Shame in medical clerkship: “You just feel like dirt under someone’s shoe”

This study explores how senior medical students ’ experience and react to shame during clinical placements by asking them to reflect on (1) manifestations of shame experiences, (2) situations and social interactions that give rise to shame, and (3) perceived effects of shame on learning and professional identity development.MethodsIn this interpretive study, the authors recruited 16  senior medical students from two classes at a Norwegian medical school. In three focus group interviews, participants were invited to reflect on their experiences of shame. The data were analyzed usingsystematic text condensation, producing rich descriptions about students ’ shame experiences.ResultsAll participants had a  range of shame experiences, with strong emotional, physical, and cognitive reactions. Shame was triggered by a range of clinician behaviours interpreted as disinterest, disrespect, humiliation, or breaches of professionalism. Shame during clinical training caused loss of confidence and motivation , worries about professional competence, lack of engagement in learning, and distancing from shame-associated specialties. No positive effects of shame were reported.DiscussionShame reactions in medical students were triggered by clinician behaviour that left students feeling unwanted, rejected, or burdensome, and by humiliating teaching situations. Shame had deleterious effects on motivation, learning, and professional identity development. This study has implications for l...
Source: Perspectives on Medical Education - Category: Universities & Medical Training Source Type: research