The Hidden Curricula of Medical Education: A Scoping Review

Lawrence, Carlton; Mhlaba, Tsholofelo; Stewart, Kearsley A.; Moletsane, Relebohile; Gaede, Bernhard; Moshabela, Mosa

doi:10.1097/acm.0000000000002004

Cited by 154 publications

(161 citation statements)

References 91 publications

(92 reference statements)

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“…The hidden curriculum has mostly been studied within the "unofficial curriculum" [22], which refers Fig. 2 Concept mapping of a PowerPoint on the management of URTI that is consistent with SDM and EBM frameworks.…”

Section: Discussionmentioning

confidence: 99%

“…A hidden curriculum may be present in all aspects of medical education [20] but formal teaching envi-ronments represent a valuable opportunity: they are ubiquitous throughout medical training and curriculum material can be monitored. In order to be addressed, however, a hidden curriculum first needs to be exposed [22], and it is not known to what extent curricular material can relay hidden messages that may conflict with the official curriculum's learning objectives. The present study was therefore undertaken to explore how assumptions of EBM and SDM can be hidden in formal curricular material.…”

Section: Introductionmentioning

confidence: 99%

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Evidence-based medicine, shared decision making and the hidden curriculum: a qualitative content analysis

Braschi¹,

Stacey²,

Légaré³

et al. 2020

Perspect Med Educ

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Introduction Medical education should portray evidence-based medicine (EBM) and shared decision making (SDM) as central to patient care. However, misconceptions regarding EBM and SDM are common in clinical practice, and these biases might unintentionally be transmitted to medical trainees through a hidden curriculum. The current study explores how assumptions of EBM and SDM can be hidden in formal curriculum material such as PowerPoint slides. Methods We conducted a qualitative content analysis using a purposive sample of 18 PowerPoints on the management of upper respiratory tract infections. We identified concepts pertaining to decision making using theory-driven codes taken from the fields of EBM and SDM. We then re-analyzed the coded text using a constructivist latent thematic approach to develop a rich description of conceptualizations of decision making in relation to EBM and SDM frameworks. Results PowerPoint slides can relay a hidden curriculum, which can normalize: pathophysiological rea-Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40037-020-00578-0) contains supplementary material, which is available to authorized users. E. Braschi ( ) soning, unexplained variations in clinical care, the use of EBM mimics, defensive medicine, an unrealistic portrayal of benefits, and paternalism. Discussion Addressing the hidden curriculum in formal curricular material should be explored as a novel strategy to foster a positive attitude towards EBM and SDM and to improve patient outcomes by encouraging the use of these skills.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evidence-based medicine, shared decision making and the hidden curriculum: a qualitative content analysis

Braschi¹,

Stacey²,

Légaré³

et al. 2020

Perspect Med Educ

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“…In contrast, learning in medical education mostly occurs outside the formal and predeter-mined curriculum, which is known as hidden curriculum (10). The first description of the term "hidden curriculum" was first used in the 1960s and it has been commonly used in medical sciences education since 1994 (11).…”

Section: Introductionmentioning

confidence: 99%

Training Professionalism Using Hidden Curriculum in an Internship Course: Account of Experiences of Undergraduate Students of Surgical Technology

Jouybari

Mojarad

Behmadi

et al. 2019

Strides Dev Med Educ

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Background: Medical students are in direct contact with patients due to their clinical situation, and one of the important goals of medical education is professional development of these students. Objectives: The purpose of this study was to explain students' experiences regarding professionalism training using hidden curriculum. Methods: This study was carried out through content analysis, and data were collected through semi-structured interviews with 6th and 8th semester undergraduate students of surgical technology. The participants were entered into the study using the purposive sampling method and each individual interview lasted for about 35-45 minutes. Semi-structured questions were used to conduct the interviews and then follow-up and exploratory questions were used to clarify the concept and to deepen the interview process. Results: Overall, 358 primary codes and the two main themes of observing patient rights and professional accountability were extracted. The theme of observing patient rights includes three sub-themes, including observing patient privacy, respect for patient's dignity and patient safety, and the theme of professional accountability comprised the three sub-themes of compliance with professional standards, professional communication and instructor as ethics teacher. Conclusions: Professors' familiarity with the training and development of professionalism among medical students, and attention to the role of hidden curriculum in the formulation of values, norms and behaviors regarding professionalism is suggested.

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“…This training takes place both formally and informally. 9,10 Formally, the general surgery clerkship rotation introduces students to surgical disease processes and provides direct interaction with faculty and residents. 11 Informally, this time also allows students a view into the work and life challenges faced by attending surgeons and residents.…”

Section: Introductionmentioning

confidence: 99%

Impact of Medical School Experience on Attrition From General Surgery Residency

Abelson

Wong

Mao

et al. 2018

Journal of Surgical Research

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Medical Undergraduate medical education Clinical clerkship General surgery Residency a b s t r a c t Background: Medical school experience informs the decision to pursue graduate surgical education. However, it is possible that inadequate preparation in medical school is responsible for the high rate of attrition seen in general surgery residency. Materials and methods: We performed a national prospective cohort study of all categorical general surgery interns who entered training in the 2007-2008 academic year. Interns answered questions about their medical school experience and reasons for pursuing general surgery residency. Responses were linked with American Board of Surgery residency completion data. Multivariable logistic regression was used to evaluate the association between medical school experiences and residency attrition.Results: Seven hundred and ninety-two surgery interns participated, and the overall attrition rate was 19.3%. Most interns had performed 8 wk of third year surgery clerkships (53.2% of those who completed versus 49.7% of those who dropped out, P ¼ 0.08). After multivariable adjustment, shorter duration of third year rotations was protective from attrition (OR: 0.53, 95% CI: 0.29-0.99; P ¼ 0.05). There was no difference in attrition based on whether a surgical subinternship was performed (OR: 0.67, 95% CI: 0.38-1.19; P ¼ 0.18).Residents who perceived that their medical school surgical faculty were happy with their careers were less likely to experience attrition (OR: 0.57, 95% CI: 0.34-0.96; P ¼ 0.03), but those who had gotten along well with attending surgeons had higher odds of attrition (OR: 2.93, 95% CI: 1.34-6.39, P < 0.01).Conclusions: Increased quality, rather than quantity, of clerkships is associated with improved rates of residency completion. Learner relationships with positive yet demanding role models were associated with a reduced risk of attrition. ª j o u r n a l o f s u r g i c a l r e s e a r c h d e c e m b e r 2 0 1 8 ( 2 3 2 ) 7 e1 4

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The Hidden Curricula of Medical Education: A Scoping Review

Abstract: Future medical education researchers should make clear the conceptual boundary or boundaries they are applying to the term "hidden curriculum," move away from general musings on its effects, and focus on specific methods for improving the powerful hidden curriculum.

Cited by 154 publications

References 91 publications

Evidence-based medicine, shared decision making and the hidden curriculum: a qualitative content analysis

Evidence-based medicine, shared decision making and the hidden curriculum: a qualitative content analysis

Training Professionalism Using Hidden Curriculum in an Internship Course: Account of Experiences of Undergraduate Students of Surgical Technology

Impact of Medical School Experience on Attrition From General Surgery Residency

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The Hidden Curricula of Medical Education: A Scoping Review

Abstract: Future medical education researchers should make clear the conceptual boundary or boundaries they are applying to the term "hidden curriculum," move away from general musings on its effects, and focus on specific methods for improving the powerful hidden curriculum.

Cited by 154 publications

References 91 publications

Evidence-based medicine, shared decision making and the hidden curriculum: a&nbsp;qualitative content analysis

Evidence-based medicine, shared decision making and the hidden curriculum: a&nbsp;qualitative content analysis

Training Professionalism Using Hidden Curriculum in an Internship Course: Account of Experiences of Undergraduate Students of Surgical Technology

Impact of Medical School Experience on Attrition From General Surgery Residency

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Product

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Evidence-based medicine, shared decision making and the hidden curriculum: a qualitative content analysis

Evidence-based medicine, shared decision making and the hidden curriculum: a qualitative content analysis