文章基本信息

标题：Shame in medical clerkship: “You just feel like dirt under someone’s shoe”
本地全文：下载
作者：Beth Whelan ; Stefan Hjörleifsson ; Edvin Schei 等
期刊名称：Perspectives on Medical Education
印刷版ISSN：2212-2761
电子版ISSN：2212-277X
出版年度：2021
卷号：10
期号：5
页码：265-271
DOI：10.1007/s40037-021-00665-w
语种：English
出版社：Springer Verlag
摘要：IntroductionThis 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 learners, educators, and clinicians, and it may contribute to increased understanding of the importance of supportive learning environments and supervisors’ social skills within the context of medical education.