‘You put up a certain attitude’: a 6-year qualitative study of emotional socialisation

Abstract

Context Emotions play a central role in the professional development of doctors; however, research into how students are socialised to deal with emotions throughout medical school is still lacking. Objectives This study aimed to gain a better understanding of the emotional socialisation of medical students (e.g. how they learn to express and respond to emotions evoked in clinical practice in the process of becoming a doctor). Methods In this longitudinal study, 12 medical students participated in annual, individual, semi‐structured interviews, capturing the full 6‐year medical school period. We carried out a thematic analysis, which was iterative and inductive. Results The socialisation of emotion in the process of becoming a doctor happens in a complex interplay between student and context. We identified two modes of emotional socialisation (e.g. explicit and implicit teaching about emotions), the latter including how the people observed by students express their emotions and how they respond to the emotions expressed by students. Although the main message conveyed to students still seemed one about hiding or suppressing emotion, we found that students were able to identify and build upon the emotional expression and responses they observed in positive role models and managed to create their own opportunities to express their emotions. We found large differences between students in how they perceived, presented and developed themselves. Conclusions Students differ in how they respond to and what they need from their environment and thus may benefit from tailored supervision in learning how to experience, express and respond to emotion. Providing students with real and authentic responsibility for patients and allowing them time and opportunity to talk about emotion might help them to create an emotional space.

Emotional socialisation and burnout in medicine and the role of medical educators

“…The extent to which medical curricula equip medical students and junior doctors to deal with the emotions they encounter in clinical practice is open to debate. Some contend that the majority of medical curricula do not have an explicit focus on how to best manage, regulate and express emotions . In addition, little is known about how medical students and junior doctors are educated and socialised about emotions by the health care professionals they encounter during their training …”

“…Medical students and trainees are said to strive to retain a sense of control in clinical practice, which is challenging, given the rapidly evolving nature of health care . Recent studies highlight the need for a renewed focus on helping medical students and junior doctors to understand that emotional responses, such as feeling out of control, are an inevitable part of delivering health care and should not be repressed or avoided. Depression in medical students is associated with year of study, gender, personal issues, family relationships and health status .…”

“…Depression in medical students is associated with year of study, gender, personal issues, family relationships and health status . The number and nature of the factors associated with burnout add credence to the notion that medical students and junior doctors require bespoke support to enable them to experience, express and regulate their emotions because unregulated emotions can influence the quality of the medical care they deliver. Medical schools and postgraduate educational organisations endeavour to provide person‐centred well‐being and mental health support to medical students and junior doctors.…”

“…'s findings about prevalences of depression amongst medical students across the world highlight the imperative to improve the emotional support that is provided by senior doctors and other health care professionals in clinical practice. Positive role models who are able to articulate their own emotions in an honest and authentic manner have been reported to convey the importance of recognising, dealing with and expressing emotions to medical students . This suggests that professional socialisation and mentorship play central roles in the development of emotional competence in those working in medicine.…”

“…Some contend that the majority of medical curricula do not have an explicit focus on how to best manage, regulate and express emotions. 3,5 In addition, little is known about how medical students and junior doctors are educated and socialised about emotions by the health care professionals they encounter during their training. 5 Emotions have physiological and cognitive elements, but are also shaped by cultural practices and social influences…”