What do we transfer in case discussions? The hidden curriculum in medicine…

Abstract

Medical students and junior doctors learn according to the formal curriculum, but they also learn unwritten rules, the specific logic of the medical world, through a socialization process called ‘the hidden curriculum’. The result of the process seems to be an exclusive professional identity, the medical habitus. This article underlines the importance of the hidden curriculum in medicine, especially in meetings where patients are discussed. These case discussions, common daily rituals in medical practice, demonstrate the dynamic interaction of learning and practice within the medical world. The article illustrates how medical core values are transferred informally and implicitly, and the role of power relations in this process. Not only are residents being assessed and trained in case discussions, but also staff are assessing each other and learning continuously. Therefore, these meetings might significantly contribute to self-regulation in medicine. The significance of the hidden curriculum should not be underestimated. Insights into the dynamics of case discussions may help medical specialists to make the most of this moment of learning and to avoid the pitfalls, for the benefit of both residents and experienced medical specialists.