Feeling a Little Self-Conscious? Who Am I, and Who Do I Strive to Be? Applying a Theory of Self-Conscious Emotions to Medical Education. Bynum WE, Artino AR. Academic Medicine. 93(6):874–880.

posted in: 2018 Journal Clubs, July 2018 | 0


Reviewed by Fatima Aly

What was the study question?
What is self-conscious emotion and what impact does it have on medical learners, especially in
regards to professional identity formation, motivation and perfectionism?

How was the study done?
The authors conducted a literature review and summarized the topic of self-conscious emotion,
with special emphasis on Tracy and Robin’s Model of Self-Conscious Emotions, which focuses
on the emotions of guilt, shame and pride. They then identified and applied these concepts to
current research in medical education, training and professional development.

What were the results?
Tracy and Robin’s Model distinguishes between self-conscious emotions that attribute credit or
blame for behaviors to immutable character of the individual (hubristic pride or shame,
respectively) and emotions that attribute credit or blame to the action itself (authentic pride or
The authors used this framework to develop a series of research questions that might follow
from the model in the areas of perfectionism, professional identity formation and motivation.
They hypothesize that emotions that focus on the individual rather than the action are

What are the implications of these findings?
Critical analysis of self-conscious emotion might be used in medical education and professional
development to facilitate processes in achieving adaptive perfectionism (as opposed to
maladaptive perfectionism), positive professional identity and motivation for lifelong learning.
It may be useful to promote wellness and mindfulness in both the learner and the teacher. This
might include emotional resilience training in medical school and residency training to
constructively process self-conscious emotion.
Current knowledge in this area, however, is minimal and research in this area is needed.

Editor’s Note: This line of research would also be useful in helping students use feedback
effectively. I suspect it is an almost universal tendency to hear feedback as a an attack on one’s
self –at least initially. (JG)