PGY1 pharmacy resident
Carroll Hospital Center
“By the end of this class, you should be able to…” Many of us are familiar with this standard opener for learning objectives. We used them as students to guide our focus and prepare for exams, and now as lecturers and future educators we use them to guide our students and illustrate for them what we would like them to learn. There is another realm of learning, however, that occurs in an educational environment, termed by Philip Jackson in his book Life in Classrooms as the hidden curriculum.
The hidden curriculum, Jackson explains, are “the norms and values that are implicitly, but effectively, taught in schools and that are not usually talked about in teachers’ statements of goals.” These values are often created by the relationship and interactions between the students and instructors. According to Jackson, the most successful students and teachers are those that have mastered both the covert and the hidden curricula (1). In 1994, Dr. Frank Hafferty applies this definition specifically to medical students in his essay The hidden curriculum, ethics teaching, and the structure of medical education. Hafferty discusses the impact of directly teaching medical ethics versus allowing students to naturally pick up on medical ethics through observation of their instructions and preceptors and concludes with a proposed framework for managing the hidden curriculum (2).
Many aspects are included in the hidden curriculum. From which students the professors choose to call on the most, to which activities are considered required versus elective, to how professors interact with their colleagues around students, students subconsciously notice these choices and begin altering their value system to accommodate them. Students see their teachers as role models. They pick up on little details such as emotions relayed while providing patient case examples and intuitively understand when professors are passionate about their subject material. While this can seem very intimidating for the instructor, Hafferty maintains that this is, in fact, positive. While classes directly teaching medical ethics can be helpful, students tend to learn this topic best when they can observe it naturally (2).
How does one go about altering the hidden curriculum? Step number one, according to Hafferty, is to simply be mindful and observant. Know that students are watching and learning. The most impressionable students are often the youngest ones and the ones who are newest to the profession as they are completely reliant on the educators to shape their knowledge of the work culture. In addition to observing yourself as a teacher to see what biases you may be projecting, provide opportunities for others to observe you and provide feedback. Be receptive to both formal and informal evaluations from students. Ask your colleagues what hidden messages you are projecting. Consider inviting an outsider who can provide an unbiased view (2).
In addition to removing negative components of the hidden curriculum, work towards consciously adding positive components. Choose to incorporate patient case examples that highlight compassion. Be respectful when interacting with colleagues and coworkers. Strive to be inclusive of all students in the classroom. Initiate conversations about medical ethics. Utilize the hidden curriculum to promote the topics you want your students to internalize (3).
Many factors help mold learners as they transition from students to contributing professionals. While not discussed as frequently as the covert academic curriculum, the hidden curriculum is important for shaping the characters of students as future healthcare professions. As educators or future educators, we should be mindful of the messages we are subliminally transmitting. When we strive to eliminate our negative, biased views and replace them with compassionate, ethical ones, we are helping to create the next generation of caring and ethical healthcare professionals.
References:
1. Jackson PW. Life in Classrooms. New York (NY): Teachers College Press; 1990.
2. Hafferty, F W; Franks, R. The hidden curriculum, ethics teaching, and the structure of medical education. Academic Medicine: 1994 Nov;69(11):861-71. https://journals.lww.com/academicmedicine/Abstract/1994/11000/The_hidden_curriculum,_ethics_teaching,_and_the.1.aspx
3. Eastwood GL. Ethical Leadership in the Hidden Curriculum. Int J Leadersh Educ: 2021 Fall;65-72. https://scholarlycommons.law.case.edu/cgi/viewcontent.cgi?article=1129&context=ijel
No comments:
Post a Comment