Learning machines or the key to care: a qualitative study exploring the impact of the hidden curriculum on medical students’ longitudinal experiences in primary care
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objective Longitudinal learning often faces implementation challenges within UK medical schools. Some have suggested that the hidden curriculum may be implicated, but there is little evidence regarding how the hidden curriculum influences student experiences of, and engagement with longitudinal learning. Given this, our objective was to explore the impact of the hidden curriculum on student experiences of a longitudinal curriculum based in primary care at a research-intensive medical school.
Design We conducted a longitudinal qualitative study. Students participated in three serial, in-depth semistructured interviews. We conducted a longitudinal thematic analysis.
Setting One research-intensive medical school based in the UK. Data collection occurred in 2021–2022.
Participants 12 penultimate year medical students taking part in a longitudinal primary care placement for 1 day a week over the course of one academic year.
Results We constructed four themes capturing insights on how hidden curricula influenced students’ experiences: (1) A culture which stresses assessment influences student engagement with longitudinal learning; (2) Longitudinal relationships can challenge the hidden curriculum; (3) Support and continuity within primary care improves skills and can influence belonging and (4) Logistical issues influence engagement with longitudinal learning.
Conclusions The hidden curriculum, particularly related to assessment, plays a large role in student perceptions of educational value and subsequent engagement with curricula. In a research-intensive institution, longitudinal learning, particularly within primary care, was perceived as at odds with what was important for assessments. Where longitudinal relationships were successfully established, students became more aware of the benefits of person-centred practice. For primary care longitudinal education to succeed in more research-intensive institutions, there must first be advocacy for greater representation of primary care and person-centred values within organisational structures to ensure meaningful curricular alignment.
Design We conducted a longitudinal qualitative study. Students participated in three serial, in-depth semistructured interviews. We conducted a longitudinal thematic analysis.
Setting One research-intensive medical school based in the UK. Data collection occurred in 2021–2022.
Participants 12 penultimate year medical students taking part in a longitudinal primary care placement for 1 day a week over the course of one academic year.
Results We constructed four themes capturing insights on how hidden curricula influenced students’ experiences: (1) A culture which stresses assessment influences student engagement with longitudinal learning; (2) Longitudinal relationships can challenge the hidden curriculum; (3) Support and continuity within primary care improves skills and can influence belonging and (4) Logistical issues influence engagement with longitudinal learning.
Conclusions The hidden curriculum, particularly related to assessment, plays a large role in student perceptions of educational value and subsequent engagement with curricula. In a research-intensive institution, longitudinal learning, particularly within primary care, was perceived as at odds with what was important for assessments. Where longitudinal relationships were successfully established, students became more aware of the benefits of person-centred practice. For primary care longitudinal education to succeed in more research-intensive institutions, there must first be advocacy for greater representation of primary care and person-centred values within organisational structures to ensure meaningful curricular alignment.
Date Issued
2023-09
Date Acceptance
2023-08-21
Citation
BMJ Open, 2023, 13 (9), pp.1-9
ISSN
2044-6055
Publisher
BMJ Publishing Group
Start Page
1
End Page
9
Journal / Book Title
BMJ Open
Volume
13
Issue
9
Copyright Statement
© Author(s) (or their
employer(s)) 2023. Re-use
permitted under CC BY-NC. No
commercial re-use. See rights
and permissions. Published by
BMJ.
employer(s)) 2023. Re-use
permitted under CC BY-NC. No
commercial re-use. See rights
and permissions. Published by
BMJ.
License URL
Identifier
https://bmjopen.bmj.com/content/13/9/e074227
Publication Status
Published
Article Number
e074227
Date Publish Online
2023-09-20