How Physicians Learn to Say "I'm Sorry": Power, Culture, and Apology in Medical Education
Background: Apologizing after a medical error is a vital component of ethical, patient-centered care. Sincere apologies can restore trust, reduce distress, and support healing. Yet the ability to apologize is not instinctive, it is shaped by institutional culture, power dynamics, and educational exp...
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| Language: | English |
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Mashhad University of Medical Sciences
2025-07-01
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| Series: | Future of Medical Education Journal |
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| Online Access: | https://fmej.mums.ac.ir/article_26331_268cb748278187eca30f4a0991ac28ea.pdf |
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| author | Stephanie Quon Sarah Low Sarah Zhou Katherine Zheng |
| author_facet | Stephanie Quon Sarah Low Sarah Zhou Katherine Zheng |
| author_sort | Stephanie Quon |
| collection | DOAJ |
| description | Background: Apologizing after a medical error is a vital component of ethical, patient-centered care. Sincere apologies can restore trust, reduce distress, and support healing. Yet the ability to apologize is not instinctive, it is shaped by institutional culture, power dynamics, and educational exposure. Despite increasing emphasis on disclosure training, no prior synthesis has thoroughly examined how medical students are taught to apologize or how sociocultural factors influence this learning. This scoping review explores how medical students learn to apologize in clinical settings, focusing on formal curricula, faculty role modeling, institutional norms, and emotional skill development.Method: Using Arksey and O’Malley’s framework, refined by Levac et al., and reported per PRISMA-ScR guidelines, we searched PubMed, MEDLINE, Scopus, ERIC, and Google Scholar. Peer-reviewed articles published in English from 2000-2024 were included if they addressed apology or error disclosure in undergraduate medical education. Two reviewers conducted independent screening and data extraction. Studies were thematically analyzed across five domains: curriculum, faculty role modeling, institutional culture, emotional skills, and outcomes.Results: Seventeen studies met inclusion criteria. Interventions such as simulations, communication frameworks, and patient safety exercises improved students’ confidence in disclosure. Faculty role modeling had strong influence, though observed apologies were often inadequate. Hidden curricula and hierarchies hindered authentic communication. Empathy training facilitated sincere apologies, yet few programs assessed long-term behaviors or addressed structural barriers.Conclusion: Teaching apology in medicine requires more than communication skills, it demands longitudinal, systems-based efforts that foster humility, transparency, and institutional accountability. |
| format | Article |
| id | doaj-art-165acf12a0664bb0a012ac1da824f400 |
| institution | Kabale University |
| issn | 2251-8347 2251-8355 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Mashhad University of Medical Sciences |
| record_format | Article |
| series | Future of Medical Education Journal |
| spelling | doaj-art-165acf12a0664bb0a012ac1da824f4002025-08-20T03:27:28ZengMashhad University of Medical SciencesFuture of Medical Education Journal2251-83472251-83552025-07-01152414710.22038/fmej.2025.87450.164126331How Physicians Learn to Say "I'm Sorry": Power, Culture, and Apology in Medical EducationStephanie Quon0Sarah Low1Sarah Zhou2Katherine Zheng3Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, CanadaDepartment of Microbiology and Immunology, Faculty of Science, University of British Columbia, Vancouver, CanadaDepartment of Microbiology and Immunology, Faculty of Science, University of British Columbia, Vancouver, CanadaDepartment of Microbiology and Immunology, Faculty of Science, University of British Columbia, Vancouver, CanadaBackground: Apologizing after a medical error is a vital component of ethical, patient-centered care. Sincere apologies can restore trust, reduce distress, and support healing. Yet the ability to apologize is not instinctive, it is shaped by institutional culture, power dynamics, and educational exposure. Despite increasing emphasis on disclosure training, no prior synthesis has thoroughly examined how medical students are taught to apologize or how sociocultural factors influence this learning. This scoping review explores how medical students learn to apologize in clinical settings, focusing on formal curricula, faculty role modeling, institutional norms, and emotional skill development.Method: Using Arksey and O’Malley’s framework, refined by Levac et al., and reported per PRISMA-ScR guidelines, we searched PubMed, MEDLINE, Scopus, ERIC, and Google Scholar. Peer-reviewed articles published in English from 2000-2024 were included if they addressed apology or error disclosure in undergraduate medical education. Two reviewers conducted independent screening and data extraction. Studies were thematically analyzed across five domains: curriculum, faculty role modeling, institutional culture, emotional skills, and outcomes.Results: Seventeen studies met inclusion criteria. Interventions such as simulations, communication frameworks, and patient safety exercises improved students’ confidence in disclosure. Faculty role modeling had strong influence, though observed apologies were often inadequate. Hidden curricula and hierarchies hindered authentic communication. Empathy training facilitated sincere apologies, yet few programs assessed long-term behaviors or addressed structural barriers.Conclusion: Teaching apology in medicine requires more than communication skills, it demands longitudinal, systems-based efforts that foster humility, transparency, and institutional accountability.https://fmej.mums.ac.ir/article_26331_268cb748278187eca30f4a0991ac28ea.pdfeducationmedicalapologymedical errorsdisclosurecurriculum |
| spellingShingle | Stephanie Quon Sarah Low Sarah Zhou Katherine Zheng How Physicians Learn to Say "I'm Sorry": Power, Culture, and Apology in Medical Education Future of Medical Education Journal education medical apology medical errors disclosure curriculum |
| title | How Physicians Learn to Say "I'm Sorry": Power, Culture, and Apology in Medical Education |
| title_full | How Physicians Learn to Say "I'm Sorry": Power, Culture, and Apology in Medical Education |
| title_fullStr | How Physicians Learn to Say "I'm Sorry": Power, Culture, and Apology in Medical Education |
| title_full_unstemmed | How Physicians Learn to Say "I'm Sorry": Power, Culture, and Apology in Medical Education |
| title_short | How Physicians Learn to Say "I'm Sorry": Power, Culture, and Apology in Medical Education |
| title_sort | how physicians learn to say i m sorry power culture and apology in medical education |
| topic | education medical apology medical errors disclosure curriculum |
| url | https://fmej.mums.ac.ir/article_26331_268cb748278187eca30f4a0991ac28ea.pdf |
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