Guilt, shame and negative emotion in undergraduate medical education: is there a role for Balint groups?

Abstract

Balint groups are a structured discussion which explores non-clinical aspects of the doctor–patient relationship. In this commentary piece we describe our experience of a Balint group for final-year medical students in a large regional hospital. We discuss that our participants reported a significant burden of negative emotion, primarily guilt and shame, in attempting to navigate the hospital environment as learners. We note how our participants perceived they would acquire the ability to manage these negative emotions simply by becoming doctors, despite being only a few months from qualification. A cultural shift in undergraduate training, combined with a challenging period for the medical profession in general, may leave new doctors isolated in the face of the emotional strain of medicine. We therefore encourage educators to consider using Balint groups as an adjunct to more traditional clinical training.

Shame, health literacy and consent

“…36 Thus, shame and related emotions frequently remain under-emphasized or entirely unappreciated, with clinicians still not trained to understand shame or its effects. 37 While the most obvious instances of health-related shame arise from the body or illness, non-corporeal shame may also arise in healthcare contexts, and hence be health-relevant. For instance, shame related to poverty, literacy levels, engagement with the criminal justice system, displacement, immigration status, trauma, class, other social dynamics or personal circumstances, may be a significant factor in how an individual interacts with healthcare professionals and services.…”

“…36 Thus, shame and related emotions frequently remain under-emphasized or entirely unappreciated, with clinicians still not trained to understand shame or its effects. 37…”