To the point: Reviews in medical education-taking control of the hidden curriculum

Department of Obstetrics and Gynecology, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.
American journal of obstetrics and gynecology (Impact Factor: 4.7). 10/2010; 203(4):316.e1-6. DOI: 10.1016/j.ajog.2010.04.035
Source: PubMed


This article, the ninth in the "To the Point" series that is prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, discusses the role of the "hidden curriculum" in shaping the professional identity of doctors in training. The characteristics that distinguish the formal curriculum and hidden curriculum are defined. Specific examples of hidden curricula in clinical environments and the positive and negative impacts that may result are highlighted. Techniques to evaluate clinical training environments and to identify the hidden curriculum are provided and are followed by methods to promote its positive messages and lessen its negative ones.

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    • "Further, unprofessional behavior is perpetuated when learners and colleagues observe faculty behaving poorly (Gino et al. 2009). The learning environment is also adversely affected by unprofessional behavior through faculty's failure to model and therefore to teach aspects of professionalism or by undermining the stated goals of the curriculum (Ephgrave et al. 2006; Chuang et al. 2010; Byszewski et al. 2012). "
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    ABSTRACT: Abstract Background: Unprofessional behavior has well documented negative effects both on the clinical care environment and on the learning environment. If unprofessional behavior varies by department or specialty, this has implications both for faculty development and for undergraduate and graduate level training. Aims: We sought to learn which unprofessional behaviors were endemic in our school, and which were unique to particular departments. Methods: Students graduating from medical school between 2007 and 2012 were asked to complete a questionnaire naming the most professional and least professional faculty members they encountered in during school. For the least professional faculty members, they were also asked to provide information about the unprofessional behavior. Results: Students noted several types of unprofessional behavior regardless of the department faculty were in; however, there were some behaviors only noted in individual departments. The unprofessional behavior profiles for Surgery and Obstetrics/Gynecology were markedly similar, and were substantially different from all other specialties. Conclusion: Undergraduate, graduate, and faculty education focused on unprofessional behavior that may occur in various learning environments may provide a feasible, practical, and an effective approach to creating a culture of professional behavior throughout the organization.
    Full-text · Article · May 2014 · Medical Teacher
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    • "Students need to learn what it truly means to be a doctor and medical education leaders must be aware of the issues in the hidden curriculum influencing this process.17,18 It has been suggested that it may be necessary to attempt to change the hidden curriculum if negative aspects are identified.19,20 Faculty development is often included as a key component of this process of change that represents an attempt to influence staff to model more ‘appropriate’ behaviours.21 "
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    ABSTRACT: CONTEXT Major influences on learning about medical professionalism come from the hidden curriculum. These influences can contribute positively or negatively towards the professional enculturation of clinical students. The fact that there is no validated method for identifying the components of the hidden curriculum poses problems for educators considering professionalism. The aim of this study was to analyse whether a cultural web, adapted from a business context, might assist in the identification of elements of the hidden curriculum at a UK veterinary school. METHODS A qualitative approach was used. Seven focus groups consisting of three staff groups and four student groups were organised. Questioning was framed using the cultural web, which is a model used by business owners to assess their environment and consider how it affects their employees and customers. The focus group discussions were recorded, transcribed and analysed thematically using a combination of a priori and emergent themes. RESULTS The cultural web identified elements of the hidden curriculum for both students and staff. These included: core assumptions; routines; rituals; control systems; organisational factors; power structures, and symbols. Discussions occurred about how and where these issues may affect students’ professional identity development. CONCLUSIONS The cultural web framework functioned well to help participants identify elements of the hidden curriculum. These aspects aligned broadly with previously described factors such as role models and institutional slang. The influence of these issues on a student’s development of a professional identity requires discussion amongst faculty staff, and could be used to develop learning opportunities for students. The framework is promising for the analysis of the hidden curriculum and could be developed as an instrument for implementation in other clinical teaching environments.
    Full-text · Article · Feb 2013 · Medical Education

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