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Lindström, Ulf H.
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Publications (2 of 2) Show all publications
Lindström, U. H., Hamberg, K. & Johansson, E. E. (2011). Medical students' experiences of shame in professional enculturation. Medical Education, 45(10), 1016-1024
Open this publication in new window or tab >>Medical students' experiences of shame in professional enculturation
2011 (English)In: Medical Education, ISSN 0308-0110, E-ISSN 1365-2923, Vol. 45, no 10, p. 1016-1024Article in journal (Refereed) Published
Abstract [en]

Context: Despite the intentions of caregivers not to harm, medical encounters may involve intimidation and induce emotions of shame. Reflection is a critical part of professional learning and training. However, the role of shame in medical education has scarcely been studied. The aim of this study was to explore medical students’ reflections on shame-related experiences in clinical situations and to examine how they tackled these experiences.

Methods: A 24-credit course in Professional Development is held at the Medical School of Umeå University, Sweden. A 1-day seminar on the theme of shame, which involves individual reflections and group discussions, is held in term 9. Medical students were invited to individually consider and write down their memories of situations in which they had experienced shame in clinical encounters. Of a total of 133 students, 75 were willing to share their written reflections anonymously. Their essays were transcribed to computer text and analysed by means of qualitative content analysis.

Results: Three themes emerged. These included: Difficulties in disclosing shame; Shame-inducing circumstances, and Avoiding or addressing shame. Initially, students experienced problems in recalling shameful incidents, but successively described various situations which related to being taken by surprise, being exposed, and being associated with staff imprudence. Students disclosed shame avoidance behaviours, but also gave examples of how addressing shame provided them with new insights and restored their dignity.

Conclusions: Students’ reflections on shameful experiences elucidated the importance of attitudes, manners, standards and hierarchies in clinical situations. These are important issues to highlight in the professional enculturation of medical students; our emphasising of them may encourage medical teachers elsewhere to organise similar activities. Opportunities for mentoring medical students in tackling shame and adverse feelings, and in resolving conflict, are needed in medical curricula.

Place, publisher, year, edition, pages
Oxford: Blackwell Science, 2011
National Category
Educational Sciences Health Care Service and Management, Health Policy and Services and Health Economy
urn:nbn:se:umu:diva-47898 (URN)10.1111/j.1365-2923.2011.04022.x (DOI)000294865300008 ()
Available from: 2011-10-04 Created: 2011-10-03 Last updated: 2018-06-08Bibliographically approved
Lindström, U., Johansson, E., Bodlund, O. & Hamberg, K. (2008). Professionell utveckling: Så förs ämnet stegvis in i läkarutbildningen i Umeå. Läkartidningen, 105(12-13), 909-913
Open this publication in new window or tab >>Professionell utveckling: Så förs ämnet stegvis in i läkarutbildningen i Umeå
2008 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, no 12-13, p. 909-913Article in journal (Refereed) Published
Abstract [en]

Since the early 90's a course called Professional Development (PD) runs through all terms of Medical School in Umeå. The course has continuously been reformed on the basis of course evaluations. Today there is a well-reasoned progression in the curricula to synthesize students' actual knowledge level, skills, and attitudes into professionalism. The teaching items and the pedagogical methods in PU all aim to develop the students' reflective stance, gender awareness, empathy, ethical reasoning and consultations skills. Taking communication as an example: During the first terms, theories and small-group training sessions are introduced. By clinical courses, students video-tape their own consultations and get structured feedback in tutor-guided groups. The last terms, role plays on difficult clinical situations are staged for training, but also to challenge attitudes on for instance ethnicity and sexuality. Finally, insights in communication theories and their applicability are examined in a written video case exam.

Professionell utveckling
National Category
General Practice Pedagogical Work
urn:nbn:se:umu:diva-9412 (URN)
Available from: 2008-03-31 Created: 2008-03-31 Last updated: 2018-06-09Bibliographically approved

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