Psychological safety and team learning during a problem-solving game for staff at a South African hospital

South Africa’s National Health Insurance (NHI) program promises to be the vehicle of universal health coverage for the country by 2030. In public healthcare organizations, which are already challenged by under-resourcing and staff shortages, the demands of NHI place a heavy burden on the healthcare workers tasked with managing the associated system changes and delivering services to program specifications. As teams are the units tasked with driving organizational adaptivity and performance in the healthcare sector globally, effective teams are critical for successful NHI implementation. We explore a cost-effective intervention for promoting teamwork in the public healthcare system. A problem-solving game called the marshmallow challenge was used as an experimental intervention at an NHI pilot site, a provincial district hospital, where staff were already familiar with the impending challenges of change management. A qualitative post-game survey was administered to gather data on the experiences of 100 participating hospital staff. Groups also engaged in a post-game reflective discussion. We examine the individuals’ experiences of the game in order to establish how interventions of this kind can empower healthcare workers to practice effective teamwork and team learning and how a psychologically safe environment can be cultivated.