Recognizing the Role of Language in the Hidden Curriculum of Undergraduate Medical Education: Implications for Equity in Medical Training

Abstract

Undergraduate medical education is a process of socialization and professionalization, 1-3 a transition from "outsider" to "insider" status that involves rigorous formal training as well as an inculturation of norms via a "hidden curriculum." 4,5 Within medical education literature, the well-established concept of a hidden curriculum describes the "values, attitudes, beliefs, and related behaviors" 6 that students learn are expected of them and that they therefore come to embody as they develop their professional identities. [6][7][8][9][10] Students are evaluated on their ability to navigate expectations of the hidden curriculum, 11 though these expectations may not be explicitly described. In this Article, we reframe the Association of American Medical Colleges (AAMC) Core Entrustable Professional Activities for Entering Residency (Core EPAs), 12 which describe the tasks that graduates should be prepared to perform under indirect supervision at the start of residency, to demonstrate their focus on language practices, and propose that the role language plays within the hidden curriculum exacerbates and perpetuates existing inequities in medical education. Language Within the Hidden CurriculumLanguage is a crucial component of medical practice, 13,14 and therefore a crucial component of medical education. Here, we begin by exploring the role of language within the hidden curriculum, which mediates socialization into professional worlds, and exploring the term "patterns of medical language" as a framework for a more expansive understanding of language in professional communities.A student who doesn't "get it" knows what a scalpel is but may not know operating

Presenting complaint: use of language that disempowers patients

“…Yet some language used either to communicate directly with patients, or when discussing patient care with other healthcare professionals, might inadvertently disempower patients 10. Although the derogatory slang that was historically used is now nearly universally recognised as unacceptable,11 language that is belittling, doubting, or blaming continues to be commonly used in everyday clinical practice, both verbally and in written notes 12131415…”

“… 10 Although the derogatory slang that was historically used is now nearly universally recognised as unacceptable, 11 language that is belittling, doubting, or blaming continues to be commonly used in everyday clinical practice, both verbally and in written notes. 12 13 14 15 …”

Competências em cuidados paliativos entre estudantes do curso de medicina

“…A aquisição de competências é complexa e depende da qualidade e forma com que o conteúdo foi apresentado, do cenário a que o estudante foi exposto, das relações que se estabelecem entre professor e estudante, do currículo oculto e da importância que a temática tem para a sociedade 12,15,[25][26][27] . Assim, compreende-se que adquirir competências não é tarefa de uma disciplina acadêmica isolada na graduação.…”

Palliative care competence among medical students

“…The acquisition of competencies is a complex process that relies on various factors, including the quality and manner in which content is presented, the learning environment, the relationships established between teachers and students, the influence of the hidden curriculum, and the societal importance of the subject 12,15,[25][26][27] . Therefore, it is understood that acquiring competencies is not solely the responsibility of an isolated academic discipline at the undergraduate level.…”