An Umbrella Review of Relational Enablers of Psychological Safety and Identity-Related Gaps in the Evidence: Implications for Healthcare and Organizational Settings

Abstract: We examined published reviews on psychological safety to synthesize key relational enablers and assess whether gaps related to culture, race, or ethnicity have been identified. Psychological safety is critical for authentic and effective teamwork. Although many reviews explore its antecedents, a synthesis of relational enablers is lacking. Identifying significant gaps related to minority identities is also essential for determining whether the evidence base applies across diverse contexts. An umbrella review was conducted using five databases (Ovid MEDLINE ALL, Embase, APA PsycInfo, Web of Science, and ABI/INFORM) and Google Scholar. Following the JBI approach, screening, data extraction, and critical appraisal were performed. Published reviews were included if they addressed antecedents of psychological safety in workplace settings, without language or date restrictions. The final search was completed on July 24, 2025. Review characteristics and findings were summarized descriptively, and qualitative content analysis was used to synthesize relational enablers. Eleven reviews met inclusion criteria, including a meta-analysis, an evidence synthesis, and systematic, scoping, integrative, and structured narrative reviews. Reviews originated from healthcare or organizational psychology and management disciplines. Participants included employees and healthcare workers, teams, and professionals. Overall quality was acceptable, though transparency regarding appraisal and data extraction varied. Four categories of relational enablers emerged: leadership (behaviors, characteristics), team dynamics (cooperation, inclusive climate), interpersonal factors (trust, open communication), and individual capacities and beliefs (emotional intelligence, experience). Most reviews acknowledged cultural limitations, while only a minority addressed race or ethnicity explicitly. This umbrella review provides a synthesized account of relational enablers of psychological safety and highlights identity-related gaps. We provide evidence-based actionable strategies to strengthen psychological safety by targeting leadership behaviors, team dynamics, interpersonal trust and communication, and individual characteristics. Lastly, the findings emphasize the need for future research to consider race, ethnicity, and culture to ensure applicability across diverse contexts. Keywords: psychological safety, relational enablers, culture, race, ethnicity, review of reviews