Addressing the Elephant in the Room: A Shame Resilience Seminar for Medical Students.

PROBLEM: Medical schools face the challenge of developing efficacious resources to promote well-being and foster resilience in students. The authors developed, implemented, and evaluated a shame resilience seminar for second-year clerkship medical students. APPROACH: In February 2018, the authors conducted a 2.5-hour seminar (part of a longitudinal series) about shame, a common and potentially damaging emotion. The seminar consisted of a large-group session to introduce the psychology of shame, during which speakers shared their personal experiences with the emotion. Next, a small-group session allowed students to discuss their reactions to the large-group content in a safe and familiar environment. Before the seminar, faculty development was provided to small-group leaders (upper-level medical students and faculty) to increase their comfort leading discussions about shame. Students completed a pre/post retrospective survey immediately following the seminar. OUTCOMES: The authors found statistically significant increases in students' confidence in identifying shame and differentiating it from guilt; in their attitudes regarding the importance of identifying shame reactions in themselves and others; and in their willingness to reach out to others during a shame reaction. Surveys of group leaders revealed no reports of significant student distress during or after the seminar. NEXT STEPS: This seminar represents a reproducible means of promoting shame resilience in medical students. The speakers' personal shame experiences and the safety of the small groups for discussions about shame were central to the seminar's apparent success. Next steps include developing an empirically derived, longitudinal shame resilience curriculum spanning the medical school years.

Duke Scholars

Author William Edwards Bynum IV Family Medicine and Community Health, Family Medicine

Author James Walter Fox Pediatrics, Emergency Medicine