title: Perception of Shame in Otolaryngology-Head and Neck Surgery Training.
abstract: OBJECTIVE
  This survey was developed to assess the prevalence and effects of the perception of shame in otolaryngology-head and neck surgery residency training in the United States.
  
  
  METHODS
  Survey.
  
  
  METHODS
  US otolaryngology training programs.
  
  
  METHODS
  Faculty and trainees in US otolaryngology training programs.
  
  
  METHODS
  A 14-item survey to assess the prevalence of the experience of shame and the attitudes toward use of shame in otolaryngology residency training was sent to all otolaryngology-head and neck surgery program directors for distribution among their respective faculty and resident cohorts.
  
  
  RESULTS
  A total of 267 responses were received (women, 24.7%; men, 75.3%): 42.7% of respondents were trainees; 7.0% of trainees thought that shame was a necessary/effective tool, compared with 11.4% of faculty; 50% of respondents felt that they had been personally shamed during residency; and 69.9% of respondents had witnessed another trainee being shamed during residency training. Trainees were most commonly shamed in the operating room (78.4%). Otolaryngology faculty members did the shaming 95.1% of the time. Although shaming prompted internal reflection/self-improvement in 57.4% of trainees, it also caused loss of self-confidence in 52.5%. Trainees who had been shamed were more likely to view shame as an appropriate educational tool (P < .05).
  
  
  CONCLUSIONS
  Half of respondents have felt shamed during their residency training, and a majority has witnessed a colleague being shamed. Understanding the negative impact that shaming behaviors have on the learning environment and on the performance of the individual within it is an important first step in creating an environment maximally conducive to learning, professional development, and patient safety.
authors.affiliation: Department of Surgery, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA kevin.mcmains@va.gov.
authors.forename: Kevin Christopher
authors.initials: KC
authors.lastname: McMains
authors.affiliation: University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Peel
authors.affiliation: Department of Surgery, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA.
authors.forename: Erik K
authors.initials: EK
authors.lastname: Weitzel
authors.affiliation: University of Vermont College of Medicine, Burlington, Vermont, USA.
authors.forename: Hirak
authors.initials: H
authors.lastname: Der-Torossian
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, USA.
authors.forename: Marion
authors.initials: M
authors.lastname: Couch
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000193:education*; D010465:Perception / Q000502:physiology*; D012752:Shame; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States
keywords: education; environment of learning; faculty; otolaryngology; teaching