The search for attitude—a hidden curriculum assessment from a central European perspective

BACKGROUND: Little is known about the development of the hidden curriculum in the medical education system. It refers to a conglomeration of implicit beliefs, attitudes and forms of conduct that are unwittingly transmitted from one generation of teaching physicians to the next. How can we describe this process, what are the potential positive or negative impacts, and last but not least, how can we measure it? METHODS: Students of the Medical University of Vienna complete their clinical rotations in Vienna and in other accredited, mostly central European hospitals. They were subsequently invited to evaluate their rotations in an online questionnaire regarding dimensions, such as professionalism, teaching, integration and appreciation. RESULTS: In total, 133 students participated in this pilot study and the average response rate was 10.1%, similar to evaluations conducted prior to that. Although the evaluation results on average were positive, several experiences of deprecation and less professional conduct were present in each evaluated rotation. Giving the students the opportunity to reflect upon their experiences could be seen as an intervention and investigation at the same time. CONCLUSIONS: This survey serves as a precursor to a qualitative interview-based study, accompanying the implementation of case-based learning designed by collaborating residents and medical students. The findings of this pilot-study support the necessity of fostering a reflective capacity in the education of medical students, enabling them to speak up and live up to the expected professionalism despite shortcomings within the hidden curriculum.