The Psychology of Shame: A Resilience Seminar for Medical Students.

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Shame is a powerful emotion that can cause emotional distress, impaired empathy, social isolation, and unprofessional behavior in medical learners. However, interventions to help learners constructively engage with shame are rare. This module educated medical students about shame, guided them through an exploration of their shame experiences, and facilitated development of shame resilience.


In this 2-hour workshop, clinical-year medical students were guided through the psychology of shame through didactic slides. Next, a small panel of volunteer students, recruited and coached prior to the workshop, shared reflections on the content, including their shame experiences during medical school. This was followed by didactic slides outlining strategies to promote shame resilience. Participants then broke into faculty-led small groups to discuss session content. The module included a small-group facilitator guide for leading discussions on shame, didactic slides, discussion prompts, an evaluation tool, and a film entitled The Shame Conversation that was created after the initial workshop.


A retrospective pre/postsurvey revealed statistically significant increases in: (1) importance ascribed to identifying shame in one's self or colleagues, (2) confidence in one's ability to recover from a shame reaction, and (3) comfort in reaching out to others when shame occurs. Analysis of open-ended questions showed that students felt the seminar would enhance future resilience by helping them identify and normalize shame, distinguish shame from guilt, and reach out to others for help.


This workshop appears to prepare students to more constructively engage with shame when it occurs in medical training.





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Publication Info

Bynum, William E, Sebastian Uijtdehaage, Anthony R Artino and James W Fox (2020). The Psychology of Shame: A Resilience Seminar for Medical Students. MedEdPORTAL : the journal of teaching and learning resources, 16(1). p. 11052. 10.15766/mep_2374-8265.11052 Retrieved from

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William Edwards Bynum

Associate Professor in Family Medicine and Community Health

Since arriving to Duke in October 2017, I have enjoyed a highly rewarding mix of patient care, teaching, and research.  Prior to coming to Duke, I served seven years on active duty in the US Air Force, during which I served as faculty in the NCC Family Medicine Residency (Fort Belvoir, VA), deployed to Djibouti in support of regional operations, and served multiple congressional delegations as a traveling physician.

I currently have the privilege of 1) providing outpatient primary care to patients from the Durham region, 2) educating Duke family medicine residents, medical students, and physician assistant students, 3) serving as the Associate Program Director of the Duke Family Medicine Residency, and 4) researching self-conscious emotion (shame, guilt, & pride) in medical learners.  In addition to ongoing empiric research, I have given numerous seminars, grand rounds, and workshops on shame in medical education, both here at Duke and in other organizations and national meetings.  I am excited by Duke's commitment to building supportive, psychologically safe learning environments and very much look forward to contributing to these ongoing efforts.


James Walter Fox

Professor of Pediatrics

Dr. Fox is a clinician-educator whose clinical practice is based in the Duke Pediatric Emergency Department.  His educational efforts are directed at learners across the medical education spectrum: from medical, nurse practitioner, and physician assistant students to residents/fellow to experienced clinicians.  In addition to teaching about clinical entities he commonly encounters on a day-to-day basis in the Pediatric emergency department, Dr. Fox has special interests in clinical decision-making (specifically the transition from novice to expert thinking), diagnostic errors, and evidence-based clinical practice.  

Dr. Fox enjoys delivering interactive teaching sessions on these topics and looks to collaborate with others interested in these topics as well.

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