Emotions and Learning in Medical Education: Studies in Feedback and Remediation

Research across multiple fields has revealed the importance of emotion and other psychological factors in the learning process, but the medical education literature does not extensively describe how medical learners’ emotions affect their learning. In this thesis, we aim to examine this concept in settings where learners’ emotions are likely to be high and have large effect on their learning: feedback and remediation. The work approaches the topic from multiple angles. First, we investigate how feedback orientation, a concept developed in management science and related to individuals’ innate attitudes toward and beliefs about feedback, applies to medical learners and how it relates to other psychological factors that affect learning. We then turn to the setting where feedback is arguably most urgent: remediation. A literature review maps the current landscape of incorporation of emotion into remediation programs and a book chapter covers the known literature about the learner’s perspective on remediation. A qualitative study then adds to that information by exploring learners’ experiences of remediation in the U.S. and the Netherlands. This work is applied via mapping onto two existing frameworks, the Master Adaptive Learner framework in education and the SPIKES framework in clinical medicine. Finally, we expand outward to describe other areas where emotion is relevant to medical education and deserves more study. Through these works, we aim to shed light on the specific roles emotion plays in learning in these high-stakes settings, and also argue for greater attention to emotion in medical education more broadly.