The Hidden Curriculum and Integrating Cure- and Care-Based Approaches to Medicine

Abstract

Although current literature about the "cure versus care" issue tends to promote a patient-centered approach, the disease-centered approach remains the prevailing model in practice. The perceived dichotomy between the two approaches has created a barrier that could make it difficult for medical students and physicians to integrate psychosocial aspects of patient care into the prevailing disease-based model. This article examines the influence of the formal and hidden curricula on the perception of these two approaches and finds that the hidden curriculum perpetuates the notion that "cure" and "care" based approaches are dichotomous despite significant changes in formal curricula that promote a more integrated approach. The authors argue that it is detrimental for clinicians to view the two approaches as oppositional rather than complementary and attempt to give recommendations on how the influence of the hidden curriculum can be reduced to get a both-cure-and-care-approach, rather than an either-cure-or-care-approach.

Classism in pain assessment and management: the mediating role of female patient dehumanization and perceived life hardship

“…As mentioned in the introduction, health-care training and profession social status may account for these group differences. Nurses, by usually being more oriented towards patient care (vs. cure) than physicians/medical students, are more willing to integrate psychosocial factors in their appraisals of clinical situations [6,15], which could explain their perceptions of the Low SES woman's pain as more severe, credible, and deserving more individualized care. Also, as in most societies doctors are considered of higher social status [37,42], our findings may be reflecting an in-group favouritism bias, i.e., the tendency to favour members of one's own group than those of other groups [23].…”

“…To test these hypotheses, we have conducted two experimental studies -with medical students (study 1) and nurses (study 2). Medical and nursing professions differ in social status [37,42] and training (focus on curing vs. caring) [6,15], which could influence the This is a post-print version of a paper published in PAIN (2021) http://dx.doi.org/10.1097/j.pain.0000000000002278 5 extent to which patient SES is integrated in medical students' and nurses' PAMP. These differences were explored.…”

The Profound Implications of the Meaning of Health for Health Care and Health Equity

“…Both undergraduate and graduate medical education provide important opportunities for training in the holistic meaning of health. The biopsychosocial model is widely taught but often undermined by the hidden curriculum in which trainees witness attending physicians focusing mainly on biomedical issues 110,111 . Addressing this significant challenge will require leadership and culture change coupled with training including mindfulness and role‐modeling in self‐care 111–115 …”

“…The biopsychosocial model is widely taught but often undermined by the hidden curriculum in which trainees witness attending physicians focusing mainly on biomedical issues. 110,111 Addressing this significant challenge will require leadership and culture change coupled with training including mindfulness and role-modeling in self-care. [111][112][113][114][115] Primary care has long embraced the concept of positive health and the central role of SDOHs.…”

Positive Consequences of the Hidden Curriculum in Undergraduate Nursing Education

“…Also, the loss of human values at the bedside, lack of updated practice, negative role models, losing confidence, and bullying behaviors and incivilities have been mentioned in other studies. [ 4 11 ] However, most of the previous studies focused on the definitions of HC concept[ 2 ] and its context, causes,[ 12 ] dimensions,[ 13 ] and processes,[ 14 ] while its consequences in nursing education were less investigated. Therefore, here, we focused on positive consequences as an approach to maintain and promote professional values.…”