The formal and informal surgical ethics curriculum: views of resident and staff surgeons in Toronto

Perceptions of Academic Health Science Research Center Personnel Regarding Informed Consent Processes and Therapeutic Misconception

“…. it’s potentially a little misleading.” The discussion about the informed consent process is consistent with previous research that found potentially misleading language in consent forms and in the language used by research staff (Howard et al, 2012). Not only can this language lead to TM in research subjects, but the language also can be an indication of TM of the research staff.…”

“…Investigations of TM have focused on potential subjects’ perceptions (Gammelgaard et al 2006; Hoehn et al 2009) in clinical trial contexts of study enrollment and informed consent processes (Nathan et al, 2010; Pletsch and Stevens, 2001; Stone et al, 2005; Tait et al, 2003). In recent years, empirical research expanded its scope to include TMs of health care providers who simultaneously serve as investigators, finding that they, too, sometimes conflate the goals of research and clinical care (Howard et al, 2012; Miller, 2000; Mueller, 2004). Moreover, the scope of inquiry about TM is widening beyond clinical trials and initial informed consent processes to other contexts.…”

Using the Hidden Curriculum to Teach Professionalism in Nursing Students

“…In this study, besides the description of ethics as an element of professionalism, the students said implicitly that the hidden curriculum has a key role in learning professional ethics and its internalization in practice. Similarly, other studies showed that the hidden curriculum is the best way for transferring and teaching the ethical principles (17, 18). Researchers believe that for ethical development in students, curriculum planners should consider both the formal curriculum and the hidden one (19).…”

Being a Surgeon—The Myth and the Reality

“…Surgeons acknowledged their strong cultural identity (image), described as a ritualistic, social construction that is informally and implicitly transmitted from one generation to the next 20,49,62 :t h e so-called "hidden curriculum." 42,43,48,49,54,62 Attached to this identity are shared social values (eg, doing a meaningful work), requirements (corresponding to subjective idealized concepts, such as selfconfidence), and expectations (presented as moral imperatives such as not giving up and being successful) ( Table 5).…”

“…Individual personal vulnerability, 20,44 do not express their fragility 41 ; do not show stress because it is seen as a weakness 51,52 ; need to be reassured 41 ; feeling more sensitive than other surgeons, 51 culture of competition Expectations 26,48,62 Do everything possible, without giving up; do not abnegate responsibility Goal of surgery is cure 33 ; fear of giving the impression that the surgeon is giving up 38 ; challenge of continuing to provide care as commitment to serve and patients' health decline 33 ; frustration 57 ; powerlessness 54 ; perceive self as the (sole) patient advocate 57 ; believe anesthesiologists and nurses have different motivations 45 ; perception of AD 24 Quick, decisive, and able to accomplish immediate task-related goals Identity as a "good" surgeon is linked to performance; efficiency defined as a production time per unit 45 ; link between task and self in case of AE 20 ; be "successful," "pressure to appear busy," filling in the operating list, "nothing more dangerous than a surgeon who has a gap in their operating room schedule" 43 ; difficulty in making the transition from routine to effortful in the operating room. 46…”