Investigation on the impact of shame in heathcare

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Researchers are to investigate impact of shame on doctors, medical students and patients as part of major new study.

Patients, doctors and medical students will share their experiences of shame as part of a new project that aims to understand the impact that the emotion has on healthcare.

The project, which is funded by Wellcome, will be run by Dr Matthew Gibson from the Department of Social Work and Social Care at the University of Birmingham, Dr Luna Dolezal from the University of Exeter, and Dr Barry Lyons a Consultant Anaesthetist and Bioethicist at Children's Health Ireland hospital in Dublin. 

Existing research indicates that shame can play a significant role in the clinical encounter. It can lead to patients avoiding treatment and concealing illness. It may also influence how doctors interact with their patients, and their colleagues, and appears related to burn out, suicide and mental health problems among those working in the medical profession. Shame also seems to be frequently experienced by medical students during their training.

Dr Gibson said, “We will be developing new ways to research shame so we can really understand the role it plays in medicine. We know from experience that we don’t talk about shame very much, but we also know from research it can have a very big impact on what people do and how they do it. What we don’t know is what kind of an impact it has in medicine and healthcare.”

Dr Dolezal said, “Shame is such a taboo emotional experience that it is very hard to investigate, but by examining different aspects of the medical profession, as well as popular culture and patient experiences, we can analyse its impact. Shame can be harmful, but it isn’t always a negative force.”

Dr Lyons said, “It is suggested that shame arises in doctors and medical students as a combination of the educational and regulatory environments, and an inherent tendency to perfectionism. We will be reaching out to communities to try to understand professionals’ experiences, and how their emotions impact upon their relationships with other clinicians, students, and patients.”

The project proposes to identify and evaluate real-time experiences of shame within the NHS. Researchers hope this will lead to more understanding of how shame can get in the way of positive healthcare experiences, for both patients and doctors.

Experts will analyse the impact of shame on patient experiences, as well as how, when, and why, medical professionals, and students, experience shame and the influence that these experiences have on their motivation, wellbeing, and developing sense of professional identity.

A series of workshops will be organised throughout the project with medical educators, students, relevant advisory board members and collaborators to develop recommendations for medical schools. The study will also result in a new book about shame for healthcare professionals, academics, and students working in medical schools.