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The Informal Curriculum of Family Medicine – what does it entail and how is it taught to residents? A systematic review.
Erica Rothlind
Karolinska Institutet
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7302-0286
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Background The informal curriculum is a seemingly well-explored concept in the realm of medical education. However, it is a concept with multiple definitions and the term “the hidden curriculum” is often used interchangeably. In short, they both refer to the implicit learning taking place outside the formal curriculum, encompassing both a trickling down effect of organizational values and attitudes passed on by a mentor or colleague. While the informal curriculum is a recurrent theme in medical education literature; it is seldom discussed in Family Medicine. As the informal curriculum is likely to be highly influential in the forming of future family practitioners our aim was to explore the area further with respect to the following: which elements of the informal curriculum are applicable in a Family Medicine context and what educational interventions for Family Medicine residents, visualizing the various educational elements of it, have been performed? Methods We conducted a systematic review comprising iterative literature searches and a narrative synthesis of the results. Results 20 articles, published between 2000 and 2019, were included in the analysis which resulted in three partly interrelated themes comprising the informal curriculum in Family Medicine: gaining cultural competence, achieving medical professionalism and dealing with uncertainty. The themes on cultural competence and uncertainty seemed to be more contextual than professionalism, the latter being discussed in relation to the informal curriculum across various medical disciplines. Formalized training for Family Medicine residents in aspects of the informal curriculum appeared to be lacking, and in general the quality of the few interventional studies found was low. Conclusions Important aspects of being a family practitioner, such as cultural competence and dealing with uncertainty, are learned through a context-dependent informal curriculum. In order to ensure a more uniform base for all residents and to reduce the impact of the individual supervisor’s preferences, complementary formalized training would be beneficial. However, to date there are too few studies published to conclude how to best teach the informal curriculum.
Keywords
Informal/hidden curriculum, family medicine, general practice, post-graduate education
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This preprint is under consideration at BMC Family Practice. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Review
The Informal Curriculum of Family Medicine – what does it entail and how is it taught to residents? A systematic review.
Erica Rothlind
Karolinska Institutet
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7302-0286
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 2
Posted 30 Jan, 2020
No community comments so far
Editor assigned
On 29 Jan, 2020
Submission checks complete
On 28 Jan, 2020
Editor invited
On 28 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 20 Jan, 2020
Review #2 received
Received 17 Jan, 2020
Review #1 received
Received 21 Dec, 2019
Reviewer #2 agreed
On 16 Dec, 2019
Reviewer #1 agreed
On 10 Dec, 2019
Reviewers invited
Invitations sent on 18 Nov, 2019
Editor assigned
On 12 Nov, 2019
Submission checks complete
On 11 Nov, 2019
Editor invited
On 11 Nov, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background The informal curriculum is a seemingly well-explored concept in the realm of medical education. However, it is a concept with multiple definitions and the term “the hidden curriculum” is often used interchangeably. In short, they both refer to the implicit learning taking place outside the formal curriculum, encompassing both a trickling down effect of organizational values and attitudes passed on by a mentor or colleague. While the informal curriculum is a recurrent theme in medical education literature; it is seldom discussed in Family Medicine. As the informal curriculum is likely to be highly influential in the forming of future family practitioners our aim was to explore the area further with respect to the following: which elements of the informal curriculum are applicable in a Family Medicine context and what educational interventions for Family Medicine residents, visualizing the various educational elements of it, have been performed? Methods We conducted a systematic review comprising iterative literature searches and a narrative synthesis of the results. Results 20 articles, published between 2000 and 2019, were included in the analysis which resulted in three partly interrelated themes comprising the informal curriculum in Family Medicine: gaining cultural competence, achieving medical professionalism and dealing with uncertainty. The themes on cultural competence and uncertainty seemed to be more contextual than professionalism, the latter being discussed in relation to the informal curriculum across various medical disciplines. Formalized training for Family Medicine residents in aspects of the informal curriculum appeared to be lacking, and in general the quality of the few interventional studies found was low. Conclusions Important aspects of being a family practitioner, such as cultural competence and dealing with uncertainty, are learned through a context-dependent informal curriculum. In order to ensure a more uniform base for all residents and to reduce the impact of the individual supervisor’s preferences, complementary formalized training would be beneficial. However, to date there are too few studies published to conclude how to best teach the informal curriculum.
Figure 1
Figure 2