Understanding the Concepts of Psychological Size and Psychological Safety episode artwork

EPISODE · Jan 3, 2026 · 24 MIN

Understanding the Concepts of Psychological Size and Psychological Safety

from Within Normal Limits: Navigating Medical Risks · host Mark Earnest MD, Eric Zacharias MD

This episode’s guest is Dr. Mark Earnest, Division Head of Internal Medicine at the University of Colorado Anschutz Medical School. The conversation centers on the concepts of psychological size and psychological safety in medicine. Psychological size is described as a relational dynamic involving power and status within professional interactions. Psychological safety refers to creating an environment where people feel comfortable having open, honest conversations. Dr. Earnest shares stories that illustrate these concepts in the healthcare setting and emphasizes how leaders must be proactive in recognizing and managing power dynamics. In addition, he highlights the benefits of early education, how ongoing modeling of positive behaviors are essential, and that organizational culture set by leadership has measurable impacts on outcomes, satisfaction, and risk. Feedback or episode ideas email the show at [email protected]: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition. 

Episode metadata supplied by the publisher feed · Published Jan 3, 2026

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This episode’s guest is Dr. Mark Earnest, Division Head of Internal Medicine at the University of Colorado Anschutz Medical School. The conversation centers on the concepts of psychological size and psychological safety in medicine. Psychological size is described as a relational dynamic involving power and status within professional interactions. Psychological safety refers to creating an environment where people feel comfortable having open, honest conversations. Dr. Earnest shares stories that illustrate these concepts in the healthcare setting and emphasizes how leaders must be proactive in recognizing and managing power dynamics. In addition, he highlights the benefits of early education, how ongoing modeling of positive behaviors are essential, and that organizational culture set by leadership has measurable impacts on outcomes, satisfaction, and risk.

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