The hidden curriculum across medical disciplines: an examination of scope, impact, and context

Authors

DOI:

https://doi.org/10.36834/cmej.75207

Abstract

Background: While research suggests that manifestations of the hidden curriculum (HC) phenomenon have the potential to reinforce or undermine the values of an institution, very few studies have comprehensively measured its scope, impact, and the varied clinical teaching and learning contexts within which they occur. We explored the HC and examined the validity of newly developed constructs and determined the influence of context on the HC.

Methods: We surveyed medical students (n =182), residents (n =148), and faculty (n = 140) from all disciplines at our institution between 2019 and 2020. Based on prior research and expertise, we measured participants’ experience with the HC including perceptions of respect and disrespect for different medical disciplines, settings in which the HC is experienced, impact of the HC, personal actions, efficacy, and their institutional perceptions. We examined the factor structure, reliability, and validity of the HC constructs using exploratory factor analysis Cronbach’s alpha, regression analysis and Pearson’s correlations.

Results: Expert judges (physician faculty and medical learners) confirmed the content validity of the items used and the analysis revealed new HC constructs reflecting negative expressions, positive impacts and expressions, negative impacts, personal actions, and positive institutional perceptions of the HC. Evidence for criterion validity was found for the negative impacts and the personal actions constructs and were significantly associated with the stage of respondents’ career and gender. Support for convergent validity was obtained for HC constructs that were significantly correlated with certain contexts within which the HC occurs.

Conclusion: More unique dimensions and contexts of the HC exist than have been previously documented. The findings demonstrate that specific clinical contexts can be targeted to improve negative expressions and impacts of the HC.

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Author Biographies

Karen Schultz, Queen's University

Dr. Karen Schultz (she/her/hers) MD, CCFP, FCFP

Associate Dean, Queen’s University Post Graduate Medical Education

Professor, Queen’s University Department of Family Medicine

70 Barrie Street

Kingston, Ontario, Canada

K7L 3N6

Phone: 613-533-2543

Fax: 613-533-2132

karen.schultz@queensu.ca

Heather Braund, Queen's University

Braund is a health sciences education researcher and consultant with the Office of Professional Development and Educational Practice in the Faculty of Health Sciences and an assistant professor (adjunct) in the Faculty of Education, Queen’s University.

Mala Joneja, Queen's University

Joneja is an associate professor and the division chair for the Division of Rheumatology in the School of Medicine at the Faculty of Health Sciences, Queen’s University.

Shayna Watson, Queen's University

S. Watson is an assistant professor and family physician in the Department of Family Medicine in the School of Medicine at the Faculty of Health Sciences, Queen’s University.

John Drover, Queen's University

Drover is a professor and intensivist in the Departments of Critical Care Medicine and Surgery in the School of Medicine at the Faculty of Health Sciences, Queen’s University.

Laura MacMillan-Jones, Queen's University

L. MacMillan-Jones is a graduate of Queen’s University School of Medicine and Queen’s Family Medicine, now working as a family physician throughout rural Ontario.

Nancy Dalgarno, Queen's University

Dalgarno is the director of education scholarship in the Office of Professional Development and Educational Practice, and an assistant professor (adjunct) in the Department of Biomedical and Molecular Sciences in the Faculty of Health Sciences, Queen’s University.

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Published

2023-06-21

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Schultz K, Cofie N, Braund H, Joneja M, Watson S, Drover J, MacMillan-Jones L, Dalgarno N. The hidden curriculum across medical disciplines: an examination of scope, impact, and context. Can. Med. Ed. J [Internet]. 2023 Jun. 21 [cited 2024 May 27];15(1):15-2. Available from: https://journalhosting.ucalgary.ca/index.php/cmej/article/view/75207

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