Measuring shame exposure & its associations

Piloting, validating, & employing a shame frequency scale (funding provided by the Duke Department of Family Medicine & Community Health)

In researching shame, its complexity and ubiquity present both challenges and opportunities. Attempting to capture the depth of this emotion (which is theoretically infinite given its uniquely individualized nature) and its breadth (which is difficult given its lack of universality) within a single study--or even single line of inquiry--is impossible. And trying to research shame will remaining firmly rooted in a single philosophical stance (e.g., constructivism vs. post-positivism) is also impossible, and futile. 

This is where the complexity of shame presents opportunities for researchers willing to broaden their philosophical and methodological horizons.  

Having largely explored shame qualitatively--a line of inquiry that has been helpful in characterizing the depth and complexity of shame but not its broader prevalence, impact, or associations--we have expanded our research to quantitatively explore shame. We are initially conducting this arm of our research in medical trainees with plans to expand broadly into healthcare and other professional settings.

Anchoring this research program is a 12-item survey instrument we developed and validated to measure the frequency of shame feelings--or "shame exposure"--over the previous three months of a medical learner's training. We applied a rigorous and scholarly approach to developing the survey, and the results of two exploratory factor analyses plus descriptive statistics showed strong evidence to support its intended use evaluating shame frequency in medical learners.

The paper outlining its development and initial validation is scheduled to be published in Academic Medicine in 2024. 

We are planning follow on studies to explore the prevalence and epidemiology of shame in medical learners and healthcare professionals. This will include exploring relationships among shame and factors such as gender, race/ethnicity, specialty, etc. These data will provide different, meaningful, and complementary insights relative to those yielded by our qualitative research program, and we will share updates as they become available.