A Novel Curricular Design Exposing Clinical Medical Students to the Hidden Curriculum

Background: Starting work as a junior doctor can be daunting for any medical student. There are numerous aspects of the hidden curriculum which many students fail to acquire during their training. Objectives: To evaluate the effectiveness of a novel foundation year one (FY1) doctor preparation course focusing on certain core topics, practical tips and components of the hidden curriculum. The primary objective was to improve the confidence level and knowledge of final year medical students transitioning to FY1 doctors. Method: A 2-day, practical course titled ‘Preparation 2 Practice’ delivering hands-on, small-group and lecture-based teaching, covering core medical student undergraduate curriculum topics in medicine and surgery. The course content spanned therapeutics, documentation skills and managing acute clinical tasks encountered by FY1 doctors during an on-call shift. A pre- and post-course survey and knowledge assessment were carried out to assess the effectiveness of the course. The assessment was MCQ-based, derived from topics covered within our course. The 20-question test and a short survey were administered electronically. Results: Twenty students from a single UK medical school attended the course. 100% participation was observed in the pre- and post-course test and survey. The median post-course test result was 22 (IQR 20.25-23.75) which was higher than the median pre-course test score of 18.75 (IQR 17-21.75). A Wilcoxon sign rank test revealed a statistically significant difference between the pre- and post-course test results ( P = .0003). The self-reported confidence score of delegates on starting work as a junior doctor was also significantly higher following the course ( P = .004). Conclusion: The results show a significant improvement in perceived confidence and knowledge on core curriculum topics amongst final year medical students having attended our FY1 doctor preparation course. We conclude that there is scope for similar supplementary courses as an adjunct to the undergraduate medical curriculum.

Download Full-text

You've got to know the rules to play the game: how medical students negotiate the hidden curriculum of surgical careers

Medical Education ◽

10.1111/medu.12488 ◽

2014 ◽

Vol 48 (9) ◽

pp. 884-894 ◽

Cited By ~ 28

Author(s):

Elspeth Hill ◽

Katherine Bowman ◽

Renée Stalmeijer ◽

Jo Hart

Keyword(s):

Medical Students ◽

Hidden Curriculum

Download Full-text

An Intervention to Remediate Unprofessional Behaviours of Pre-Clinical Medical Students

Education in Medicine Journal ◽

10.21315/eimj2021.13.2.7 ◽

2021 ◽

Vol 13 (2) ◽

pp. 83-90

Author(s):

Chan Choong Foong ◽

Nurul Atira Khairul Anhar Holder ◽

Aswini R Dutt ◽

Hidayah Mohd Fadzil

Keyword(s):

Professional Development ◽

Medical Students ◽

Thematic Analysis ◽

Hidden Curriculum ◽

Healthcare Education ◽

Medical Practitioners ◽

Corrective Measures ◽

Published Evidence ◽

One Year

Remediating the unprofessional behaviours of medical students is essential because the unprofessional behaviours of medical practitioners could be traced back to their previous behaviours in medical schools. This study evaluated a programme that used reflection in remediating students with unprofessional behaviours. Personal and professional development (PPD) assignments have a “hidden curriculum” on professional behaviours expected of medical students. Seven students who repeatedly failed to complete the PPD assignments were required to attend a remediation programme. The remediation programme aims to help students reflect on their behaviours. They compared professional behaviours between medical practitioners and students and discussed unprofessional behaviours using actual cases. Thematic analysis was performed on the reflective essays of the students, collected at the beginning and the end of the remediation programme. At the beginning of the programme, students expressed anger because they felt that the PPD assignments were minor tasks. At the end of the programme, students expressed their regretful feelings; they recognised lessons learnt and developed corrective measures. A follow-up reported that the faculty no longer deemed the students unsatisfactory in their professional behaviours one year later. Reflection is recognised as useful in healthcare education, but there is a lack of published evidence to answer whether reflection can be learned. In this study, the students learnt to reflect on their previous professional behaviours, and they developed corrective measures to avoid the recurrence of these previous behaviours. The findings may imply that reflection could be taught and learned to cultivate professional behaviours among medical students.

Download Full-text

‘I know my place’- The hidden curriculum of professional hierarchy in a South African undergraduate medical program: A Qualitative Study

10.21203/rs.3.rs-745000/v1 ◽

2021 ◽

Author(s):

Jacob Sons ◽

Bernhard Gaede

Keyword(s):

South Africa ◽

Medical Students ◽

South African ◽

Clinical Setting ◽

Hidden Curriculum ◽

Ethnographic Study ◽

Local Context ◽

Local Analysis ◽

Clinical Teachers ◽

Post Colonial

Abstract Background The hidden curriculum of professional hierarchy refers a tacitly acquired perception of a power differential between medical students and their clinical teachers. This power gradient is enforced and maintained by means of humiliation and race- and gender prejudices. The consequences of these pedagogical approaches include disillusionment, anxiety, depression and suicide among student populations. Little is known about this phenomenon in the post- colonial African setting.ObjectivesThe aim of this study was to explore the hidden curriculum of professional hierarchy as it is perceived by medical students. The objective was to define how it manifests and to describe the mechanism that enforce and maintain it.MethodsAn ethnographic study was conducted at a South African University. Through twelve in- depth interviews and 6 months’ participant observations in the clinical setting an understanding of the students’ experience was explored. NVivo software was used to perform a thematic analysis using an open coding method. The themes were then progressively refocussed as broader themes emerged and a deeper understanding of the hidden curriculum developed.ResultsFrom the interviews and the observations, we found that humiliation of students, racism and sexism was used to enforce the professional hierarchy between clinical teachers and students. Students felt discouraged and demotivated by such encounters.ConclusionsThe hidden curriculum of professional hierarchy plays a significant role in how students understand and find their place in the clinical setting. Humiliation continues to play a role despite institutional policies and guidelines and the transition to a democratic dispensation in 1994 in South Africa. Our findings resonated with the findings of international studies exploring the hidden curriculum. Using a historical perspective of the medical school where the study was conducted, the post-colonial lens offers a useful local analysis of the hidden curriculum in the local context of continued gender-based violence, racial, socio-political and economic inequalities in South Africa. It may allow for a more critical engagement with the students’ experience and hopefully assists in exploring institutional values in more profound ways.

Download Full-text

“Without any indication”: stigma and a hidden curriculum within medical students' discussion of elective abortion

Social Science & Medicine ◽

10.1016/j.socscimed.2018.07.014 ◽

2018 ◽

Vol 214 ◽

pp. 26-34 ◽

Cited By ~ 7

Author(s):

Benjamin Elliot Yelnosky Smith ◽

Deborah Bartz ◽

Alisa B. Goldberg ◽

Elizabeth Janiak

Keyword(s):

Medical Students ◽

Hidden Curriculum ◽

Elective Abortion

Download Full-text

Assessing the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after an educational intervention*

Journal of Chiropractic Education ◽

10.7899/jce-14-16 ◽

2014 ◽

Vol 28 (2) ◽

pp. 112-122 ◽

Cited By ~ 6

Author(s):

Jessica J. Wong ◽

Luciano Di Loreto ◽

Alim Kara ◽

Kavan Yu ◽

Alicia Mattia ◽

...

Keyword(s):

Medical Students ◽

Focus Group ◽

Educational Intervention ◽

Hidden Curriculum ◽

Comparative Method ◽

Clinical Settings ◽

Cross Sectional ◽

Negative Attitudes ◽

Wilcoxon Rank Sum Test ◽

Before And After

Objective We assessed the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after a 1-hour educational intervention. Methods A mixed-methods approach was used with a 52-item cross-sectional paper survey and 1 focus group of third-year medical students. The views of these medical students towards chiropractic were assessed previously in their second-year of medical school. ANOVA and the Wilcoxon rank-sum test were used to assess between-group differences between the medical students' views before and after the educational intervention. The constant comparative method for analyzing qualitative data was used to identify emergent themes from the focus group transcript. Results Of 112 third-year medical students, 58 completed the survey (51.7% response rate). The focus group consisted of 6 medical students. Self-reported understanding of chiropractic and number of attitude-positive responses were significantly higher in the group after the educational session. The average number of correct responses assessing knowledge on chiropractic also was significantly higher. Focus group themes were that medical students wanted exposure to chiropractic in clinical settings, had negative attitudes towards chiropractic formed from hidden curriculum, had concerns regarding evidence and safety of chiropractic, and thought that timing of the session on chiropractic was too late in the curriculum. Conclusions The attitudes and knowledge of medical students towards chiropractic improved immediately after a 1-hour educational intervention. Formally educating medical students on chiropractic may help minimize hidden curriculum issues regarding chiropractic, as identified by the medical students, and facilitate collaboration between medical and chiropractic providers.

Download Full-text

The role of hidden curriculum in the formation of professional ethics in the Iranian medical students

10.21203/rs.2.22726/v1 ◽

2020 ◽

Author(s):

yahya safari ◽

Alireza khatoni ◽

ehsan Khodamoradi ◽

mansour Rezaei

Keyword(s):

Medical Education ◽

Medical Students ◽

Professional Ethics ◽

Hidden Curriculum ◽

Individual Characteristics ◽

Factors Affecting ◽

Learning And Teaching ◽

Data Collection And Analysis ◽

Data Saturation

Abstract Background: Professionalism and medical ethics are a vital quality for doctors, which has been taken into account seriously in recent years. Perception of the factors affecting professionalism may help to develop more efficient approaches to promote this quality in medical education. Objective: This study was aimed to explain the role of hidden curriculum in the formation of professional ethics in the Iranian medical students. Methods: This qualitative study was performed on 15 medical interns using grounded theory. Sampling was started by purposive sampling and continued through theoretical sampling until complete data saturation. Data collection and analysis were done simultaneously. Results: The analysis of the participants’ interviews and reduction of findings using common themes yielded one class and four categories as well as a number of concepts as the role of hidden curriculum in the formation of professional ethics in medical students. The categories included the role of modeling in the formation of professional ethics, role of education in formation of professional ethics, role of environmental factors in the formation of professional ethics, and role of personal and inherent attributes in the formation of professional ethics. Conclusion: The curriculum developers and medical education authorities need to proceed in line with the findings of the present study to provide a proper learning environment in which the modeling, learning, and teaching conditions and supportive environmental atmosphere are taken into account in accordance with the inherent and individual characteristics of the learners in order to guarantee the formation of professional ethics in the medical students.

Download Full-text

Learning about gender on campus: an analysis of the hidden curriculum for medical students

Medical Education ◽

10.1111/medu.12628 ◽

2015 ◽

Vol 49 (3) ◽

pp. 321-331 ◽

Cited By ~ 29

Author(s):

Ling-Fang Cheng ◽

Hsing-Chen Yang

Keyword(s):

Medical Students ◽

Hidden Curriculum

Download Full-text

Effect of Targeted Curricular Reform on the Learning Environment, Student Empathy, and Hidden Curriculum in a Medical School: A 7-Year Longitudinal Study

Journal of Medical Education and Curricular Development ◽

10.1177/2382120520953106 ◽

2020 ◽

Vol 7 ◽

pp. 238212052095310

Author(s):

Nathalie K Zgheib ◽

Zakia Dimassi ◽

Thalia Arawi ◽

Kamal F Badr ◽

Ramzi Sabra

Keyword(s):

Longitudinal Study ◽

Medical Students ◽

Learning Environment ◽

Hidden Curriculum ◽

Traditional Curriculum ◽

American University ◽

Curricular Intervention ◽

American University Of Beirut ◽

Education Environment ◽

New Curriculum

Objective: The American University of Beirut Faculty of Medicine follows the American model of medical education. In 2013-2014, a carefully designed new curriculum replaced the previous, largely traditional curriculum, and aimed to improve student wellbeing, upgrade the learning environment, enhance student empathy, and counter the negative influences of the hidden curriculum. This longitudinal study assessed the effectiveness of the new curriculum in those domains over a period of 7 years. Methods: Three cohorts of medical students anonymously filled a paper-based survey at the end of years 1, 2, 3, and 4 of the 4-year curriculum. These included the Class of 2016, the last batch of students who followed the old curriculum, and 2 cohorts that followed the new curriculum (Class of 2017 and Class of 2019). The perceived learning environment was assessed by the Dundee Ready Education Environment Measurement survey; the student’s empathy was assessed by the Jefferson Scale of Physician Empathy-Student version; and the hidden curriculum was examined using a locally developed survey. Results: The scores on the learning environment survey were significantly higher among the cohorts following the new curriculum relative to those following the old curriculum. Similar significant results appeared when looking at each of the subscales for the learning environment. The students’ empathy scores were also significantly higher in both cohorts of the new curriculum when compared with the old curriculum. Nevertheless, there was a significant decrease in empathy in both third and fourth years relative to second year. The new curriculum also improved aspects of the students’ perceptions and responses to the hidden curriculum. Conclusion: In conclusion, a well-planned and well-researched curricular intervention, based on sound educational theories, practices, and standards can indeed transform the learning environment, as well as the attitudes, values, and experiences of medical students.

Download Full-text

Drug company gifts to medical students: the hidden curriculum

BMJ ◽

10.1136/bmj.f1113 ◽

2013 ◽

Vol 346 (feb20 1) ◽

pp. f1113-f1113 ◽

Cited By ~ 1

Author(s):

A. S. Kesselheim

Keyword(s):

Medical Students ◽

Drug Company ◽

Hidden Curriculum

Download Full-text