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Decoding the Learning Environment of Medical Education: A Hidden Curriculum Perspective for Faculty Development

Hafler, Janet P. EdD; Ownby, Allison R. PhD; Thompson, Britta M. PhD; Fasser, Carl E.; Grigsby, Kevin DSW; Haidet, Paul MD, MPH; Kahn, Marc J. MD; Hafferty, Frederic W. PhD

doi: 10.1097/ACM.0b013e31820df8e2
Faculty Development

Medical student literature has broadly established the importance of differentiating between formal-explicit and hidden-tacit dimensions of the physician education process. The hidden curriculum refers to cultural mores that are transmitted, but not openly acknowledged, through formal and informal educational endeavors. The authors extend the concept of the hidden curriculum from students to faculty, and in so doing, they frame the acquisition by faculty of knowledge, skills, and values as a more global process of identity formation. This process includes a subset of formal, formative activities labeled “faculty development programs” that target specific faculty skills such as teaching effectiveness or leadership; however, it also includes informal, tacit messages that faculty absorb. As faculty members are socialized into faculty life, they often encounter conflicting messages about their role. In this article, the authors examine how faculty development programs have functioned as a source of conflict, and they ask how these programs might be retooled to assist faculty in understanding the tacit institutional culture shaping effective socialization and in managing the inconsistencies that so often dominate faculty life.

Dr. Hafler is associate professor, Yale School of Medicine, Yale University, New Haven, Connecticut.

Dr. Ownby is director of educational programs and assistant professor, Department of Pediatrics, University of Texas Medical School at Houston, Houston, Texas.

Dr. Thompson is assistant professor, Department of Pediatrics, assistant dean for medical education, and director, Office of Educational Development and Support, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma.

Mr. Fasser is professor, Department of Allied Health Sciences and Department of Family and Community Medicine, and director, Department of Allied Health Sciences, Baylor College of Medicine, Houston, Texas.

Dr. Grigsby is senior director, Organizational Leadership Development, Association of American Medical Colleges, Washington, DC.

Dr. Haidet is director of medical education research and professor of medicine and humanities, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.

Dr. Kahn is senior associate dean for admissions and student affairs and professor of medicine, Tulane University School of Medicine, New Orleans, Louisiana.

Dr. Hafferty is professor of medical education and associate director, Program in Professionalism and Ethics, Mayo Clinic, Rochester, Minnesota.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Dr. Hafler, Yale University School of Medicine, Edward S. Harkness Hall, 367 Cedar Street, ESH 315, New Haven, CT 06510; telephone: (203) 737-5952; fax (203) 737-4199; e-mail:

First published online February 21, 2011

© 2011 Association of American Medical Colleges