Meta-emotion in health professions education: a theoretical integrative review

Emotions play a central role in clinical decision-making, communication, empathy, and professional identity formation, yet medicine has traditionally privileged rationality and composure over engagement with emotional experience. Although health professions education has increasingly incorporated empathy, communication, and mindfulness-based interventions, these approaches tend to focus on discrete skills and behaviours without a coherent conceptual framework for understanding how clinicians interpret and respond to emotion. Meta-emotion may offer such a framework, but the construct remains inconsistently defined across philosophical, psychological, developmental, and educational literatures. This theoretical integrative review (TIR) examines how meta-emotion has been conceptualised across disciplines and explores its relevance to health professions education. Searches across eight databases identified literature addressing meta-emotion and related constructs. Selection focused on papers making substantive conceptual contributions, resulting in 34 studies included in the final synthesis. Analysis identified four broad paradigms conceptualising meta-emotion as experiential, evaluative, regulatory, or socialisation-oriented. Across these traditions, meta-emotion consistently involved reflexive engagement with emotional experience through processes of attention, interpretation, evaluation, and response. Rather than representing competing definitions, these paradigms appeared to reflect complementary dimensions of a broader phenomenon. The review proposes that meta-emotion is best understood as a socially and developmentally structured, belief-mediated system linking emotional awareness, interpretive frameworks, and regulatory responses. This formulation provides an integrative framework for understanding how clinicians make sense of emotional experience within professional and organisational contexts and offers a foundation for educational approaches that are attentive to emotional socialisation, reflexivity, and professional culture.