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There is a renewed interest in teaching and cultivating compassionate patient-centered care among trainees and faculty. Much of the erosion in medical professionalism can be attributed to what has been labeled the "Hidden Curriculum." We have identified eight archetypal areas where the Hidden Curriculum exerts influence on trainees and faculty. These include: Lack of Accountability to Patients, The Influence of Legal Phobia, Physician and Nursing Overload (how documentation and busy work detracts from patient-centered care), Negative Attitudes and Apathy from Teachers, The Influence of the Electronic Health Record (EHR) in Patient Depersonalization, The Negative Effect of "Work-Life" Balance, The Concept of the "Difficult Patient," and the Negative impact of Evidence-Based Medicine on a Patient-Centered Approach. We believe that we need to focus and assess the residents and faculty's knowledge and attitudes towards the Hidden Curriculum. We believe that reflective learning can enhance professionalism, humanism and compassionate patient-centered care. Reflective learning with specific focus on hidden curriculum can also contribute to the continuous improvement of care in our complex health care environment. In addition interprofessional seminars debating impact of Hidden Curriculum can increase awareness among health professionals on the hidden curriculum in daily practice and education.

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Behavioral and social science integration in clinical practice improves health outcomes across the life stages. The medical school curriculum requires an integration of the behavioral and social science principles in early medical education. We developed and delivered a four-week course entitled "LifeStages" to the first year medical students. The learning objectives of the bio-behavioral and social science principles along with the cultural, economic, political, and ethical parameters were integrated across the lifespan in the curriculum matrix. We focused on the following major domains: Growth and Brain Development; Sexuality, Hormones and Gender; Sleep; Cognitive and Emotional Development; Mobility, Exercise, Injury and Safety; Nutrition, Diet and Lifestyle; Stress and coping skills, Domestic Violence; Substance Use Disorders; Pain, Illness and Suffering; End of Life, Ethics and Death along with Intergenerational issues and Family Dynamics. Collaboration from the clinical and biomedical science departments led to the dynamic delivery of the course learning objectives and content. The faculty developed and led a scholarly discussion, using the case of a multi-racial, multi-generational family during Active Learning Group (ALG) sessions. The assessment in the LifeStages course involved multiple assessment tools: including the holistic assessment by the faculty facilitator inside ALGs, a Team-Based Learning (TBL) exercise, multiple choice questions and Team Work Assessment during which the students had to create a clinical case on a LifeStages domain along with the facilitators guide and learning objectives.

Residency programs are arduous and rigorously structured surrounding active patient care management. Residency years are formative years for physician's career. Gaining trust and autonomy from supervising physicians for their actions is critical to be an effective team member and gaining clinical experience and education. . Entrusting a resident with critical actions and behaviors shapes their competency and judgments. Becoming a competent practicing physician requires clinical problem solving and judgment during training years. Residents are negatively impacted by a lack of trust in their skills, autonomy, and a blurred sense of accountability in current teamwork environment. Entrustment is necessary for a trainee to begin to practice autonomously and be accountable for their actions and decisions. The complex interplay between trust, autonomy, and accountability during clinical training allows them to become highly motivated, develop competency, independently manage their patients, become autonomous learners and teachers, and deliver effective patient care.Supervising physician trust in a resident implies a personal judgment in the outcome of the resident's future performance. Trust is not an observed ability; rather, it is a "gut feeling" that may not always match up for formally assessed knowledge or skill. Entrustment require selfcontrol, masterful inactivity and watchful expectancy in his/her resident. This style of supervision gives the resident psychological, emotional and cognitive safety and create nurturing learning environment. The residency programs should strive to provide optimal balance between trust, accountability and autonomy with best patient safety. This trust become more evident during the night medicine or night time duties for residents when supervising physicians are not always available for immediate supervision.