Research network hosts first Duke Kunshan workshop on resilience

The prevalence of shame in the medical field was highlighted at the first Duke Kunshan University workshop on resilience.

Will Bynum, associate professor in family medicine and community health at Duke University, called on his own experience of making a mistake in theater as he told the DKU Resilience Research Network panel of the need to “bring shame out of the shadows of health care”.

Also addressing the June 29 event was Sulfikar Amir, associate professor of science, technology and society at Nanyang Technological University (NTU) in Singapore, whose research into social resilience has covered the 2011 Fukushima nuclear disaster in Japan and the COVID-19 crisis in Southeast Asia.

The Duke Kunshan network was founded in October last year by five DKU scholars with the shared aim of building an interdisciplinary framework for understanding resilience in health care and wellbeing.

Funded by the undergraduate studies and interdisciplinary offices at Duke Kunshan, its membership is drawn from fields including global health, neuroscience, psychology, and computation and design.

The founding directors (pictured above, left to right) are Lijing Yan, professor of global health; Shan Wang, assistant professor of psychology; Chenkai Wu, assistant professor of global health; Xin Tong, assistant professor of computation and design; and Sze Chai Kwok, associate professor of neuroscience.

Undergraduate students are encouraged to participate in network activities and carry out research with faculty supervision. Several from the classes of 2022-2025 — Lingli Tang, Fei (Cara) Wu, Tzu-Ying (Jean) Chuang, Meichen Yap and Xulei Huang – have already been closed involved.

In a powerful account, guest Bynum told the Zoom event how a non-fatal error he made during a childbirth procedure as a second-year resident doctor triggered an intense emotional response in him and a compulsion to investigate shame in medical settings.

Will Bynum

He found that feelings of shame — defined as a painful self-conscious emotion occurring typically in response to a triggering event when an individual assesses their global self to be flawed, deficient or unworthy — were widespread in medical students and resident doctors, often leading to a crisis of identity, confidence and self-worth in individuals.

Triggers ranged from committing medical errors with fatal or severe consequences for patients to students who were gripped by perfectionism and constantly comparing themselves to others.

“Health care is filled with sentinel events that can lead to significant morbidity and mortality in the patient. Shame experiences may be sentinel emotional events that cause significant emotional morbidity in health care providers,” Bynum said.

The family medicine physician warned that the failure in particular of men to address their feelings of shame was a source of concern given that so many males held senior positions in the field.

Asked in the discussion about the possibility of overcoming shame, he said, “Shame absolutely has the potential to catalyze resilience development.

“The way in which a person engages with that experience — whether they really move through it or proactively engage with it versus running away, avoiding or repressing it — does seem to have some influence or impact on the ways in which they might respond to future threats or future shame.

“There are individual characteristics that seem to confer shame susceptibility versus resilience but the environment is also critical to that.”

Introducing social resilience as an academic framework, Amir told the panel it had been the subject of study across a wide range of fields such as engineering, psychology, economics, sociology and anthropology.

The faculty member of the sociology program at NTU’s School of Social Sciences said resilience was first studied as an academic concept in the 1970s by biologists and ecologists, who were wondering how nature was able to recover after long-term changes to the environment.

In the 1980s, child psychologists started observing how young people recovered from psychological disturbances, before engineers took an interest as they looked to improve the robustness and reliability of systems facilitating the likes of airplanes, highways and the internet.

“It was not until around the 2000s that social scientists began to pay attention to resilience,” he said.

“In general, we can say that resilience is defined as the capacity to bounce back and this definition is widely accepted by different fields. The thing is resilience has different meanings to different fields.”

Sulfikar Amir

Much of Amir’s own research on the topic explores questions surrounding the capacity for people and organizations to respond to crises, such as natural disaster, resource scarcity and social change.

He said individuals and communities were key to developing resilience, but their efforts would be meaningless without institutional structures.

“Social resilience is a phenomenon that is determined by institutions,” Amir said.

“Institutions and organizations are the ones that facilitate cooperation and collaboration, which are considered to be the basis of resilience capacity.

“You cannot respond to a crisis without cooperating with one another. You cannot achieve recovery without collaborating with different entities and groups.”

Lingli Tang is one of several students to have worked with the network

Yan, one of the network directors, said they were excited to host the workshop.

“Our fledging network epitomizes the interdisciplinary nature of DKU’s research,” she said. “We hope to continue our research and create a hub for all faculty, staff, and students interested in studying resilience, especially human resilience for promoting people’s wellbeing during the COVID pandemic and beyond.”

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Gareth McPherson

Email: gareth.mcpherson@dukekunshan.edu.cn

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