Medical students and professionalism – Do the hidden curriculum and current role models fail our future doctors?

Abstract

Purpose: Formal medical curricula aim to promote professionalism through learning from lectures, interactive tutorials and simulations. We report an exploratory voting exercise, conducted within a new integrated professional teaching module, examining the likely influence on students’ knowledge and perceptions of truth telling.

Methods: Responses were collected from cohorts of final year students over a six-year period. Students were asked to pick between two responses to a standardized clinical vignette, firstly the response that they personally thought was the more desirable action, and subsequently the response they believed would most likely result in the context of everyday real-life clinical practice.

Results: The difference (proportional change) in voting for “avoid full disclosure” from vote 1 (more desirable action) to vote 2 (likely real-life response) was 50% (95% CI: 36–64%, p < 0.001) favoring avoidance of full disclosure.

Conclusions: This finding highlights a substantial inconsistency between the knowledge taught by the formal curriculum, and the perception generated by the hidden curriculum. Medical Schools should develop strategies to manage the hidden curriculum, prepare clinical teachers to be good role models, and prepare students to be discerning about the hidden curriculum and when choosing role models.

Ethical approval

Determined by Survey and Behavioral Research Ethics Committee of the Chinese University of Hong Kong not to be subject to requirements for human subject research approval.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Hidden curriculum: A set of influences that function at the level of organization structure and culture prevailing in the clinical learning environment (Hafferty FW. 1998. Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med. 73:403–407), or the unofficial and unacknowledged rules, values, and perspectives that students learn in the institutional environment.

Role-model: A person looked to by others as an example to be imitated (https://en.oxforddictionaries.com).

Mentor: An experienced and trusted advisor (https://en.oxforddictionaries.com).

Additional information

Notes on contributors

Gavin Matthew Joynt

Gavin Matthew Joynt, MBBCh FCICM FRCP, is Chairman and Professor, Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong ([email protected]).

Wai-Tat Wong

Wai-Tat Wong, MBBS, FRCP, is an Assistant Professor, Department of Anaesthesia and intensive Care, The Chinese University of Hong Kong ([email protected]).

Lowell Ling

Lowell Ling, MBBS, MPhil, is a Resident, Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Shatin, New Territories, Hong Kong ([email protected]).

Anna Lee

Anna Lee, MPH, PhD, FACE, is a Professor, Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong ([email protected]).