Humility in medical practice: a qualitative study of peer-nominated excellent clinicians.

ABSTRACT

BACKGROUND: Humility has recently been conceptualized as a positive, multifaceted attribute in fields outside of medicine, such as psychology and philosophy. In medicine, there has been limited study into the nature of humility and its role in clinical practice. We sought to develop a deeper understanding of humility in medical practice through the lived-experiences of peer-nominated excellent clinicians. METHODS: We conducted a qualitative study with secondary analysis of transcripts from individual open ended, semi-structured interviews of 13 peer nominated physicians [7 (54%) female] at an academic centre. Using constant comparative analysis, the transcripts were analyzed for instances where humility was discussed as it related to clinical practice. RESULTS: Participants perceived humility to be an important driver for excellence in clinical practice. This was further explained using two overarching themes an inward, intellectual perspective and an outward, social perspective. The physician's inward perspective was their view of their abilities and limits, their self-confidence, and their intellectual openness and adaptability to the limitations and evolving nature of knowledge in medicine. Their outward perspective was an understanding and appreciation for the larger system in which they worked, an openness to others, and valuing patients' experience. Through these perspectives, humility positively influenced clinical care, learning and curiosity, motivation in the care of others, and relationships with team members and patients. CONCLUSIONS: Humility in medicine is a rich, multifaceted construct that was perceived to be a driver for excellence in medical practice by peer-nominated excellent clinicians. Humility was seen as an active force in formulating and calibrating a clinician's perspective of self and of others, and as such, positively influencing clinical practice. These findings will help inform a discourse in medical education and faculty development about the important role of humility in medical practice.