THE HIDDEN CURRICULUM IN MEDICAL EDUCATION:

Taking stock, promoting the positive, and mitigating the negative

The FMEC PG Project’s Recommendation #3 (“create positive and supportive learning and work environments”) includes a call to identify and address both positive and negative aspects of the hidden curriculum (HC). Effecting meaningful change around the HC poses a challenge for medical schools. Our work aims to provide guidance for implementing strategies that address the HC.

A committee comprised of academic leaders, learners and other medical education stakeholders conducted a literature review of key articles related to the HC. Postgraduate accreditation standards relevant to the HC were also reviewed. Using an implementation lens, the committee then engaged in an iterative process of discussion and consensus building to develop recommendations.

There is nothing currently to guide postgraduate programs with regards to the hidden curriculum. Current postgraduate accreditation standards do not explicitly address the HC, although several standards touch on elements of the educational environment. It is as important to identify and celebrate the positives in the HC. Building on these will help to bring about culture change by helping people focus on what they are doing well.

There is no evidence in the literature that postgraduate programs currently identify or reflect on the hidden curriculum in their environments. There is helpful guidance from the Committee on Accreditation of Canadian Medical Schools (CACMS) with regards to the hidden curriculum.

Canada’s three certifying colleges (Royal College, CFPC, CMQ) are currently undertaking a transformational revision of their accreditation standards.

Using CACMS standards as a guideline, three recommendations were communicated to these three colleges to add to their deliberations.

Konkin J, Watling C, Busing N, Raegele M and FMEC PG Sub Committee on Learning & Work Environment

BACKGROUND/PURPOSE METHODS

RESULTS/OBSERVATIONS

Guidelines for new accreditation standards: Postgraduate programs should: 1. Demonstrate regular review of hidden curriculum, 2. Identify positive and negative influences of hidden curriculum and, 3. Take steps to promote the positive and mitigate the negative.

1. Identify current data available to programs to identify elements of their hidden curriculum, 2. Identify tools to assist in environmental reviews to determine elements of hidden curriculum 3. Develop, where necessary, new tools to assist programs in this endeavor

NEXT STEPS

CONCLUSION