The Impact of Hidden Curriculum in Clinical Learning Environment: Exploring Resident’s Perceptions
DOI:
https://doi.org/10.51253/pafmj.v74i2.10367Keywords:
Consultants/seniors, Formal curriculum, Hidden curriculum, Peers, Residents/Trainees, Medical EducationAbstract
Objective: To explore and identify residents' perceptions regarding the hidden curriculum in dermatology practice and make it explicit.
Study Design: Phenomenology Qualitative study.
Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital, Rawalpindi Pakistan Aug to Oct 2021.
Methodology: Data was gathered from one focus group discussion and five face-to-face semi-structured interviews and analyzed by thematic analysis of the generated themes.
Results: Residents described a hierarchical and competitive atmosphere in the department. Positive and negative role models were identified. Organized teaching and approachable seniors were appreciated, whereas favouritism and a lack of empathy were undervalued.
Conclusion: This study highlights the hidden curriculum in dermatology and attempts to recognize its important aspects. A continuous effort should be made to unravel it and align its positive aspects with the formal curriculum. This will lead to ethical and professional doctors and better health care.
Downloads
References
Hafferty FW, Franks R.The hidden curriculum, ethics teaching, and the structure of medical education.Acad Med 1994; 69: 861–871 https://doi.org/10.1097/00001888-199411000-00001
Higashi RT, Tillack A, Steinman MA, Johnston CB, Harper GM. The ‘worthy’ patient: rethinking the ‘hidden curriculum’ in medical education. Anthropol Med 2013; 20(1): 13-23.
https://doi.org/10.1080/13648470.2012.747595
Ozolins I, Hall H, Peterson R. The student voice: Recognising the hidden and informal curriculum in medicine. Med Teach 2008; 30(6): 606-611. https://doi.org/10.1080/01421590801949933
Mulder H, ter Braak E, Chen HC, ten Cate O. Addressing the hidden curriculum in the clinical workplace: A practical tool for trainees and faculty. Med Teach 2018: 1-8.
https://doi.org/10.1080/0142159x.2018.1436760
Neve H, Collett T. Empowering students with the hidden curriculum. Clin Teach 2018; 15(6): 494-499.
https://doi.org/10.1111/tct.12736
Collier VU, McCue JD, Markus A, Smith L. Stress in medical residency: status quo after a decade of reform? Ann Intern Med 2002 136 384–390. https://doi.org/10.7326/0003-4819-136-5-200203050-00011
Freiman A, Barzilai DA, Barankin B, Natsheh A, Shear NH. National appraisal of dermatology residency training: a Canadian study. Arch Dermatol 2005; 141(9): 1100-1104.
https://doi.org/10.1001/archderm.141.9.1100
Khan AZ. Non-academic attributes of hidden curriculum in medical schools. J Coll Physicians Surg Pak 2013; 23(1): 5-9.
Côté L, Turgeon J. Appraising qualitative research articles in medicine and medical education. Med Teach 2005; 27(1): 71- 75. https://doi.org/10.1080/01421590400016308
Kitzinger J. Qualitative research: Introducing focus groups. BMJ 1995; 311(7000): 299-302.
https://doi.org/10.1136/bmj.311.7000.299
Begley CM. Using triangulation in nursing research. Journal of Advanced Nursing. 1996; 24(1): 122-128.
https://doi.org/10.1046/j.1365-2648.1996.15217.x
Unluer S. Being an insider researcher while conducting case study research. Qual Rep 2012; 17(29): 1–14.
https://doi.org/10.46743/2160-3715/2012.1752
Rauf A, Fatima F, Tayyab A, Qamar K, Ayub AM, Baig L. Exploring the Elements of Hidden Curriculum in Medical Institutes: An Ethnographic Approach. Multicultural Education 2021; 7(10). https://doi.org/10.5281/zenodo.5579345
Mulder H, Ter Braak E, Chen HC, Ten Cate O. Addressing the hidden curriculum in the clinical workplace: A practical tool for trainees and faculty. Med Teach 2019; 41(1): 36-43.
https://doi.org/10.1080/0142159X.2018.1436760
Mahmood SBZ, Zahid A, Nasir N, Tahir M, Ghouri U, Almas A, et al Triggering and protective factors of burnout in medical resident physicians in a lower-middle-income country: A cross-sectional study. Ann Med Surg 2021; 67: 102500.
https://doi.org/10.1016/j.amsu.2021.102500
Vanstone M, Grierson L. Thinking about social power and hierarchy in medical education. Medical Education 2022; 56(1): 91-97. https://doi.org/10.1111/medu.14659
Salehi PP, Jacobs D, Suhail-Sindhu T, Judson BL, Azizzadeh B, Lee YH. Consequences of medical hierarchy on medical students, residents, and medical education in otolaryngology. Otolaryngol Head Neck Surg 2020; 163(5): 906-914.
https://doi.org/10.1177/0194599820926105
West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet 2016; 388(10057): 2272-2281.
https://doi.org/10.1016/s0140-6736(16)31279-x
Barrett J, Scott KM. Acknowledging medical students’ reports of intimidation and humiliation by their teachers in hospitals. J Paediatr Child Health 2018; 54(1): 69-73.
https://doi.org/10.1111/jpc.13656
Crowe S, Clarke N, Brugha R. ‘You do not cross them’: Hierarchy and emotion in doctors' narratives of power relations in specialist training. Soc Sci Med 2017 Aug 1; 186: 70-77. https://doi.org/10.1016/j.socscimed.2017.05.048
Smith AC, Kleinman S. Managing emotions in medical school: Students' contacts with the living and the dead. Soc Psychol Quart 1989: 56-69. https://doi.org/10.2307/2786904
Passi V, Johnson S, Peile ED, Wright S, Hafferty F, Johnson N. Doctor role modelling in medical education: BEME Guide No. 27. Med Teach 2013; 35(9): e1422-36.
https://doi.org/10.3109/0142159X.2013.806982
Goldie J, Dowie A, Goldie A, Cotton P, Morrison J. What makes a good clinical student and teacher? An exploratory study. BMC Med Educ 2015; 15: 40. https://doi.org/10.1186/s12909-015-0314-5
Le Blanc PM, Hox JJ, Schaufeli WB, Taris TW, Peeters MC. Take care! The evaluation of a team-based burnout intervention program for oncology care providers. J Appl Psychol 2007; 92(1): 213. https://doi.org/10.1037/0021-9010.92.1.213
Aslam F, Jawad U, Hotiana UA, Mahboob U, Ashfaq S, Jawad MY. Medical Students’ Perspective about Attributes of Role Models-The Other Side of Story. J Evo Med Dent Sci 2021; 10(22): 1692-1698. https://doi.org/10.14260/jemds/2021/350
Jayasuriya-Illesinghe V, Nazeer I, Athauda L, Perera J. Role models and teachers: medical students perception of teaching-learning methods in clinical settings, a qualitative study from Sri Lanka. BMC Med Educ 2016; 16(1): 1-8.
https://doi.org/10.1186/s12909-016-0576-6
Dunn PM, Arnetz BB, Christensen JF, Homer L. Meeting the imperative to improve physician well-being: assessment of an innovative program. J General Intern Med 2007; 22(11): 1544-1552. https://doi.org/10.1007/s11606-007-0363-5
West CP, Shanafelt TD, Kolars JC. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA 2011; 306(9): 952-960.
https://doi.org/10.1001/jama.2011.1247
Afaq A, Mahboob U. PICABOO: Effects of Hidden Curriculum on student's behavior. Health Professions Educ J 2021; 4(2): 9-15. https://doi.org/10.53708/hpej.v4i2.1091
Plaut SM, Baker D. Teacher–student relationships in medical education: boundary considerations. Med Teach 2011; 33(10): 828-833. https://doi.org/10.3109/0142159X.2010.541536
Downloads
Published
Issue
Section
How to Cite
