The Hidden Curriculum: Changing The Water In Which We Swim | Health Affairs Blog

Tim Lahey writing about a recent essay in Health Affairs discussing medical education’s ‘hidden curriculum’:

There is no doubt we need a better culture of safety in medical education. In a survey of Iowa medical students, 32 percent reported inadequate communication to families, 19 percent saw patient confidentiality breached, and 14 percent witnessed deliberate deception in the context of medical care. A New York state study called out another likely universal problem: medical students fear reprisal if they report errors to protect patient safety.


Amid such efforts, we must be mindful that there is more to culture change than talking about it, or even speaking up about medical error. Culture is constructed of words, undoubtedly, but the context in which those words occur is at least as important as the words themselves. We must remember, as McLuhan reminded us, the medium is the message. And the medium in medical education—from morning report to ward rounds and every committee meeting in between—is teamwork.

Great insights throughout this article. In current medical culture, physicians (specifically attending physicians) still function as leaders of care teams. A culture of patient safety begins with their leadership and their sense of inclusivity in terms of discussing patient care with the entire team.