“Speed up”! The Influences of the Hidden Curriculum on the Professional Identity Development of Medical Students

Abstract

Purpose

To map and understand the influences of the hidden curriculum on the professional identity development of medical students based on the socialization process as proposed by Cruess et al. in a South American medical school.

Method

Between 2014 and 2016, the authors performed 13 focus groups interviews with a total of 102 final-year medical students in Brazil and analyzed the data using thematic template analysis.

Results

The authors identified three domains through which the hidden curriculum influences professional identity formation: (1) Speeding up - Repetition without reflection ends in a lack of awareness of professional identity formation; (2) Emotional dissonance in the context of negative role modeling; and (3) the conflict between personal and professional life.

Discussion

As teachers “Speed up” the clinical encounters, acting as negative role models, students internalized behaviors without reflecting on their attitudes, which culminates in a state of dissonance between the physician they wanted to be and the professionals they actually are, triggering feelings of shame and guilt. Without feeling the rewards that a meaningful practice can provide, students struggled with the idea of sacrificing themselves to become physicians. Physicians/teachers who did not have a meaningful relationship with their profession, who did not cultivate the values and virtues of good medicine and did not found joy in being a physician were not able to nurture meaning and fulfillment in their students. The concepts of socialization and professional identity formation fit the purpose of grounding the local understanding of the several components of the hidden curriculum. The authors believe that this map can be used as a guide to design targeted pedagogical activities.