami J, Lee J, Le Pertel N, Matthews JA, Millstein RA, Phillips EM. Positive psychology in health care: defining key stakeholders and their roles. Translational Behavioral Medicine. 2020 Jun;10(3):637-47. Frewer LJ. Trust, transparency, and social context: Implications for social amplification of risk. The social amplification of risk. 2003 Jul 10;123:131-7. Lundgren RE, McMakin AH. Risk communication: A handbook for communicating environmental, safety, and health risks. John Wiley & Sons; 2018 Jul 10. Campbell C, Murray M. Community health psychology: Promoting analysis and action for social change. Journal of health psychology. 2004 Mar;9(2):187-95. Chung CL, Bellis KS, Pullman A, O'Connor A, Shultz A. building biosafety capacity in our nation's laboratories. Health security. 2019 Oct 1;17(5):353-63. Velasco JM. Principles of Biosafety in Resource Limited Settings. In Biosafety and Biosecurity (pp. 49-64). CRC Press. Cornish NE, Anderson NL, Arambula DG, Arduino MJ, Bryan A, Burton NC, Chen B, Dickson BA, Giri JG, Griffith NK, Pentella MA. Clinical laboratory biosafety gaps: lessons learned from past outbreaks reveal a path to a safer future. Clinical microbiology reviews. 2021 Jun 16;34(3):10-128. Ando H, Cousins R, Young C. Achieving saturation in thematic analysis: Development and refinement of a codebook. Comprehensive Psychology. 2014 Jan 1;3:03-CP. Bird S, Klein E, Loper E. Natural language processing with Python: analyzing text with the natural language toolkit. " O'Reilly Media, Inc."; 2009 Jun 12. Wang M, Hu F. The application of nltk library for python natural language processing in corpus research. Theory and Practice in Language Studies. 2021 Sep 1;11(9):1041-9. Basha SM, Fathima AS. Natural Language Processing: Practical Approach. MileStone Research Publications; 2023 Feb 26. Schmitt X, Kubler S, Robert J, Papadakis M, LeTraon Y. A replicable comparison study of NER software: StanfordNLP, NLTK, OpenNLP, SpaCy, Gate. In 2019 sixth international conference on social networks analysis, management and security (SNAMS) 2019 Oct 22 (pp. 338-343). IEEE. OpenAI. ChatGPT3.5 (September 2023 version) [Large language model]. 2023. Available from: https://chat.openai.com/chat Vogler AJ, Jones S, Keim P. Incident reporting and biosafety training in a BSL-3 select agent facility. Applied Biosafety. 2014 Dec 1;19(4):192-200. Mahajan RP. Critical incident reporting and learning. British journal of anaesthesia. 2010 Jul 1;105(1):69-75. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4969510","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":345511672,"identity":"7c24ecba-26fe-4d42-937d-c16ccf50f5e3","order_by":0,"name":"Moana Sargent","email":"","orcid":"","institution":"Kansas State University","correspondingAuthor":false,"prefix":"","firstName":"Moana","middleName":"","lastName":"Sargent","suffix":""},{"id":345511673,"identity":"c100284b-40ea-47ba-a2e7-bdc37d17ea5c","order_by":1,"name":"Ashley Sylvara","email":"","orcid":"","institution":"Kansas State University","correspondingAuthor":false,"prefix":"","firstName":"Ashley","middleName":"","lastName":"Sylvara","suffix":""},{"id":345511674,"identity":"f37947ea-ff52-40b1-b728-dbdf2792beba","order_by":2,"name":"Leah Klos","email":"","orcid":"","institution":"Kansas State University","correspondingAuthor":false,"prefix":"","firstName":"Leah","middleName":"","lastName":"Klos","suffix":""},{"id":345511675,"identity":"9e7dfcf2-2e40-4b2d-b817-3b112afc3530","order_by":3,"name":"Jacob Gallagher","email":"","orcid":"","institution":"Kansas State University","correspondingAuthor":false,"prefix":"","firstName":"Jacob","middleName":"","lastName":"Gallagher","suffix":""},{"id":345511676,"identity":"50261ce3-eacd-44e9-817d-8a357c5bdaad","order_by":4,"name":"Kutina Cabrera","email":"","orcid":"","institution":"Kansas State 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Facility","correspondingAuthor":false,"prefix":"","firstName":"Alfonso","middleName":"","lastName":"Clavijo","suffix":""},{"id":345511680,"identity":"56dc9381-808d-44f8-a866-81e8127750b3","order_by":8,"name":"Jin Lee","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAq0lEQVRIiWNgGAWjYBACxmYGxgMMDDYGYB4PkVoYgFrSSNACAkAth0nQwtzOe+DAh4rzxvIzEhgfvG0jymF8CQdnnLltZnAjgdlwLnFaeAwO87bdtjGQSGCT5iVay99/52yADmP/TbwWxoYDZgw3EtiYidZysOdYsrHBmYfNknPOEaHFsP+M4YMfNXaG89uTD354U0aMlgaEhQ04VaEAeeKUjYJRMApGwYgGAN1gNnqlyClCAAAAAElFTkSuQmCC","orcid":"","institution":"Kansas State University","correspondingAuthor":true,"prefix":"","firstName":"Jin","middleName":"","lastName":"Lee","suffix":""}],"badges":[],"createdAt":"2024-08-24 14:06:04","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4969510/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4969510/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s40359-025-02763-4","type":"published","date":"2025-05-22T15:57:01+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":65170537,"identity":"1752b6bb-bbd5-4c86-8ec5-9a3bacaa930f","added_by":"auto","created_at":"2024-09-24 10:55:31","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":111567,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCommunity Evaluation of Incident Reporting Format’s Association with Psychological Safety\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-4969510/v1/4ceeb163e07fdeb86132e7b6.png"},{"id":83459960,"identity":"2a4f09cf-8e6c-4273-8ce2-cc843532c70c","added_by":"auto","created_at":"2025-05-26 16:06:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":839934,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4969510/v1/a05c5f2d-b74b-431a-b71d-b5284c0787d4.pdf"},{"id":65170538,"identity":"b3374b54-d16c-4e78-8edd-eea2630018b7","added_by":"auto","created_at":"2024-09-24 10:55:32","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":1506946,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix.docx","url":"https://assets-eu.researchsquare.com/files/rs-4969510/v1/f61c9bac6f227c5fc156fba4.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Perceptions of psychological safety in high-containment laboratories: Mixed method survey of community members and industry experts","fulltext":[{"header":"Background","content":"\u003cp\u003eHigh-reliability organizations (HROs) are defined as organizations that operate in high-risk environments with low accident rates [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In these organizations, safety is paramount as critical incidents or failures can result in significant consequences, including severe occupational and environmental health impacts [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Notably, in high-containment laboratories, stringent safety protocols are imperative due to the potentially catastrophic consequences of safety lapses [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. For example, an economic analysis of a food-and-mouth (FMD) outbreak, even with emergency protocols, estimates economic loss of \u003cspan\u003e$\u003c/span\u003e56\u0026nbsp;billion and even significant job losses [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Beyond endangering the health and safety of lab personnel, such lapses also pose significant risks to the surrounding community [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn this context, psychological safety is a critical factor for maintaining operational integrity and mitigating potential risks, especially where safety is a critical function [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Previous meta-analyses established significant links between psychological safety and key workplace factors, such as task performance, work engagement, and information/knowledge sharing [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Rooted in organizational and social psychology theories, psychological safety refers to the perception of an environment where individuals feel safe to express concerns, voice opinions, and take interpersonal risks without fear of reprisal or negative consequences [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. This concept gained prominence through research conducted by Amy Edmondson, whose studies explored its effects on team performance and organizational learning [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWithin high-containment laboratories, where personnel handle hazardous pathogens and adhere to complex protocols, the presence of psychological safety is paramount [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Workers must feel comfortable acknowledging errors, reporting incidents, and collaborating effectively to address safety concerns. Without psychological safety, there is a heightened risk of underreporting incidents, reluctance to disclose errors, and a breakdown in communication\u0026mdash;all of which can compromise safety protocols and increase the likelihood of accidents [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. For example, envision a scenario where a laboratory technician identifies a potential safety hazard but hesitates to report it due to concerns about negative repercussions from management. Without a culture of psychological safety, this technician may opt to remain silent, allowing the hazard to persist and potentially lead to a safety incident. Conversely, in an environment where psychological safety is fostered, the technician would feel empowered to voice concerns, enabling timely intervention and hazard mitigation.\u003c/p\u003e\n\u003ch3\u003eTheoretical Underpinning\u003c/h3\u003e\n\u003cp\u003eThe synthesis of the Theory of Planned Behavior (TPB) [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] and Social Exchange Theory (SET) [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] offers a comprehensive framework for fostering psychological safety within high-containment laboratories, crucial for promoting trust, collaboration, and knowledge sharing among personnel. According to TPB, individual behavior within such environments is influenced by attitudes, subjective norms, and perceived behavioral control. Positive attitudes toward safety practices, coupled with a supportive organizational culture, are pivotal in cultivating psychological safety among lab personnel. Subjective norms, reflecting the perceived social pressure from peers and supervisors, shape employees' safety-related behaviors, emphasizing the importance of establishing norms that prioritize safety and encourage open communication. Perceived behavioral control, shaped by access to resources including supervision and training, directly impacts employees' sense of agency and control over their work environment, contributing significantly to psychological safety.\u003c/p\u003e \u003cp\u003eComplementing TPB, SET underscores the importance of trust, collaboration, and knowledge sharing in fostering psychological safety within high-containment labs. Trust, as a cornerstone of social exchange, is cultivated through transparent communication, supportive leadership, and shared values, enabling employees to feel secure in expressing concerns and ideas [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Collaboration emerges as a natural outcome of trust, as individuals engage in cooperative behaviors when they perceive mutual benefit. Encouraging collaboration among lab personnel fosters a culture of reciprocity and mutual support, further enhancing psychological safety.\u003c/p\u003e \u003cp\u003eAdditionally, knowledge sharing, driven by the principles of social exchange, promotes organizational resilience by facilitating the dissemination of best practices and innovative solutions to safety challenges. This collective intelligence empowers the organization to adapt and respond effectively to safety threats, ultimately bolstering its resilience and safety response capabilities. By integrating TPB and SET principles, high-containment labs can establish a robust framework for fostering psychological safety, underpinning a culture of trust, collaboration, and knowledge sharing essential for organizational resilience and safety excellence.\u003c/p\u003e \u003cp\u003eAccording to the organizational learning theory [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], psychological safety can advance the process of workplace safety management by efficiently identifying related problems and encouraging team-based learning that help members obtain knowledge, skills, and abilities to solve the identified problems [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. These theories underscore psychological safety\u0026rsquo;s pivotal role in promoting safety, communication, and organizational learning within high-risk environments like high-containment laboratories. By cultivating an environment where individuals feel psychologically safe to voice concerns and contribute to safety improvement efforts, organizations can enhance their ability to operate safely. This helps mitigate the potential risks associated with handling hazardous materials and pathogens, thereby protecting human and animal health, and the surrounding environment.\u003c/p\u003e\n\u003ch3\u003eDiverse Voices, Unified Safety Standards\u003c/h3\u003e\n\u003cp\u003eExamining the perceptions of both community residents [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] and subject matter experts (SMEs) [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] regarding psychological safety within high-containment laboratories is paramount from a community psychology perspective due to the inherent interdependence between these facilities and the communities in which they operate. Transparency is a fundamental principle in fostering trust and collaboration between high-containment labs and their surrounding communities [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Community members' perceptions of psychological safety not only reflect their sense of trust in the safety measures employed by these facilities but also influence their level of engagement and cooperation [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Involving these residents in the assessment of psychological safety ensures that their voices are heard, and their concerns are addressed, promoting a sense of ownership and accountability for safety outcomes [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Additionally, by incorporating community perspectives, high-containment laboratories can better align their safety protocols with community values and priorities, enhancing overall community resilience and well-being.\u003c/p\u003e \u003cp\u003eFurthermore, the safe operation of high-containment laboratories has significant public and animal health implications that extend beyond the laboratory walls. Community psychology emphasizes the importance of understanding the broader social, economic, and environmental factors that shape health outcomes within communities [\u003cspan additionalcitationids=\"CR30\" citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. In the context of high containment laboratories, maintaining psychological safety is critical for the safety of laboratory personnel and for preventing potential public and animal health crises. Community members' perceptions of psychological safety can provide valuable insights into how safety lapses within these facilities may impact public health outcomes, such as the spread of infectious diseases or environmental contamination. By engaging with community residents, high-containment laboratories can enhance their responsiveness to community needs and concerns, strengthening the overall public and animal health infrastructure and promoting collaboration between stakeholders.\u003c/p\u003e \u003cp\u003eInvolving SMEs in the assessment of psychological safety within high-containment laboratories is equally crucial. SMEs bring a wealth of technical knowledge and practical experience that can identify potential risks and effective mitigation strategies that may not be apparent to community residents. Their insights can enhance the development and implementation of robust safety protocols, including risk assessments [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], ensuring that these facilities not only comply with regulatory standards but also exceed them. By integrating the expertise of SMEs with the perspectives of community residents, high-containment laboratories can foster a more comprehensive approach to safety that addresses both technical and community-based concerns, ultimately contributing to greater trust, transparency, and collaboration.\u003c/p\u003e \u003cp\u003eTherefore, examining the perceptions of both community residents and SMEs regarding Psychological safety within high-containment laboratories is essential for promoting transparency, trust, and collaboration between these facilities and their surrounding communities. By incorporating community perspectives, high-containment laboratories can enhance their safety protocols, aligning them with community values and priorities to better protect public health and ensure the safe operation of these facilities.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStudy Aims\u003c/h2\u003e \u003cp\u003eThe current study aims to address three primary questions to enhance our understanding of the role of psychological safety in high-containment lab safety:\u003c/p\u003e \u003cp\u003e \u003cem\u003eRQ1. Do community members perceive psychological safety as essential for the safe operation of high containment laboratories?\u003c/em\u003e \u003c/p\u003e \u003cp\u003eUnderstanding the perceptions of community members, who may be directly impacted by safety incidents originating from high containment laboratories, is crucial. Their perspectives can shed light on the broader societal implications of psychological safety within these environments and inform community engagement strategies aimed at promoting safety and transparency, which may help to increase community trust in the facility.\u003c/p\u003e \u003cp\u003e \u003cem\u003eRQ2. Which incident reporting approach better reflects psychological safety: solution-oriented approach focusing on corrective actions or problem-oriented approach focusing on risk and root cause identification?\u003c/em\u003e \u003c/p\u003e \u003cp\u003eIncident reporting serves as a critical communication tool for informing community members about biotechnical hazards and risks within high containment laboratories [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Different incident reporting methodologies may prioritize different aspects of safety culture, which can, in turn, influence perceptions of psychological safety. By comparing approaches focused on corrective actions versus those emphasizing risk and root cause identification, this study seeks to elucidate how these methodologies align with the promotion of psychological safety within high-containment laboratories contexts.\u003c/p\u003e \u003cp\u003e \u003cem\u003eRQ3. Is there a discrepancy in the assessment of psychological safety between community members and SMEs in high containment laboratories?\u003c/em\u003e \u003c/p\u003e \u003cp\u003eExamining potential discrepancies in the assessment of psychological safety between community members and SMEs provides insights into the alignment of perceptions and priorities regarding safety. Identifying any disparities can inform targeted interventions aimed at bridging gaps in understanding and fostering a shared commitment to promoting psychological safety and enhancing safety within high containment laboratories.\u003c/p\u003e \u003cp\u003eThis study addresses a significant gap in the literature by investigating the role of psychological safety in high-containment laboratories safety from multiple perspectives, including those of community members and industry experts. The findings have the potential to inform policies, procedures, and training initiatives aimed at cultivating a culture of safety and resilience within high-risk environments.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eThe study engaged two distinct groups: residents of a community adjacent to a high containment laboratory (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;147) and SMEs currently working in high containment laboratories (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;20). In justification of the sample size of high containment laboratory SMEs, for thematic analysis previous research has suggested 12 interviews adequately achieve data saturation [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Community residents were recruited from a midwestern public university located directly next to a high-containment lab facility. Their average age was 19.51 (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.30) and the majority were female (62.6%). The average familiarity with high containment laboratories was low (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.30 out of 5, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.67) and they had modest familiarity with the concept of psychological safety (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.13 out of 5, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.87). SMEs were recruited from two different high containment laboratories, with sixteen SMEs from one high containment laboratory and four from the other. Specific demographic information was only collected from the four SMEs at one facility, while demographic data from the sixteen SMEs was not collected to maintain confidentiality in reporting qualitative results to upper management. The average tenure in the facility for these SMEs was 2.73 years (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.49). They ranged in General Schedule levels from 7 to 14 and represented various facility units. The four SMEs (50% male, 50% female) had an average age of 44.75 years (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;25.94). Their education levels ranged from some college to Doctorate or professional degree, and they were all familiar with both high containment laboratories (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.75, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.5) and psychological safety (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.75, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.5).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eProcedures\u003c/h2\u003e \u003cp\u003eA mixed methods approach was adopted to gain a richer understanding of community members and SMEs\u0026rsquo; perceptions of psychological safety in a high containment laboratory. Questionnaires and qualitative interview questions varied between community members and SMEs since workers in high containment laboratories receive extensive training on safety protocols and psychological safety. To ensure consistent understanding of psychological safety, both community members and SMEs were provided with an operational definition of psychological safety. Community members were also provided with an example of high containment laboratories to inform their answers, in case they were unfamiliar with them.\u003c/p\u003e \u003cp\u003eCommunity residents evaluated the potential impact of inadequate psychological safety on safe operations in high containment laboratories and two incident reporting formats for their association with psychological safety. The examples of incident reporting were obtained from the potential exposure incident quarterly reports (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.bu.edu/neidl/safety-security/neidl-quarterly-incident-reports/\u003c/span\u003e\u003cspan address=\"https://www.bu.edu/neidl/safety-security/neidl-quarterly-incident-reports/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) by the National Emerging Infectious Diseases Laboratories at Boston University. See \u003cspan refid=\"Sec14\" class=\"InternalRef\"\u003eAppendix A\u003c/span\u003e for survey materials and survey items. A paired \u003cem\u003et\u003c/em\u003e-test was conducted to compare within-subject ratings of incident reports.\u003c/p\u003e \u003cp\u003eFinally, both groups of participants, community residents and SMEs, were asked to provide open-ended responses to the question \u0026ldquo;Do you think a high containment laboratory with low psychological safety can operate safely? Why?\u0026rdquo; Community residents were asked via an online survey, and SMEs were asked via an in-person interview. SME responses were transcribed, and all the qualitative responses were analyzed via semantic analysis to identify common keywords, phrases, and their relationships regarding psychological safety in participant responses. Key themes were derived from them using the thematic analysis framework.\u003c/p\u003e \u003cp\u003eIndividual differences (i.e., age, gender, education, HCL familiarity, and psychological safety familiarity) were assessed as control variables. Descriptive statistics and regression analysis (i.e., psychological safety implication\u0026thinsp;=\u0026thinsp;Age\u0026thinsp;+\u0026thinsp;Gender\u0026thinsp;+\u0026thinsp;Education\u0026thinsp;+\u0026thinsp;HCL familiarity\u0026thinsp;+\u0026thinsp;Psychological safety familiarity) were examined to ensure that psychological safety implication perceptions do not systematically differ across demographic factors and individual differences. See Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRegression Results of Psychological Safety Implications Across Individual Differences\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEstimate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e(Intercept)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale (vs. Male)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.97\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHCL familiarity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePS familiarity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eNote. HCL\u0026thinsp;=\u0026thinsp;High-containment laboratory; PS\u0026thinsp;=\u0026thinsp;Psychological safety; SE\u0026thinsp;=\u0026thinsp;Standard error.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eThematic Analysis\u003c/h2\u003e \u003cp\u003eInitially, the semantic analysis conducted using Python with the Natural Language Toolkit (NLTK) [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] library followed a systematic approach outlined in several key steps. First, text preprocessing was performed to prepare the data for analysis. This involved gathering relevant text data, such as interview transcripts or survey responses, and then cleaning the text by removing irrelevant information such as headers, footers, and punctuation. The text was then tokenized to break it down into individual words or meaningful units, followed by the removal of stopwords\u0026mdash;common words that do not carry much meaning on their own (e.g., \u0026ldquo;\u003cem\u003ethe\u003c/em\u003e\u0026rdquo;, \u0026ldquo;\u003cem\u003eand\u003c/em\u003e\u0026rdquo;, \u0026ldquo;\u003cem\u003eso\u003c/em\u003e\u0026rdquo;. The next step in the process was Word Sense Disambiguation (WSD), which is essential for accurately understanding words with multiple meanings (polysemy). Techniques such as NLTK's WordNet and SpaCy were employed to identify the most likely meaning of ambiguous words based on context [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Following WSD, the analysis focused on identifying themes within the text. Named Entity Recognition (NER) tools provided by NLTK [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e] were utilized to identify key entities such as high containment laboratories or researchers, aiding in pinpointing relevant actors and locations. OpenAI\u0026rsquo;s ChatGPT 3.5 [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e] was leveraged to enhance the interpretation and develop custom algorithms to identify recurring themes based on keywords or phrases related to \"psychological safety\u0026rdquo;, \"operational safety\u0026rdquo;, \"communication\", etc. The accuracy of the identified themes was reviewed through an iterative process, with adjustments made based on initial findings to refine steps like WSD or theme identification algorithms for improved accuracy. Overall, this systematic approach allowed for a comprehensive analysis of the text data, providing valuable insights into the topics under investigation.\u003c/p\u003e \u003cp\u003eIn justifying the sample size, the analysis utilized a thematic framework to identify key themes and patterns indicative of data saturation. The consistency across responses in emphasizing the critical role of psychological safety in a high containment laboratory operation was notable. Participants recurrently emphasized themes such as communication, trust, and mistake reporting, indicating a shared understanding. Despite diverse perspectives, underlying themes remained consistent, reinforcing the significance of psychological safety. Moreover, the depth of insights provided by participants, coupled with the absence of novel insights after analyzing numerous responses, further affirmed data saturation. This comprehensive analysis suggests the sample size was adequate in capturing the breadth and depth of participant perspectives on psychological safety in the context of high containment laboratories.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eCommunity members emphasized the critical role of psychological safety in high-containment lab safety (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.67 out of 5, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.60). Despite demographic variations in terms of age, sex, education, familiarity with the HCL environment, and the concept of psychological safety, community members consistently recognized the link between inadequate psychological safety and unsafe operations within high containment laboratories (\u003cem\u003eF\u003c/em\u003e(6, 121)\u0026thinsp;=\u0026thinsp;1.638, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.14).\u003c/p\u003e \u003cp\u003eIn the context of a high containment laboratory, solution-oriented incident reporting focused on corrective actions appeared to indicate higher levels of psychological safety (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.34, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.18) compared to problem-oriented incident reporting centered on risk and root cause identification (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.09, SD\u0026thinsp;=\u0026thinsp;1.09; \u003cem\u003et\u003c/em\u003e[128]\u0026thinsp;=\u0026thinsp;2.27, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.03), with a mean difference of 0.25 and a 95% confidence interval of 0.03\u0026ndash;0.46 (see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eResults from the sematic analyses identified the following key themes from the community residents and high containment laboratories SMEs (see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSummary of Key Themes from Thematic Analysis by Group\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTheme and Definition\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCommunity Residents\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigh Containment Laboratory Facility Subject Matter Experts\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026bull; Open \u0026amp; honest communication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull; Effective internal \u0026amp; external communication \u0026amp; transparency\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrust\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026bull; Positive team dynamics \u0026amp; collaboration\u003c/p\u003e \u003cp\u003e\u0026bull; Trust and confidence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull;Loss of trust due to lack of communication\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncident Handling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026bull; Enhancing learning from mistakes and feedback\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull; Effective handling of incidents\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRisk Management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026bull; Mitigating risk of mistakes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull; Preparedness through drills, procedures, and continuous improvement\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCulture of Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026bull; Positive organizational culture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull; Positive safety culture\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployee Well-Being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026bull; Mitigating stress and anxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull; Poor well-being from stress and frustration with working conditions\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunity Trust\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eNA\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull; Positive relationship with community \u0026amp; reputation\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployee Turnover\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eNA\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026bull; Preventing high turnover \u0026amp; hiring challenges\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFor community residents, several respondents emphasized the importance of open and honest \u003cem\u003ecommunication\u003c/em\u003e for identifying and addressing safety concerns. They also indicated that psychological safety fosters \u003cem\u003etrust\u003c/em\u003e and confidence among team members, which is essential for effective \u003cem\u003eincident handling\u003c/em\u003e the high-risk environment of a high containment laboratory and allows for learning from mistakes and feedback and continuous improvement. Whereas fear of repercussions may discourage reporting errors, which could compromise safety and increases the likelihood of \u003cem\u003emistakes\u003c/em\u003e, which can be dangerous in a high-risk environment like a high containment laboratory. When psychological safety perceptions are low, this can lead to increased stress and anxiety, negatively impacting \u003cem\u003eemployees' well-being\u003c/em\u003e ability to perform their tasks efficiently and safely. Psychological safety also influences \u003cem\u003eteam dynamics and collaboration\u003c/em\u003e by fostering mutual support from team members, which is vital for maintaining a safe and effective working environment. At a higher level, a positive organizational culture (i.e., \u003cem\u003eculture of safety\u003c/em\u003e) that promotes psychological safety is seen as crucial for the well-being and performance of employees, especially in high-risk facilities. Overall, the responses suggest a consensus that psychological safety is important for operating a high containment laboratory safely, as it contributes to better communication, trust, and error handling.\u003c/p\u003e \u003cp\u003eSMEs emphasized the importance of a workplace environment where employees feel comfortable speaking up about safety concerns. This is linked to physical safety, as an environment where employees fear speaking up can lead to dangerous situations or failures to follow procedures. \u003cem\u003eCommunication\u003c/em\u003e and transparency are vital for psychological safety, both internally (between employees and management) and externally (with the community). A lack of proper communication can lead to misunderstandings, fear, and loss of \u003cem\u003etrust\u003c/em\u003e. They also emphasized the need for a strong \u003cem\u003eculture of safety\u003c/em\u003e that prioritizes the safety of employees and the community. The absence of such a culture can lead to accidents, loss of trust, and even life-threatening situations. High \u003cem\u003eemployee turnover\u003c/em\u003e and hiring challenges are seen as a risk for safety and efficiency. Difficulties in finding and retaining qualified staff, as well as hiring constraints (e.g., regulatory-established hiring preferences) can impact the quality of the workforce. Effectively \u003cem\u003ehandling incidents\u003c/em\u003e, including quick and clear communication and involving all necessary parties, is important for maintaining trust and safety. The need for ongoing \u003cem\u003erisk management\u003c/em\u003e and preparedness through drills, procedures, and continuous improvement in safety practices. Safety issues can have a significant \u003cem\u003eimpact on the community's trust\u003c/em\u003e and reputation in the facility and its operations. Negative events can harm the facility's reputation and potentially the wider agricultural industry. Poor \u003cem\u003eemployee well-being\u003c/em\u003e, including increased levels of stress and frustration among employees due to lack of communication, safety concerns, or work culture can lead to disengagement and mistakes. These themes are interconnected, with psychological safety underpinning the overall safety culture and affecting communication, employee well-being, and the handling of incidents. A lack of any of these components can lead to a breakdown in safety and trust both internally and with the community. The results presented focus on key themes related to the importance of psychological safety, communication, and organizational culture within a high-risk environment such as a high containment laboratory.\u003c/p\u003e \u003cp\u003eThere are some notable similarities between key themes derived from community residents and SMEs. Results from both groups highlight the importance of psychological safety in the workplace, where employees can speak up about safety concerns without fear of repercussions. This is crucial in a high-risk environment like a high containment laboratory. Open and honest communication was emphasized by both groups as essential for identifying and addressing safety concerns. Effective communication between employees and management, and with the community, helps build trust and transparency. Both groups stressed the need for a strong safety culture that prioritizes the well-being and safety of employees and the community. A positive safety culture is linked to effective handling of risks and incidents. Both results acknowledge low psychological safety can lead to increased stress and anxiety among employees, impacting their ability to perform tasks efficiently and safely. The importance of team dynamics, collaboration, and mutual support is acknowledged by both groups as vital for maintaining a safe and effective working environment.\u003c/p\u003e \u003cp\u003eIn addition to overlap in key themes, there were some notable differences between community residents and SMEs. Community members emphasize the role of organizational culture in promoting psychological safety, which contributes to better communication, trust, and error handling. SME results focus more on the impact of organizational culture on employee well-being and the handling of incidents. SMEs discuss the importance of properly managing incidents, including clear communication and involving all necessary parties. This aspect is less prominent among community members. SMEs emphasize ongoing risk management and preparedness through drills, procedures, and continuous improvement in safety practices, whereas community member results do not explicitly mention this aspect. The SMEs discuss the potential impact of safety issues on the community's trust in the facility and its operations, as well as the facility's reputation and the wider agricultural industry. This aspect is less prominent in community members\u0026rsquo; results. SMEs mention high employee turnover and hiring challenges as risks to safety and efficiency, a theme not covered by community residents. In summary, while both results share common themes related to psychological safety, communication, and safety culture, the SMEs provided more specific insights into risk management, preparedness, and the impact on community and reputation.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study investigates psychological safety in high containment laboratories, which is crucial for maintaining safety standards in high-risk environments. By integrating the TPB [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] and SET [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] frameworks, it explores how psychological safety fosters trust and collaboration among personnel. Additionally, the study examines community and expert perceptions to inform safety protocols and community engagement strategies, aiming to enhance organizational resilience and public health outcomes.\u003c/p\u003e \u003cp\u003eThe findings presented in the results emphasize the critical role of psychological safety in the context of laboratory safety, particularly within high containment laboratories. The data suggests that community members (BSL novices) recognize the link between inadequate psychological safety and unsafe operations, highlighting its significance in fostering a safe working environment. Findings also suggest that incident analyses rooted in corrective action, rather than root cause identification may increase perceptions of psychological safety. Determining the root cause of an incident can be useful for mitigating future accidents and similar incidents [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e], while corrective action provides insight into how follow-up with personnel was handled. These results are aligned with the tenets of the TPB [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], which posits that individuals' behavioral intentions are influenced by their attitudes, subjective norms, and perceived behavioral control. In this context, psychological safety influences employees' attitudes toward safety practices, norms regarding reporting safety concerns, and their perceived control over safety-related actions. Additionally, how incidents are reported may be important for community perceptions of safety and transparency [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMoreover, the emphasis on open communication, trust, and error handling underscores the importance of SET. According to this theory, individuals engage in relationships where they perceive benefits outweighing costs. In the workplace, employees are more likely to engage in safety behaviors when they perceive support from their organization (in the form of psychological safety) and anticipate positive outcomes such as trust and error learning. This aligns with the findings that psychological safety fosters trust and confidence among team members, encourages reporting of errors, and contributes to a supportive organizational culture [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eConsidering both community and experts' input on the importance of psychological safety in high containment laboratories offer invaluable insights from managerial and community health perspectives. From a managerial standpoint, integrating community feedback enhances transparency and fosters trust, vital for maintaining public support and cooperation [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Expert input ensures alignment with industry standards and best practices, optimizing safety protocols and operational efficiency [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. From a community health perspective, understanding community perceptions informs tailored engagement strategies, promoting mutual understanding and collaboration between facilities and surrounding communities [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. By incorporating diverse perspectives, organizations can enhance safety culture, mitigate risks, and safeguard both employee well-being and community health.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003ePractical Implications\u003c/h2\u003e \u003cp\u003ePractical takeaways from the study's findings include the importance of promoting psychological safety through transparent communication, building a strong safety culture, and addressing stress and anxiety among employees. Organizations can implement strategies such as fostering open dialogue, providing training on error management, and creating support systems to enhance psychological safety. Additionally, the emphasis on risk management, incident handling, and community impact highlights the need for comprehensive safety protocols and preparedness measures within high containment laboratories. One of our key findings suggests that when communicating any incidents, providing examples of actions to mitigate or prevent incidents might contribute to the organizational context of open, transparent, and constructive sharing of ideas above and beyond the approach of analyzing and pinpointing reasons for the incidents. This strategic communication should avoid individual blame, instead emphasizing corrective action and fostering continuous feedback for organizational members [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn addition, results highlight that community members have a general awareness of the importance of psychological safety and the implications of low psychological safety in high containment laboratories. Practically, this highlights an area that may benefit from enhanced communication. Facilities that operate under high-risk have the unique opportunity to inform their surrounding communities about safety status, protocols in place for protecting the community, and the importance of maintaining safety in their organizations. A recent study on a relatively new high containment laboratory [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] found that transparency was positively associated with social support and approval from the community, which in turn was associated with positive public perceptions regarding trust, perceived benefits, and lower risk perceptions. Thus, engaging with the surrounding community can help build trust in high containment laboratory operations, increase transparency, and promote collaboration with the public, which would help address any perceived and actual health disparities in the community. This transparent communication may enhance the relationship between surrounding communities and high containment laboratories and ensure that health disparities are minimized for the surrounding area.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThe study has limitations which warrant consideration. First, the data are based on self-report measures, which may be subject to social desirability bias. Future studies could utilize objective measures or observational methods to corroborate findings. Second, the study primarily focuses on perceptions within a specific context (high containment laboratories), limiting generalizability to other settings. Future research could explore the applicability of these findings across different industries and organizational contexts. Moreover, longitudinal studies could assess the long-term effects of psychological safety interventions on safety outcomes and organizational performance, as well as community perceptions. Third, the sample size for SMEs was small, limiting the ability to conduct more advanced sematic analyses. Future studies are encouraged to recruit a larger sample with the goal of uncovering additional themes.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eFindings of our study underscore the importance of psychological safety in promoting safety culture and effective communication within high-risk environments such as high containment laboratories. Theoretical implications for TPB and SET highlight the role of attitudes, norms, and perceived benefits in shaping safety behaviors. Practical implications suggest strategies for enhancing psychological safety and improving safety outcomes.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eHRO \u0026ndash; High-reliability organization\u003c/p\u003e\n\u003cp\u003eHCL \u0026ndash; High-containment laboratory\u003c/p\u003e\n\u003cp\u003eTBP \u0026ndash; Theory of planned behavior\u003c/p\u003e\n\u003cp\u003eSET \u0026ndash; Social exchange theory\u003c/p\u003e\n\u003cp\u003eSME \u0026ndash; Subject matter expert\u003cbr\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u0026nbsp;\u003c/strong\u003eThis research was approved by the Kansas State University Institutional Review Board (IRB-11728).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e De-identified data from community members are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This study was sponsored by the United States Department of Agriculture (USDA), Grant Agreement Number: 58-3022-3-011.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u003c/strong\u003e Moana Sargent: Writing \u0026ndash; review \u0026amp; editing, Methodology, Investigation. Ashley Sylvara: Writing \u0026ndash; review \u0026amp; editing, Methodology, Investigation. Leah Klos: Writing \u0026ndash; review \u0026amp; editing, Methodology, Investigation. Jacob Gallagher: Writing \u0026ndash; review \u0026amp; editing. Kutina Cabrera: Investigation. Molly Goff: Investigation. Jesica Luna: Investigation. Alfonso Clavijo: Writing - review \u0026amp; editing, Co-PI. Jin Lee: Writing \u0026ndash; original draft, Methodology, Formal Analysis, Conceptualization, Supervision, Project administration, Funding acquisition.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e Not applicable.\u003cbr\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAppelt S, Jacob D, Rohleder AM, Br\u0026aring;ve A, Bj\u0026ouml;rndal \u0026Aring;S, Di Caro A, Grunow R. Assessment of biorisk management systems in high containment laboratories, 18 countries in Europe, 2016 and 2017. 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Available from: https://chat.openai.com/chat \u003c/li\u003e\n\u003cli\u003eVogler AJ, Jones S, Keim P. Incident reporting and biosafety training in a BSL-3 select agent facility. Applied Biosafety. 2014 Dec 1;19(4):192-200.\u003c/li\u003e\n\u003cli\u003eMahajan RP. Critical incident reporting and learning. British journal of anaesthesia. 2010 Jul 1;105(1):69-75.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Environmental health, psychological safety, biosafety level facilities, high-reliability organizations, community residents, subject matter experts, incident reporting","lastPublishedDoi":"10.21203/rs.3.rs-4969510/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4969510/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eIn high-reliability organizations (HROs), where safety is paramount, psychological safety is crucial for maintaining operational integrity and mitigating potential risks. The interdependence between HROs and surrounding communities necessitates examining the perceptions of conditions for safe and transparent operation from both community residents and subject matter experts (SMEs). This study aims to understand community residents\u0026rsquo; perceptions of psychological safety in the operation of A high-containment laboratory (HCL), how incident reporting reflects the psychological safety of a facility, and the alignment in community residents and SMEs\u0026rsquo; assessments of psychological safety in these laboratories.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA mixed methods approach was used to collect data from community residents and a high containment laboratory SMEs. Community residents evaluated the potential impact of inadequate psychological safety on safe operations in high containment laboratories and two incident reporting formats for their association with PS. Both community residents and SMEs provided open-ended responses regarding the role of psychological safety in a high containment laboratory.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eCommunity members emphasized that psychological safety plays a key role for safe and reliable operations within High containment laboratories, and solution-oriented incident reports that focus on corrective actions appeared to indicate higher levels of psychological safety than problem-oriented reports focused on identifying the root cause of the incident. Thematic analysis showed overlap in key themes from community residents and SMEs, suggesting that psychological safety is important for safe operations, safety culture, and communication. Uniquely, SMEs offered more detailed insights into risk management, preparedness, and the impact on community and reputation.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eFindings underscore the importance of psychological safety in promoting safety culture and effective communication within HROs, which is recognized by the surrounding community of residents. Transparent reporting with a focus on corrective action may be perceived as more indicative of psychological safety than reports centered on root cause analysis. Lastly, there is a shared understanding of the importance of psychological safety between community residents and SMEs, with SMEs providing a more nuanced perspective on improving psychological safety in HROs.\u003c/p\u003e","manuscriptTitle":"Perceptions of psychological safety in high-containment laboratories: Mixed method survey of community members and industry experts","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-24 10:55:27","doi":"10.21203/rs.3.rs-4969510/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-08-27T05:07:51+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-08-26T05:19:32+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-08-26T05:17:48+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2024-08-24T14:04:51+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1c67d737-d55a-4df3-8eea-736d5bb05dd7","owner":[],"postedDate":"September 24th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-05-26T15:59:32+00:00","versionOfRecord":{"articleIdentity":"rs-4969510","link":"https://doi.org/10.1186/s40359-025-02763-4","journal":{"identity":"bmc-psychology","isVorOnly":false,"title":"BMC Psychology"},"publishedOn":"2025-05-22 15:57:01","publishedOnDateReadable":"May 22nd, 2025"},"versionCreatedAt":"2024-09-24 10:55:27","video":"","vorDoi":"10.1186/s40359-025-02763-4","vorDoiUrl":"https://doi.org/10.1186/s40359-025-02763-4","workflowStages":[]},"version":"v1","identity":"rs-4969510","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4969510","identity":"rs-4969510","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}