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A Piece of My Mind
December 15, 2015

From Shame to Guilt to Love

Author Affiliations
  • 1Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland; and Departments of Anesthesiology & Critical Care Medicine, Surgery, and Health Policy and Management, Johns Hopkins University, Baltimore, Maryland
  • 2Departments of Psychiatry and Behavioral Sciences and Mental Health, Johns Hopkins University, Baltimore, Maryland
JAMA. 2015;314(23):2507-2508. doi:10.1001/jama.2015.11521

Several months ago, one of us (P.J.P.) attended a quality-of-care conference and spoke candidly and confidentially with several medical students and residents from around the United States. These students and trainees, our future leaders of health care quality, were both excited about advances in the field and distressed about responses to their errors.

One surgical resident described being chastised and shamed for obtaining an endocrine consult for a patient he was uncomfortable managing on his own, when none of his seniors on the surgical team responded to his pages. Multiple residents and students described being shamed by senior clinicians for voicing their concerns during past clinical cases, learning to stay quiet even when they perceived risks.

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