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Table 1 Major and minor themes of the hidden curriculum as depicted in television dramas

From: Life imitating art: Depictions of the hidden curriculum in medical television programs

Theme

Definition

Example

Major themes

Hierarchical nature of medicine

Discipline

This centers around the primacy put on certain specialties and sub specialties.

Perceived “superiority” of some specialties over others

Position in the hierarchy

The reinforcement of junior-senior interprofessional relations and positions within the medical hierarchy.

A staff physician belittling a junior resident

Patient perspective

Patients reinforcing hierarchy among medical trainees.

Patient refuses the services of a younger-looking professional over an older professional

Unprofessionalism

This refers to an individual’s behavior that demonstrates a lack of integrity or responsibility from others

Unprofessionalism from a staff physician

Evidence of tolerance of unprofessional behavior

Patient dehumanization

A broad term that demonstrates a lack of empathy or respect for patients from medical professionals.

Treating patients as objects/ data sources

Not referring to patients by name but by diagnosis

Life balance

This encompasses the challenges experienced by all medical professionals in keeping an equilibrium between hours worked and the demands of personal/ family life.

Putting aside personal time to stay beyond the time needed for a shift

Role modeling

How medical students “model” exemplary behavior of staff doctors

Trainees modeling/ tailoring behaviors to meet needs of staff doctors

Discussions regarding behaviors they ‘have to model’ but will not continue when they are independent

Minor themes

Consequences of the hidden curriculum

This refers to the loss of idealism among medical students as they progress from their first year into their residency and beyond.

Loss of idealism of trainees

Emotional neutralization/ suppression

Adoption of a “ritualized” professional identity

Change in ethical integrity

Shift from focus on patient care to medical technology or nature of procedure

Staging

Challenges during transitional stages in medicine

Discrepancy between what is seen in theory and on the wards

Faking it

Reflects dishonest behavior for personal gain regarding prestige, competition, and favoritism.

Overstating capabilities