Vulnerability as strength: Thoughts on changing medicine’s hidden curriculum

Lab-coats-300x223My most recent post at Absolutely, Maybe is up. Here’s an excerpt:

I recently read this article in Health Affairs regarding the effects of the hidden curriculum on patient safety and, in my usual fashion, have been thinking about it ever since.

Dr Joshua Liao describes an experience he had as a medical student on labor and delivery, when the dynamics of his team contributed to his fear of speaking up about not knowing how to do something. He highlights the importance of subtle team dynamics and pressures:

“Egregious behavior is just the visible tip of a much larger iceberg. Far more prevalent are the subtle behaviors that threaten patient safety but go largely unnoticed and unaddressed… Progress in patient safety may be hindered as much by such subtle behaviors as by overtly inappropriate physicians.”

I share his concern about the challenges of eliminating the hidden curriculum. My medical school’s patient safety curriculum included several small group sessions, during which I heard my own concerns echoed by classmates: how should we navigate hierarchy? Who can we turn to for support? How do we avoid retaliation – both overt and subtle?

Read more

* Image: Lab 15 – Lab coats, from Pi via Wikimedia Commons.

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