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Hosseini A, Ghasemi E, Nasrabadi AN, Sayadi L. Strategies to improve hidden curriculum in nursing and medical education: a scoping review. BMC MEDICAL EDUCATION 2023; 23:658. [PMID: 37691094 PMCID: PMC10494411 DOI: 10.1186/s12909-023-04652-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND The importance of hidden curriculum cannot be neglected in education. Despite much research in the field, there have been limited studies on HC improvement in nursing and medical education. This scoping review aimed to determine the scope of strategies to improve HC in nursing and medical education. METHOD PubMed, EBSCO/Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Scopus, Web of Science, Proquest and Persian-language databases of Magiran and SID were searched in January 2023 without a time filter. According to the PRISMA flow diagram, two independent reviewers selected the records that fit the inclusion and exclusion criteria via title and abstract screening. Next, the reviewers studied the full texts of the related articles. The data extracted from the selected articles were tabulated and ultimately synthesized. FINDINGS Out of the eight examined studies, published from 2017 to 2022, only one was in the field of nursing and seven were in medicine. The central strategies were implementing new curricula to replace the previous ones, utilizing team-based clinical clerkship, proposing a HC improvement model, implementation a case-based faculty development workshop, implementation longitudinal and comprehensive educational courses, and incorporating an educational activity into a small group program. CONCLUSION Students and faculty members familiarization on the topic of HC, implementing new curricula, utilizing team-based clerkship, and using comprehensive models were among the HC improvement strategies. Focusing on upgrading the learning environment, particularly the clinical settings, can also be helpful in HC improvement.
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Affiliation(s)
- Amin Hosseini
- School of Nursing and Midwifery, Department of Medical Surgical Nursing, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ghasemi
- Community-Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Nikbakht Nasrabadi
- School of Nursing and Midwifery, Department of Medical Surgical Nursing, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Sayadi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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Pourbairamian G, Bigdeli S, Soltani Arabshahi SK, Yamani N, Sohrabi Z, Ahmadi F, Sandars J. Hidden Curriculum in Medical Residency Programs: A Scoping Review. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2022; 10:69-82. [PMID: 35434154 PMCID: PMC9005762 DOI: 10.30476/jamp.2021.92478.1486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 11/13/2022] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Hidden curriculum is important in medical education and has numerous, long-lasting effects on medical residency. The present scoping review seeks to investigate, identify, and plot the main concepts relating to hidden curriculum and its dimensions, domains, impacts and factors in medical residency courses based on the main references and evidence. METHODS Scoping review methodology was used to guide a search of electronic databases for relevant papers. Of the 394 abstracts initially identified, after screening of both abstracts and full-text papers, 43 studies were selected for inclusion in this review. Following abstraction of key information from each study, a content analysis was undertaken. RESULTS Eleven themes were identified from the content analysis: 1) Organizational Issues (13.77%), 2) Socio-cultural Issues (10.5%), 3) Professional Issues (13.41%), 4) Communicational Factors (8.7%), 5) Educational Issues (22.83%), 6) Resident Personal Characteristics (21.01%), and 7) Resident Educational Characteristics (9.78%). Among the extracted effective hidden curriculum factors, the role modeling had the highest frequency and was emphasized in the studies. CONCLUSIONS Although this study explained and identified the components, elements and also the preparation of the initial format of the hidden curriculum framework of the medical residency program, its results can reduce the negative effects of the hidden curriculum on it. More extensive and in-depth studies with different qualitative methods or mixed methods related to the hidden curriculum in different contexts and disciplines of medical residency are recommended to define characteristics of a constructive hidden curriculum of medical residency programs.
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Affiliation(s)
- Ghadir Pourbairamian
- Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shoaleh Bigdeli
- Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Kamran Soltani Arabshahi
- Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Nikoo Yamani
- Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zohreh Sohrabi
- Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fazlollah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - John Sandars
- Edge Hill University Medical School, Edge Hill University, Ormskirk, UK
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MacNeil KA, Regehr G, Holmes CL. Contributing to the hidden curriculum: exploring the role of residents and newly graduated physicians. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022; 27:201-213. [PMID: 34822055 DOI: 10.1007/s10459-021-10081-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/31/2021] [Indexed: 06/13/2023]
Abstract
The hidden curriculum has been investigated as a powerful force on medical student learning and ongoing physician professional development. Previous studies have largely focused on medical students' experiences as 'receivers' of the hidden curriculum. This study examined how residents and newly graduated physicians conceived of their roles as active participants in the hidden curriculum. An interpretative phenomenological study was employed using individual, semi-structured interviews with residents and newly graduated physicians (n = 5) to examine their roles in perpetuating the hidden curriculum. A thematic analysis was conducted using a reflexive approach. Findings include insight into how residents and newly graduated physicians: (a) navigate the hidden curriculum for their own professional development; (b) intervene in others' enactment of the hidden curriculum; and (c) seek to repair the hidden curriculum for the next generation through their teaching. In light of our findings, we argue that: (a) more research is needed to understand how early career physicians navigate their engagement with the hidden curriculum; (b) students and educators be supported to consider how their agency to impact the hidden curriculum is influenced by the sociocultural context; and (c) residents and early career physicians are poised to powerfully impact the hidden curriculum through the learning environments they create.
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Affiliation(s)
- Kimberley A MacNeil
- Department of Educational and Counselling Psychology, and Special Education, Faculty of Education, University of British Columbia, Vancouver, Canada.
| | - Glenn Regehr
- Centre for Health Education Scholarship & Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Cheryl L Holmes
- Department of Medicine, Division of Critical Care, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Kolomitro K, Graves L, Kirby F, Turnnidge J, Hastings Truelove A, Dalgarno N, van Wylick R, Stockley D, Mulder J. Developing a Curriculum for Addressing the Opioid Crisis: A National Collaborative Process. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2022; 9:23821205221082913. [PMID: 35493965 PMCID: PMC9047040 DOI: 10.1177/23821205221082913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The burgeoning use of opioids and the lack of attention to the safe prescribing, storage, and disposal of these drugs remains a societal concern. Education plays a critical role in providing a comprehensive response to this crisis by closing the training gaps and empowering the next generation of physicians with the knowledge, skills, and resources needed to diagnose, treat and manage pain and substance use. Curricular Development: The Association of Faculties of Medicine of Canada (AFMC) developed a competency-based, bilingual curriculum for undergraduate medical students to be implemented in all Canadian medical schools. The authors describe the principles and framework for developing a national curriculum. The curriculum design process was situated in the Knowledge to Action theoretical framework. Throughout the development of this curriculum, different stakeholder groups were engaged, and their needs and contexts were considered. CONCLUSION The curriculum ensures that consistent information is taught across all medical schools to educate future physicians on pain management, opioid stewardship and substance use disorder.
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Affiliation(s)
- Klodiana Kolomitro
- Office of Professional Development and Educational Scholarship, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Lisa Graves
- Family and Community Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Fran Kirby
- Faculties of Medicine of Canada, St. John’s, NL, Canada
| | - Jennifer Turnnidge
- Office of Professional Development and Educational Scholarship, Queen’s University, Kingston, ON, Canada
| | - Amber Hastings Truelove
- Office of Professional Development and Educational Scholarship, Queen’s University, Kingston, ON, Canada
| | - Nancy Dalgarno
- Office of Professional Development and Educational Scholarship, Department of Biomedical and Molecular Sciences, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Richard van Wylick
- Department of Pediatrics, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Denise Stockley
- Office of the Provost (Teaching and Learning Portfolio), Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Jeanne Mulder
- Office of Professional Development and Educational Scholarship, Department of Biomedical and Molecular Sciences, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
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Hernandez S, Nnamani Silva ON, Conroy P, Weiser L, Thompson A, Mohamedaly S, Coe TM, Alseidi A, Campbell AR, Sosa JA, Gosnell J, Lin MYC, Roman SA. Bursting the Hidden Curriculum Bubble: A Surgical Near-Peer Mentorship Pilot Program for URM Medical Students. JOURNAL OF SURGICAL EDUCATION 2022; 79:11-16. [PMID: 34315681 PMCID: PMC9308488 DOI: 10.1016/j.jsurg.2021.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/11/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Abstract
The hidden curriculum of unspoken professional expectations negatively impacts medical student interest in surgery. Medical student mentorship and early surgical exposure have been shown to demystify the hidden curriculum. Although residents and faculty play a vital role, near-peer mentorship may aid in uncovering the hidden curriculum and promoting medical student interest in surgery, especially for those learners who are underrepresented in medicine. We developed and implemented a formalized near-peer mentorship program composed of quarterly small group Surgical Peer Teacher led lessons and one-on-one Surgical Support Team mentorship meetings covering surgical curriculum topics for medical students at an academic medical school. This structured near-peer mentorship model provides a mechanism to demystify surgical culture, increase early access to surgical mentorship, and develop mentorship skills amongst students. This program aims to uncover the surgical hidden curriculum to improve surgical career support and interest among medical students with less exposure and access to physician role models. This longitudinal mentorship model is student-run and can be easily adapted to enhance existing support models at medical schools. Future studies will evaluate utilization, impact on surgical specialty interest, and efficacy in demystifying the surgical hidden curriculum.
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Affiliation(s)
- Sophia Hernandez
- University of California, San Francisco Department of Surgery, San Francisco, California
| | - Ogonna N Nnamani Silva
- Department of Surgery, Division of Plastic Surgery, Harvard Medical School, Boston, Massachusetts
| | - Patricia Conroy
- University of California, San Francisco Department of Surgery, San Francisco, California
| | - Lucas Weiser
- University of California, San Francisco School of Medicine, San Francisco, California
| | - Avery Thompson
- University of California, San Francisco School of Medicine, San Francisco, California
| | - Sarah Mohamedaly
- University of California, San Francisco Department of Surgery, San Francisco, California
| | - Taylor M Coe
- Massachusetts General Hospital, Department of Surgery, Boston, Massachusetts
| | - Adnan Alseidi
- University of California, San Francisco Department of Surgery, San Francisco, California
| | - Andre R Campbell
- University of California, San Francisco Department of Surgery, San Francisco, California
| | - Julie Ann Sosa
- University of California, San Francisco Department of Surgery, San Francisco, California
| | - Jessica Gosnell
- University of California, San Francisco Department of Surgery, San Francisco, California
| | - Matthew Y C Lin
- University of California, San Francisco Department of Surgery, San Francisco, California
| | - Sanziana A Roman
- University of California, San Francisco Department of Surgery, San Francisco, California.
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Mohos A, Frese T, Kolozsvári L, Rinfel J, Varga A, Hargittay C, Csatlós D, Torzsa P. Earning opportunities and informal payment as influencing factors in medical students' speciality choice. BMC FAMILY PRACTICE 2021; 22:258. [PMID: 34969365 PMCID: PMC8716841 DOI: 10.1186/s12875-021-01608-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 09/07/2021] [Indexed: 11/21/2022]
Abstract
Background The Hungarian primary care system faces a severe shortage of family physicians. Medical students’ perceptions of family medicine need to be known and medical students need to be given appropriate and comprehensible information about this speciality. The expected future salary is an important factor in career choice. Most of the family doctors are self-employed and the practices have a corrected capitation-type financing. Although the majority of health care services are covered by social health insurance and are provided for the insured patients free of charge, informal payment is an existing phenomenon with different motivations and consequences. This study aimed to investigate medical students’ knowledge about their future earning opportunities and their attitudes towards informal payment. Methods A cross sectional survey with a self-administered questionnaire was conducted. Each of the four Hungarian medical universities were represented by their medical students who attended family medicine lectures in person from December 2019 to April 2020. The students were asked about their career plans, about their estimations of current and ideal expected salaries and about the effect of expected income for the choice of specialisation. Their attitudes towards informal payment were assessed. Results Response rate was 67.3% (N = 465/691). Almost two-thirds of the participants were women. Only 5% of the respondents (N = 23/462) plan to work as a family doctor in the future. The vast majority (91.9%) of the students had already thought about their future income. On a 10-point Likert scale (1 = ‘no influence’, 10 = ‘very big influence’) 76% answered that the expected future income exerts a considerable (≥5 Likert points) influence on their career choice in general. The mean of the ideal expected monthly income of the residents, GPs and other specialists was €1154 ± 648, €1696 ± 904 and €2174 ± 1594, respectively. The mean of the monthly income for a GP, as estimated by the studenst, was €1140 in rural and €1122 in urban settings. More than four-fifths of the students (N = 375/453) rejected the practice of informal payment. Conclusions Expected salaray is one important aspect in the career choice of medical students, students wish to have more information on this topic. The reported ideal incomes are higher than those expected. This points to a relevant gap. However, most of the students do not accept informal payment as a possibility to close this gap. The expected and the ideal income differ from the real incomes of Hungarian GPs – this indicates the need of bringing objectoive information to the students to enhance attractivity of GP as a carer choice.
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Affiliation(s)
- András Mohos
- Faculty of Medicine, Department Family Medicine, University of Szeged, 6725 Tisza Lajos krt. 109, Szeged, Hungary.
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle/Saale, Germany
| | - László Kolozsvári
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, 4028 Kassai út 26, Debrecen, Hungary
| | - József Rinfel
- Institute of Primary Care, University of Pécs, 7623 Rákoczi St. 2, Pécs, Hungary
| | - Albert Varga
- Faculty of Medicine, Department Family Medicine, University of Szeged, 6725 Tisza Lajos krt. 109, Szeged, Hungary
| | - Csenge Hargittay
- Department of Family Medicine, Semmelweis University, 1085 Stáhly u. 9, Budapest, Hungary
| | - Dalma Csatlós
- Department of Family Medicine, Semmelweis University, 1085 Stáhly u. 9, Budapest, Hungary
| | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, 1085 Stáhly u. 9, Budapest, Hungary
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Banovac I, Katavić V, Blažević A, Bičanić I, Hladnik A, Kovačić N, Petanjek Z. The anatomy lesson of the SARS-CoV-2 pandemic: irreplaceable tradition (cadaver work) and new didactics of digital technology. Croat Med J 2021. [PMID: 33938657 PMCID: PMC8107989 DOI: 10.3325/cmj.2021.62.173] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Aim To compare the efficacy of different components of online and contact anatomy classes as perceived by medical students. Methods An anonymous course evaluation survey was conducted at the end of the academic year 2019/2020. The organization of classes due to the SARS-CoV-2 pandemic provided our students with a unique opportunity to compare online and contact classes. Students’ responses were analyzed according to the type of obtained data (ratio, ordinal, and categorical). Results The response rate was 95.58%. Approximately 90% of students found anatomical dissection and practical work in general to be the most important aspect of teaching, which could not be replaced by online learning. During online classes, students missed the most the interaction with other students, followed by the interaction with student teaching assistants and teaching staff. Very few students found contact lectures useful, with most students reporting that they could be replaced with recorded video lectures. In contrast, recorded video lectures were perceived as extremely helpful for studying. Regular weekly quizzes were essential during online classes as they gave students adequate feedback and guided their learning process. Students greatly benefitted from additional course materials and interactive lessons, which were made easily available via e-learning platform. Conclusions Anatomical dissection and interaction during contact classes remain the most important aspects of teaching anatomy. However, online teaching increases learning efficiency by allowing alternative learning strategies and by substituting certain components of contact classes, thus freeing up more time for practical work.
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Affiliation(s)
| | | | | | | | | | | | - Zdravko Petanjek
- Zdravko Petanjek, Department of Anatomy and Clinical Anatomy and Croatian Institute for Brain Research, University of Zagreb School of Medicine, Šalata 11, 10 000 Zagreb, Croatia,
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Civitelli G, Liddo M, Mutta I, Maisano B, Tarsitani G, Marceca M, Cedeno GC, Geraci S. A service-learning experience in a free medical centre for undocumented migrants and homeless people. ACTA ACUST UNITED AC 2021; 79:7. [PMID: 33436087 PMCID: PMC7801867 DOI: 10.1186/s13690-021-00530-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/05/2021] [Indexed: 02/08/2023]
Abstract
Background Service-learning experiences, informed by the realities of poverty and marginalization, are important for the education of future health professionals in order to commit them to tackling health inequalities and working with underserved populations. At the Caritas Medical Centre for undocumented migrants and homeless in Rome, students obtain an educational experience of service. The aim of this study is to try to measure the long-term impact of this experience on the professional and life choices of the student participants. Methods A questionnaire was designed and distributed by email to all 19–29 years old participants in the experience. Responses were collected and analysed in a quantitative descriptive way and in a qualitative way using the knowledge, skills and attitudes model. Results One hundred and seven students responded from the total 763 questionnaires distributed. Ninety-five percent of participants expressed a very high overall satisfaction, 93% declared that the experience influenced his/her future personal choices, and 84% found that the experience influenced their professional choices. Results were arranged into 6 categories of comments: knowledge about the realities of migration, poverty, and marginalization; relational skills; collaborative skills; attitudes towards migrants, poor people and others; Attitudes towards future professions; Attitudes towards life. A final category was listed with self-reflective questions related to the experience. Conclusion This research shows the importance of service-learning experiences made during academic studies from young students of medicine and other faculties. Developing a relationship with marginalized and homeless people, within a voluntary service setting, can influence the future professional and personal choices of students. Universities should recognize the value of such experiences and establish partnerships with non-profit organizations to allow future health professionals to confront health inequities and commit themselves to their reduction.
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Affiliation(s)
- Giulia Civitelli
- Department of Public Health and Infectious Diseases - Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy. .,Caritas Medical Area, Via Marsala 103, 00185, Rome, Italy.
| | - Marica Liddo
- Caritas Medical Area, Via Marsala 103, 00185, Rome, Italy
| | - Irene Mutta
- Caritas Medical Area, Via Marsala 103, 00185, Rome, Italy
| | - Bianca Maisano
- Caritas Medical Area, Via Marsala 103, 00185, Rome, Italy
| | - Gianfranco Tarsitani
- Department of Public Health and Infectious Diseases - Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases - Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
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Abstract
Although current literature about the “cure versus care” issue tends to promote a patient-centered approach, the disease-centered approach remains the prevailing model in practice. The perceived dichotomy between the two approaches has created a barrier that could make it difficult for medical students and physicians to integrate psychosocial aspects of patient care into the prevailing disease-based model. This article examines the influence of the formal and hidden curricula on the perception of these two approaches and finds that the hidden curriculum perpetuates the notion that “cure” and “care” based approaches are dichotomous despite significant changes in formal curricula that promote a more integrated approach. The authors argue that it is detrimental for clinicians to view the two approaches as oppositional rather than complementary and attempt to give recommendations on how the influence of the hidden curriculum can be reduced to get a both-cure-and-care-approach, rather than an either-cure-or-care-approach.
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Affiliation(s)
| | - Nico Nortjé
- Department of Critical Care, Division of Anesthesiology and Critical Care, University of Texas MD Anderson Cancer Center, Houston, TX, USA. .,Department of Dietetics and Nutrition, University of the Western Cape, Bellville, South Africa. .,Centre for Health Care Ethics, Lakehead University, Thunder Bay, Ontario, Canada.
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