title: Student and Faculty Reflections of the Hidden Curriculum.
abstract: The hidden curriculum, or the socialization process of medical training, plays a crucial role in the development of physicians, as they navigate the clinical learning environment. The purpose of this qualitative study was to examine medical faculty and students' perceptions of psychological, moral, and spiritual challenges during medical training in caring for critically ill patients. Focus groups were conducted with 25 Harvard Medical School (HMS) students, and interviews were conducted with 8 HMS faculty members. Five major themes emerged as important in shaping students' medical training experiences. First, students and faculty discussed the overall significance of the hidden curriculum in terms of the hierarchy of medicine, behavioral modeling, and the value placed on research versus clinical work. Second, respondents articulated values modeled in medicine. Third, students and faculty reflected on changes in student development during their training, particularly in terms of changes in empathy and compassion. Fourth, respondents discussed challenges faced in medical school including professional clinical education and the psychosocial aspects of medical training. Finally, students and faculty articulated a number of coping mechanisms to mitigate these challenges including reflection, prayer, repression, support systems, creative outlets, exercise, and separation from one's work. The results from this study suggest the significance of the hidden curriculum on medical students throughout their training, as they learn to navigate challenging and emotional experiences. Furthermore, these results emphasize an increased focus toward the effect of the hidden curriculum on students' development in medical school, particularly noting the ways in which self-reflection may benefit students.
authors.affiliation: 1 Department of Sociology, Brandeis University, Waltham, MA, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Bandini
authors.affiliation: 2 Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Mitchell
authors.affiliation: 3 Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Zachary D
authors.initials: ZD
authors.lastname: Epstein-Peterson
authors.affiliation: 4 Harvard Medical School Boston, Boston, MA, USA.
authors.forename: Ada
authors.initials: A
authors.lastname: Amobi
authors.affiliation: 5 Theology Department, Boston College, Chestnut Hill, MA, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cahill
authors.affiliation: 6 Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School Boston, Boston, MA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Peteet
authors.affiliation: 7 Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School Boston, Boston, MA, USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Balboni
authors.affiliation: 8 Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School Boston, Boston, MA, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Balboni
mesh_terms: D001291:Attitude of Health Personnel; D016638:Critical Illness / Q000628:therapy; D003479:Curriculum; D004501:Education, Medical / Q000379:methods; D004645:Empathy; D005180:Faculty, Medical / Q000523:psychology*; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D036301:Qualitative Research; D012951:Socialization; D013337:Students, Medical / Q000523:psychology*
keywords: hidden curriculum; medical education; professionalism; training