Department of Medical Education Research, Isfahan University of Medical Sciences, Isfahan, Iran


Emotions are universal in academic and clinical settings. A student is likely to hope for success,
maybe be worried about failure, or may feel comfortable after an exam. These feelings undoubtedly
affect his/her motivation, effort, academic performance, and progress. This study aimed to investigate
the role of emotion in the learning and performance of medical students and its mechanism. This
study was a scoping review conducted in 2022 to examine the role of emotions in medical education.
The three databases PubMed, ERIC, and Science Direct and the search engine Google Scholar
were searched using the following keywords: “emotion,” “medical student,” “teaching,” “learning,”
and “medical education.” English articles published from 2010 to 2022 were reviewed, and finally,
34 articles that met the inclusion criteria were reviewed. Review of the selected articles showed that
there was a significant relationship between the cognitive system and emotions in the brain. The
conceptual framework of the relationship between cognition and emotion can be explained in the
form of dimensional and discrete views of emotions and based on cognitive load theory. Emotions
affect cognition with the four mechanisms of memory, cognitive resources, cognitive strategies,
and motivation and can be effective in learning self‑regulation, clinical reasoning, and academic
achievement of medical students. Emotions in medical education is a double‑edged sword. In other
words, it is highly recommended to divide emotions into activating and inactivating, instead of dividing
them into positive and negative ones. In this context, medical educators can use the positive aspects
of nearly all emotions to improve the quality of their teaching.


  1. LeBlanc VR, McConnell MM, Monteiro SD. Predictable chaos:
    A review of the effects of emotions on attention, memory and
    decision making. Adv Health Sci Educ 2015;20:265‑82.
    2. Sheikhbardsiri H, Sheikhasadi H, Mahani SA, Mohamadi MMD.
    Emotional intelligence and learning strategies of postgraduate
    students at Kerman University of Medical Sciences in the
    southeast of Iran. J Educ Health Promot 2020;9:66.
    3. Jennings PA, Greenberg MT. The prosocial classroom: Teacher
    social and emotional competence inrelation to student and
    classroom outcomes. Rev Educ Res 2009;79:49.
    4. Tyng CM, Amin HU, Saad MNM, Malik AS. The influences of
    emotion on learning and memory. Front Psychol 2017;8:1454.
    5. KremerT, Mamede S, MartinsMA, TempskiP, van den BroekWW.
    Investigating the impact of emotions on medical students’
    learning. Health Prof Educ 2019;5:111‑9.
    6. Artino AR Jr, Holmboe ES, Durning SJ. Can achievement
    emotions be used to better understand motivation, learning, and
    performance in medical education? Med Teach 2012;34:240‑4.
    7. Omid A, Haghani F, Adibi P. Clinical teaching with emotional
    intelligence: A teaching toolbox. J Res Med Sci 2016;21:27.
    8. Keskitalo T, Ruokamo H. Exploring learners’ emotions and
    emotional profiles in simulation‑based medical education.
    Australas J Educ Technol 2021;37:15‑26.
    9. McConnell MM, Monteiro S, Pottruff MM, Neville A, Norman GR,
    Eva KW, et al. The impact of emotion on learners’ application
    of basic science principles to novel problems. Acad Med
    10. Artino AR Jr, Naismith LM. ‘But how do you really feel?’Measuring
    emotions in medical education research. Med Educ 2015;49:140‑2.
    11. Gooding H, Mann K, Armstrong E. Twelve tips for applying the
    science of learning to health professions education. Med Teach
    12. O’Callaghan A. Emotional congruence in learning and health
    encounters in medicine: addressing an aspect of the hidden
    curriculum. Adv Health Sci Educ 2013;18:305‑17.
    13. Artino AR Jr, Holmboe ES, Durning SJ. Control-value theory:
    Using achievement emotions to improve understanding of
    motivation, learning, and performance in medical education:
    AMEE Guide No. 64. Med Teach 2012;34:e148‑60.
    14. Hayat AA, Salehi A, Kojuri J. Medical student’s academic
    performance: The role of academic emotions and motivation.
    J Adv Med Educ Prof 2018;6:168‑75.
    15. Crowe S, Clarke N, Brugha R. ‘You do not cross them’: Hierarchy
    and emotion in doctors’ narratives of power relations in specialist
    training. Soc Sci Med 2017;186:70‑7.
    16. Friedlander MJ, Andrews L, Armstrong EG, Aschenbrenner C,
    Kass JS, Ogden P, et al. What can medical education learn from
    the neurobiology of learning? Acad Med 2011;86:415‑20.
    17. Mills LM, Boscardin C, Joyce EA, Ten Cate O, O’Sullivan PS.
    Emotion in remediation: A scoping review of the medical
    education literature. Med Educ 2021;55:1350‑62.
    18. DeMaria S Jr, Bryson EO, Mooney TJ, Silverstein JH, Reich DL,
    Bodian C, et al. Adding emotional stressors to training in simulated
    cardiopulmonary arrest enhances participant performance. Med
    Educ 2010;44:1006‑15.
    19. Gifford H, Varatharaj A. The ELEPHANT criteria in medical
    education: Can medical education be fun? Med Teach
    20. Jarrell A, Harley JM, Lajoie SP. The link between achievement
    emotions, appraisals, and task performance: Pedagogical
    considerations for emotions in CBLEs. J Comput Educ
    21. Jarrell A, Harley JM, Lajoie S, Naismith L. Success, failure and
    emotions: Examining the relationship between performance
    feedback and emotions in diagnostic reasoning. Educ Technol
    Res Dev 2017;65:1263‑84.
    22. Hautz WE, Schröder T, Dannenberg KA, März M, Hölzer H,
    Ahlers O, et al. Shame in medical education: A randomized study
    of the acquisition of intimate examination skills and its effect on
    subsequent performance. Teach Learn Med 2017;29:196‑206.
    23. Fraser K, Huffman J, Ma I, Sobczak M, McIlwrick J, Wright B,
    et al. The emotional and cognitive impact of unexpected
    simulated patient death: A randomized controlled trial. Chest
    24. Hayat AA, Shateri K, Amini M, Shokrpour N. Relationships
    between academic self‑efficacy, learning‑related emotions, and
    metacognitive learning strategies with academic performance in
    medical students: A structural equation model. BMC Med Educ
    25. Lajoie SP, Zheng J, Li S. Examining the role of self‑regulation
    and emotion in clinical reasoning: Implications for developing
    expertise. Med Teach 2018;40:842‑4.
  2. 26. Kremer T, Mamede S, van den Broek WW, Schmidt HG,
    do PT Nunes M, Martins MA. Influence of negative emotions
    on residents’ learning of scientific information: An experimental
    study. Perspect Med Educ 2019;8:209‑15.
    27. McConnell MM, Eva KW. The role of emotion in the learning
    and transfer of clinical skills and knowledge. Acad Med
    28. Bynum WE IV, Artino AR Jr, Uijtdehaage S, Webb AM, Varpio L.
    Sentinel emotional events: The nature, triggers, and effects of
    shame experiences in medical residents. Acad Med 2019;94:85‑93.
    29. Bynum WE IV, Artino AR Jr. Who am I, and who do I strive to
    be? Applying a theory of self‑conscious emotions to medical
    education. Acad Med 2018;93:874‑80.
    30. WhelanB, Hjörleifsson S, ScheiE. Shame in medical clerkship:“You
    just feel like dirt under someone’s shoe”. Perspect Med Educ
    31. Li S, Zheng J, Lajoie SP. The frequency of emotions and emotion
    variability in self‑regulated learning: What matters to task
    performance? Frontline Learn Res 2021;9:76‑91.
    32. Jakobsen F, Musaeus P, Kirkeby L, Hansen TB, Mørcke AM.
    Emotions and clinical learning in an interprofessional outpatient
    clinic: Afocused ethnographic study. JInterprof Care 2019;33:57‑65.
    33. Ghanbari S, Haghani F, Akbarfahimi M. Practical points for
    brain-friendly medical and health sciences teaching. J Educ Health
    Promot 2019;8:198.
    34. Wijekumar KK. Influence of emotions on digital learning. Educ
    Technol Res Dev 2021;69:55‑7.
    35. Behrens CC, Dolmans DH, Gormley GJ, Driessen EW. Exploring
    undergraduate students achievement emotions during ward
    round simulation: A mixed‑method study. BMC Med Educ
    36. Yu JH, Chang HJ, Kim SS, Park JE, Chung WY, Lee SK, et al. Effects
    of high‑fidelity simulation education on medical students’ anxiety
    and confidence. PLoS One 2021;16:e0251078.