Personal | Relational | Contextual |
---|---|---|
Knowledge base/judgement/certainty Perceived personal responsibility for patient Clinical autonomy; perceived agency and ability to change clinical decisions Communication skills Perceived efficacy of speaking up Bravery/assertiveness/confidence Moral courage Prioritisation of personal ‘likeability’ Psychological safety
Causal attribution
| Familiarity with individual/approachability Encouragement from senior clinicians Privacy
Fear of self-alienation from team members Fear of getting someone else in trouble Other expected repercussions
| Individual case-based factors:
Meaningful change after speaking up Preparation and support
|