Study reveals 'hidden' curriculum of humiliation in medical school

September 30, 2004

A 'hidden' curriculum of haphazard tuition and teaching by humiliation exists in undergraduate medical education, finds a study in this week's BMJ.

Researchers interviewed 36 students at one UK medical school about their experiences and perceptions of the quality of teaching received during their undergraduate training.

Students reported many examples of positive role models and effective, approachable teachers. However, students also described a hierarchical and competitive atmosphere in which haphazard tuition and teaching by humiliation continue to occur.

Twenty-five students described the haphazard nature of teaching, particularly by clinical staff, who often disregarded the formal timetable. Final year students were especially critical of what they perceived as a lack of commitment and poor teaching skills in some staff members.

Twenty-one students reported 29 incidents of humiliation, particularly during ward rounds in their clinical years. Almost all the reported perpetrators were male doctors and three quarters were senior medical staff. One student said: "I've found my first rotation was very stressful, humiliating, I worked and read because of fear, because of being targeted - and that was just miserable."

Overall, half of the students reported that competition rather than co-operation was the defining characteristic of medicine.

Although this study relies on interview accounts rather than observation of actual teaching and the data were collected from only one medical school, the reports suggest a worrying lack of accountability of medical teachers in overstretched clinical settings, say the authors.

Medical education has largely escaped from the quality control rigours imposed on clinical practice. Indeed, relatively few doctors have received formal training in teaching methods, educational theories, or modes of assessment.

Recognition and reform of the hidden curriculum is required to achieve the necessary fundamental changes to the culture of undergraduate medical education, they conclude.


Related Medical Education Articles from Brightsurf:

How can education researchers support education and public health and institutions during COVID-19?
As education researchers' ongoing work is interrupted by school closures, what can they do to support education and public health institutions dealing with the Covid-19 pandemic?

Online education platforms could scale high-quality STEM education for universities
Online and blended (online and in-person) STEM instruction can produce the same learning outcomes for students as traditional, in-person classes at a fraction of the cost, finds research published today in Science Advances.

Teaming basic scientists with clinicians may improve medical education retention
There is a trend in modern medical school curriculum design to integrate the basic sciences and clinical sciences.

Medicare overpayments for graduate medical education could total $1.28 billion annually
If Medicare capped funds for Graduate Medical Education (GME) at the rate of $150,000 per resident, the move would free up more than $1 billion a year, according to a study published today in JAMA Internal Medicine.

Gamification can give dental and medical education a boost
Introducing gamification to medical and dental education can boost student motivation and lead to better learning outcomes, a new study from the University of Eastern Finland shows.

Flipped classroom enhances learning outcomes in medical certificate education
The quality of medical certificates written by students of medicine was better when they were taught by using the flipped classroom approach instead of traditional lecturing.

Most surgical residents want personal financial education offered during medical training
Close to 80 percent of resident respondents to one online survey said they think personal financial education is needed during residency, according to study findings in the Journal of the American College of Surgeons.

Centralized infrastructure facilitates medical education research
The Council of Academic Family Medicine Educational Research Alliance has enabled a large number of research teams to conduct meaningful scholarship with a fraction of the usual time and energy.

Individual education programs not being used as intended in special education
Gone are the days when students with disabilities were placed in a separate classroom, or even in a completely different part of the school.

Springer Healthcare launches Medicine Matters, a new medical education website
Springer Healthcare launches Medicine Matters, a new medical education website.

Read More: Medical Education News and Medical Education Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to