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Hidden in Plain Sight: The Formal, Informal, and Hidden Curricula of a Psychiatry Clerkship

Wear, Delese PhD; Skillicorn, Jodie DO

Academic Medicine:
doi: 10.1097/ACM.0b013e31819a80b7
The Educational Environment

Purpose: To examine perceptions of the formal, informal, and hidden curricula in psychiatry as they are observed and experienced by (1) attending physicians who have teaching responsibilities for residents and medical students, (2) residents who are taught by those same physicians and who have teaching responsibilities for medical students, and (3) medical students who are taught by attendings and residents during their psychiatry rotation.

Method: From June to November 2007, the authors conducted focus groups with attendings, residents, and students in one midwestern academic setting. The sessions were audiotaped, transcribed, and analyzed for themes surrounding the formal, informal, and hidden curricula.

Results: All three groups offered a similar belief that the knowledge, skills, and values of the formal curriculum focused on building relationships. Similarly, all three suggested that elements of the informal and hidden curricula were expressed primarily as the values arising from attendings’ role modeling, as the nature and amount of time attendings spend with patients, and as attendings’ advice arising from experience and intuition versus “textbook learning.” Whereas students and residents offered negative values arising from the informal and hidden curricula, attendings did not, offering instead the more positive values they intended to encourage through the informal and hidden curricula.

Conclusions: The process described here has great potential in local settings across all disciplines. Asking teachers and learners in any setting to think about how they experience the educational environment and what sense they make of all curricular efforts can provide a reality check for educators and a values check for learners as they critically reflect on the meanings of what they are learning.

Author Information

Dr. Wear is professor of behavioral sciences, Northeastern Ohio Universities College of Medicine, Rootstown, Ohio.

Dr. Skillicorn is attending physician, Department of Psychiatry, Summa Health System, Akron, Ohio.

Correspondence should be addressed to Dr. Wear, Behavioral Sciences Department, NEOUCOM, 4209 State Route 44, Rootstown, OH; telephone: (330) 325-6125; fax: (330)-325-5911; e-mail: (

© 2009 Association of American Medical Colleges