Shame and Guilt in Health Professions Learners: Building Resilience and Fostering a Healthy Learning Environment

Lecture by: Anthony R. Artino, Jr., PhD

Learning to become a health professional is an emotionally charged undertaking. Consider the second-year medical resident who is preparing to conduct a clinical procedure for the first time. She probably hopes for success, worries about failure, and feels ashamed if the procedure goes poorly. These emotions—hope, worry, and shame—have the potential to influence her motivation, the effort she puts forth, and even her professional identity as a doctor. Historically, such emotions have received little attention in health professions education. More recently, however, educators and researchers alike have acknowledged the importance of emotions and their role in learning to become a health professional. The purpose of this plenary is to raise awareness about emotions in health professions education, introduce the self-conscious emotions of shame and guilt, and describe how shame—a potentially destructive emotion—might manifest during training. Using theory, research, and a series of authentic stories from medical education, the session will help both educators and trainees better comprehend the role of emotions in health professions education; recognize the value of shame resilience; develop specific strategies for constructively engaging with shame; and create learning environments that facilitate adaptive responses to shame.

By the end of the presentation, attendees will be able to…

  1. Discuss emotions and appreciate that emotions can have significant influences on learning, performance, and wellbeing in health professions education;
  2. Recognize shame and guilt and distinguish them from one another;
  3. Describe the relationship between shame, perfectionism, and motivation to learn;
  4. List specific strategies to (a) constructively engage with shame when it occurs and (b) create learning environments that facilitate adaptive responses to shame.

Anthony R. Artino, Jr., PhD, is a Professor of Medicine and Deputy Director for Graduate Programs in Health Professions Education (HPE) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. He holds a joint appointment in the Department of Preventive Medicine and Biometrics. A graduate of the University of Connecticut with a PhD in educational psychology, Dr. Artino mentors graduate students and teaches in the HPE degree programs, as well as the Master of Health Administration and Policy and the Master of Public Health degree programs. As a researcher, he is the Principal Investigator (or Associate Investigator) on several funded research projects totaling more than $7.9 million. In this role, Dr. Artino collaborates with a team of scientists trained in a variety of academic disciplines, including psychology, epidemiology, physiology, medicine, and English. This interdisciplinary team studies various aspects of human motivation, learning, and performance in medical education.

Dr. Artino is a Deputy Editor for the Journal of Graduate Medical Education, an Assistant Editor for Academic Medicine, and is on the editorial boards of several peer-reviewed journals, including Military Medicine, Military Psychology, and The Internet and Higher Education. Dr. Artino has published more than 110 peer-reviewed journal articles on learning and motivation, survey design, and online education. Over the last 10 years, he has presented over two dozen survey-design workshops at national and international meetings around the globe.