Development and Initial Validation of the Shame Frequency Questionnaire in Medical Students

Authors

William E. Bynum, W.E. Bynum is associate professor, Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina; ORCID: https://orcid.org/0000-0003-3796-9301.
Ting Dong, T. Dong is research associate professor, Center for Health Professions Education, Uniformed Services University, Bethesda, Maryland; ORCID: https://orcid.org/0000-0002-4939-6865.
Sebastian Uijtdehaage, S. Uijtdehaage is professor, Center for Health Professions Education, Uniformed Services University, Bethesda, Maryland; ORCID: https://orcid.org/0000-0001-8598-4683.
Franz Belz, F. Belz is a fourth-year medical student, Duke University School of Medicine, Durham, North Carolina; ORCID: https://orcid.org/0000-0002-6538-1014.
Anthony R. Artino, A.R. Artino is professor, Department of Health, Human Function, and Rehabilitation Sciences, School of Medicine and Health Sciences, George Washington University, Washington, DC; ORCID: https://orcid.org/0000-0003-2661-7853.

Document Type

Journal Article

Publication Date

3-22-2024

Journal

Academic medicine : journal of the Association of American Medical Colleges

DOI

10.1097/ACM.0000000000005713

Abstract

PURPOSE: This study presents the steps taken to develop and collect initial validity evidence for the Shame Frequency Questionnaire in Medical Students. METHOD: The instrument was based on a 7-step survey design; validity evidence was collected from content, response process, internal structure, and relationship to other variables. A literature review and qualitative interviews led to the design of the initial 16-item scale. Expert review and cognitive interviewing led to minor modifications in the original structure. Initial pilot testing was conducted in August 2019 in Uniformed Services University (USU) medical students; reliability assessment and exploratory factor analysis were performed. The revised 12-item scale was tested in January 2022 in Duke University School of Medicine medical students; reliability assessment, exploratory factor analysis, and correlation analysis with depression, burnout, anxiety, emotional thriving, and emotional well-being were performed. RESULTS: A total of 336 of 678 USU students (50%) and 106 of 522 Duke students (20%) completed the survey. Initial exploratory factor analysis of the USU data revealed 1 factor (shame), and 4 items were dropped from the scale according to predefined rules. Subsequent exploratory factor analysis of the Duke data revealed 1 factor; no further items were removed according to predefined rules. Internal consistent reliability was 0.95, and all interitem correlations were less than 0.85 for USU and Duke samples. As predicted, mean shame scale scores were positively correlated with anxiety (r = 0.54, P < .001), burnout (r = 0.50, P < .001), and depression (r = 0.47, P < .001) and negatively correlated with emotional thriving (r = -0.46, P < .001) and emotional recovery (r = -0.46, P < .001). CONCLUSIONS: The Shame Frequency Questionnaire in Medical Students is a psychometrically sound instrument with strong internal reliability and multisource validity evidence, supporting its use in studying shame in medical students.

APA Citation

Bynum, William E.; Dong, Ting; Uijtdehaage, Sebastian; Belz, Franz; and Artino, Anthony R., "Development and Initial Validation of the Shame Frequency Questionnaire in Medical Students" (2024). GW Authored Works. Paper 4492.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4492

Department

Health, Human Function, and Rehabilitation Sciences