Abstracts
Abstract
Background: While research suggests that manifestations of the hidden curriculum (HC) phenomenon have the potential to reinforce or undermine the values of an institution, very few studies have comprehensively measured its scope, impact, and the varied clinical teaching and learning contexts within which they occur. We explored the HC and examined the validity of newly developed constructs and determined the influence of context on the HC.
Methods: We surveyed medical students (n =182), residents (n =148), and faculty (n = 140) from all disciplines at our institution between 2019 and 2020. Based on prior research and expertise, we measured participants’ experience with the HC including perceptions of respect and disrespect for different medical disciplines, settings in which the HC is experienced, impact of the HC, personal actions, efficacy, and their institutional perceptions. We examined the factor structure, reliability, and validity of the HC constructs using exploratory factor analysis Cronbach’s alpha, regression analysis and Pearson’s correlations.
Results: Expert judges (physician faculty and medical learners) confirmed the content validity of the items used and the analysis revealed new HC constructs reflecting negative expressions, positive impacts and expressions, negative impacts, personal actions, and positive institutional perceptions of the HC. Evidence for criterion validity was found for the negative impacts and the personal actions constructs and were significantly associated with the stage of respondents’ career and gender. Support for convergent validity was obtained for HC constructs that were significantly correlated with certain contexts within which the HC occurs.
Conclusion: More unique dimensions and contexts of the HC exist than have been previously documented. The findings demonstrate that specific clinical contexts can be targeted to improve negative expressions and impacts of the HC.
Résumé
Contexte : Bien que la recherche porte à croire que les expressions du curriculum caché (CC) ont le potentiel de renforcer ou de miner les valeurs d’un établissement, très peu d’études ont évalué de manière exhaustive sa portée, ses effets et les divers contextes d’enseignement et d’apprentissage cliniques dans lesquels elles se produisent. Nous avons exploré le CC, examiné la validité de nouvelles notions et déterminé l’influence du contexte sur le CC.
Méthodes : Entre 2019 et 2020, nous avons interrogé des étudiants (n =182), des résidents (n =148) et des membres du corps professoral (n = 140) de notre établissement, toutes disciplines médicales confondues. Sur la base de travaux et d’expertises antérieures, nous avons mesuré l’expérience des participants par rapport au CC, y compris leurs perceptions du respect ou du non-respect dans diverses disciplines médicales, les contextes dans lesquels ils ont été confrontés au CC, les effets du CC, les actions personnelles des participants et leur efficacité, de même que les perceptions des établissements. Nous avons analysé la structure factorielle, la fiabilité et la validité des notions du CC à l’aide d’une analyse factorielle exploratoire, du coefficient alpha de Cronbach, d’une analyse de régression et des corrélations de Pearson.
Résultats : Des juges experts (médecins enseignants et apprenants) ont confirmé la validité du contenu des éléments utilisés et l’analyse a révélé de nouvelles notions du CC reflétant des expressions négatives, des expressions et des effets positifs, des effets négatifs, des actions personnelles et des perceptions positives du CC au sein des établissements. Une validité de critère a été démontrée pour les notions d’effets négatifs et d’actions personnelles et a été associée de manière significative à l’étape de la carrière des répondants et à leur sexe.une validité convergente a été confirmée pour les notions de CC qui étaient significativement corrélées à certains contextes dans lesquels le CC se manifeste.
Conclusion : Il existe plus de dimensions et de contextes uniques du CC que ceux qui avaient été rapportés par le passé. Nos résultats montrent que des contextes cliniques spécifiques peuvent être ciblés pour améliorer les expressions négatives et les effets négatifs du CC.
Appendices
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