Hidden Curriculum in Medical Residency Programs: A Scoping Review

Abstract

INTRODUCTION: Hidden curriculum is important in medical education and has numerous, long-lasting effects on medical residency. The present scoping review seeks to investigate, identify, and plot the main concepts relating to hidden curriculum and its dimensions, domains, impacts and factors in medical residency courses based on the main references and evidence. METHODS: Scoping review methodology was used to guide a search of electronic databases for relevant papers. Of the 394 abstracts initially identified, after screening of both abstracts and full-text papers, 43 studies were selected for inclusion in this review. Following abstraction of key information from each study, a content analysis was undertaken. RESULTS: Eleven themes were identified from the content analysis: 1) Organizational Issues (13.77), 2) Socio-cultural Issues (10.5), 3) Professional Issues (13.41), 4) Communicational Factors (8.7), 5) Educational Issues (22.83), 6) Resident Personal Characteristics (21.01), and 7) Resident Educational Characteristics (9.78). Among the extracted effective hidden curriculum factors, the role modeling had the highest frequency and was emphasized in the studies. CONCLUSIONS: Although this study explained and identified the components, elements and also the preparation of the initial format of the hidden curriculum framework of the medical residency program, its results can reduce the negative effects of the hidden curriculum on it. More extensive and in-depth studies with different qualitative methods or mixed methods related to the hidden curriculum in different contexts and disciplines of medical residency are recommended to define characteristics of a constructive hidden curriculum of medical residency programs.