'I too can be a good physician who still makes mistakes': Exploring medical students' emotions and emotional regulation towards mistakes

PURPOSE: Medical mistakes evoke intense emotions among trainees and are often framed through shame and distress. This study explores how medical students respond emotionally to clinical mistakes and how they regulate those emotions through reflective writing after hearing health professionals share stories of error.

METHODS: We conducted a qualitative descriptive study analyzing reflective essays from 21 medical students following a panel on clinical mistakes. Thematic analysis was guided by Gross's Process Model of Emotional Regulation, while allowing for inductive themes to emerge.

RESULTS: Students described a range of emotional responses, including fear, guilt, and shame, rooted in personal histories and the culture of medicine. Emotional regulation strategies included cognitive reappraisal, response modulation, and metacognitive reflection. Students demonstrated self-awareness, growth mindset, and commitments to personal accountability. Students also emphasized the importance of help-seeking and social support in navigating emotionally challenged experiences.

CONCLUSIONS: Mistakes in medicine are emotionally complex and shaped by systemic and cultural forces. Reflective writing can foster adaptive emotional regulation and support professional identity development. Structuring emotionally safe learning environments is critical to transforming the culture around medical errors.