Professional Development and the Informal Curriculum in End-of-Life Care

Baker, Megan; Wrubel, Judith; Rabow, Michael W.

doi:10.1007/s13187-011-0199-x

Cited by 20 publications

(28 citation statements)

References 18 publications

(19 reference statements)

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“…The element identified as 'achieving medical professionalism' seems to be a recurring theme of the informal curriculum across both educational levels and disciplines [54][55][56][57][58][59]. Our study confirmed that in FM this is no exception.…”

Section: Findings In Relation To Previous Worksupporting

confidence: 76%

The informal curriculum of family medicine – what does it entail and how is it taught to residents? A systematic review

et al. 2020

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Background: The informal curriculum is a seemingly well-explored concept in the realm of medical education. However, it is a concept with multiple definitions and the term "the hidden curriculum" is often used interchangeably. In short, they both refer to the implicit learning taking place outside the formal curriculum, encompassing both a trickling down effect of organizational values and attitudes passed on by a mentor or colleague. While the informal curriculum is a recurrent theme in medical education literature; it is seldom discussed in Family Medicine. As the informal curriculum is likely to be highly influential in the forming of future family practitioners, our aim was to explore the area further, with respect to the following: which elements of the informal curriculum are applicable in a Family Medicine context and what educational interventions for Family Medicine residents, visualizing the various educational elements of it, have been performed? Methods: We conducted a systematic review comprising iterative literature searches and a narrative synthesis of the results. Results: Twenty articles, published between 2000 and 2019, were included in the analysis which resulted in three partly interrelated themes comprising the informal curriculum in Family Medicine: gaining cultural competence, achieving medical professionalism and dealing with uncertainty. The themes on cultural competence and uncertainty seemed to be more contextual than professionalism, the latter being discussed in relation to the informal curriculum across other medical disciplines as well. Formalized training for Family Medicine residents in aspects of the informal curriculum appeared to be lacking, and in general, the quality of the few interventional studies found was low. Conclusions: Important aspects of being a family practitioner, such as cultural competence and dealing with uncertainty, are learned through a context-dependent informal curriculum. In order to ensure a more uniform base for all residents and to reduce the impact of the individual supervisor's preferences, complementary formalized training would be beneficial. However, to date there are too few studies published to conclude how to best teach the informal curriculum. Trial registration: The systematic review was registered with Prospero; registration number CRD42018104819.

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Section: Findings In Relation To Previous Worksupporting

confidence: 76%

The informal curriculum of family medicine – what does it entail and how is it taught to residents? A systematic review

et al. 2020

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“…The two‐stage screening process resulted in 92 studies included in the scoping review . Of these, 57 investigated PIF in medical students and/or residents, 26 involved nurse trainees (associate, bachelor, graduate and nurse managers), and nine involved counselling or psychology undergraduate or graduate students …”

Section: Resultsmentioning

confidence: 99%

“…Of these, 57 investigated PIF in medical students and/or residents, 26 involved nurse trainees (associate, bachelor, graduate and nurse managers), and nine involved counselling or psychology undergraduate or graduate students . Three of the studies had a mixed‐methods design, six were quantitative and 83 were qualitative …”

Section: Resultsmentioning

confidence: 99%

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

et al. 2019

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OBJECTIVE Despite a recent surge in literature identifying professional identity formation (PIF) as a key process in physician development, the empiric study of PIF in medicine remains in its infancy. To gain insight about PIF, the authors examined the medical literature and that of two other helping professions.METHODS The authors conducted a scoping review and qualitative metasynthesis of PIF in medicine, nursing and counselling/psychology. For the scoping review, four databases were searched using a combination of keywords to identify empiric studies on PIF in trainees. After a two-step screening process, thematic analysis was used to conduct the metasynthesis on screened articles. RESULTSA total of 7451 titles and abstracts were screened; 92 studies were included in the scoping review. Saturation was reached in the qualitative metasynthesis after reviewing 29 articles.CONCLUSION The metasynthesis revealed three inter-related PIF themes across the helping professions: the importance of clinical experience, the role of trainees' expectations of what a helping professional is or should be, and the impact of broader professional culture and systems on PIF. Upon reflection, most striking was that only 10 of the 92 articles examined trainee's sociocultural data, such as race, ethnicity, gender, sexual orientation, age and socioeconomic status, in a robust way and included them in their analysis and interpretation. This raises the question of whether conceptions of PIF suffer from sociocultural bias, thereby disadvantaging trainees from diverse populations and preserving the status quo of an historically white, male medical culture.Professional identity formation (PIF) in medicine focuses attention on the career-long process of becoming a clinician. 1,2 PIF can be thought of as a double helix: the individual and the profession form parallel strands that become intertwined. Each strand must bend in order to accommodate the other; however, this burden of bending and changing to accommodate seems to fall more acutely on the individual strand, with the profession's strand remaining more fixed. PIF frequently involves experimentation, change and uncertainty, and ideally results in the successful reconciliation of conflicting ideals, values and roles. Although successful formation of a professional identity has been linked to career success 3 and creativity at work, 4 a mismatch between an individual's internal bearings and the roles and expectations of the profession can create anxiety, frustration and feelings of inadequacy, and can result in the individual leaving the profession. 5 The role of culture, race, socioeconomic status and gender might be expected to be critical components of the individual strand, and could prove to be important confounders in the study of this complex process.We set out to gain an understanding of the current state of the PIF literature in medicine by conducting a scoping review and metasynthesis of the literature across three of the helping professions (medicine, nursing and counselling/ p...

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“…[13][14][15][16][17][18][19][20] The minimal amount of palliative content in nurse practitioner programs may hinder the next generation of practitioners from developing skills to provide excellent palliative care if they believe it is not a valued part of their education. 23 This lack of exposure can have long-term effects. End-of-life care education is one of the most significant factors affecting nurses' knowledge, skills, and attitudes toward the care of those with life-limiting illness.…”

Section: Discussionmentioning

confidence: 99%

Palliative Care Education in Nurse Practitioner Programs

Jensen-Seaman

Hebert

2016

Nurse Educator

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The need for clinicians trained in palliative care will increase as more Americans live with life-limiting illness. Although multiple studies have described the nature of palliative care education in prelicensure programs, there have been no similar studies of nurse practitioner programs. We surveyed 101 nurse practitioner programs. Most programs provide little instruction in palliative care; education is often limited to a few hours of lecture. One-third of programs offer no instruction. Although palliative care is an important component of advanced practice nursing practice, programs may not be providing adequate education.

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Professional Development and the Informal Curriculum in End-of-Life Care

Cited by 20 publications

References 18 publications

The informal curriculum of family medicine – what does it entail and how is it taught to residents? A systematic review

The informal curriculum of family medicine – what does it entail and how is it taught to residents? A systematic review

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

Palliative Care Education in Nurse Practitioner Programs

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