460 - How Black Medical Students Who Identify as Women Experience Hidden Curriculum During Their Preclinical Years of Medical Education

Publication Number: 460.5161

Shari Snyder Pollack, UH Rainbow Babies & Children's Hospital, Cleveland, OH, United States

Background: The hidden curriculum in medical education encompasses the implicit values, behaviors, and cultural norms learned outside formal training. Unlike structured lessons, this curriculum is absorbed through interactions and experiences in clinical settings. For diverse student populations, the hidden curriculum includes experiences of racial discrimination and microaggressions that affect their medical education and overall experience.

Objective: The first objective of this Interpretative Phenomenological Analysis (IPA) qualitative study was to explore how first and second-year (pre-clinical) medical students who identified as Black women experienced hidden curriculum at their medical school. The second objective was to have participants describe how their lived experiences impacted their pursuit of medical education.

Design/Methods: Emails were sent to DEI leaders at 105 allopathic medical schools; each DEI leader was responsible for forwarding study information to their student population. Participants identified as Black women in their pre-clinical years of medical school at predominantly white medical institutions. Data was collected via a 90-minute semi-structured interview and participants provided a written/audio account of their experience with hidden curriculum. Data was analyzed utilizing IPA and intersectionality theory lenses.

Results: Of the 11 students who consented, five completed the study. The results indicated that the students experience the hidden curriculum similarly, even though their individual experiences vary. Data analysis produced six themes, including (1) the whole ecosystem that impacts a student’s perceptions, (2) the real pressure on students resulting from the minority tax, (3) fear of ramifications associated with being vulnerable, (4) cultural influence on the student’s pursuit of medical education, (5) semantics and actions used to communicate, and (6) the uniqueness/specialness of working on behalf of all Black medical students who identify as women.

Conclusion(s): This study reveals the significant effects of the hidden curriculum on Black women in pre-clinical medical education. Participants faced challenges such as the minority tax and fear of vulnerability, which hindered open discussions about identity and discrimination. The insights gained underscore the necessity for medical schools to address the hidden curriculum and cultivate inclusive environments. By doing so, they can empower all students and promote equity within the medical profession.

Thematic Links to Hidden Curriculum Categories
This table outlines connections between specific themes of students' experiences with hidden curriculum.

Participants LIved Experience Themes and Qualitative Descriptions
This table explores various themes related to the lived experiences of students encountering hidden curriculum in medical education

Hidden Curriculum Categories Plus Burden
The basis of this study was to focus on the four categories of hidden curriculum as defined by Hafferty and Franks (1994) - Policy, Assessment & Evaluation, Funding Allocation and Institutional Language. In talking with the study participants, for them another category became evident. It is here that it is necessary to add "burden."

Thematic Links to Hidden Curriculum Categories
This table outlines connections between specific themes of students' experiences with hidden curriculum.

Participants LIved Experience Themes and Qualitative Descriptions
This table explores various themes related to the lived experiences of students encountering hidden curriculum in medical education

Hidden Curriculum Categories Plus Burden
The basis of this study was to focus on the four categories of hidden curriculum as defined by Hafferty and Franks (1994) - Policy, Assessment & Evaluation, Funding Allocation and Institutional Language. In talking with the study participants, for them another category became evident. It is here that it is necessary to add "burden."