Implicit versus explicit curricula in general pediatrics education: is there a convergence?

Area of Science:

• Medical Education
• Pediatrics
• Curriculum Development

Background:

• The explicit curriculum in medical education outlines formal learning objectives.
• The implicit curriculum encompasses unstated lessons learned through daily experiences.
• Understanding the interplay between implicit and explicit curricula is crucial for effective resident training.

Purpose of the Study:

• To analyze the implicit curriculum in a general pediatrics inpatient setting.
• To assess how the implicit curriculum aligns with competency-based goals in the explicit curriculum.

Main Methods:

• A case study involving 143 hours of direct observation over 8 months.
• 39 in-depth interviews with pediatric residents and attending physicians.
• Inductive coding of field notes and interview transcripts to identify themes.

Main Results:

• The implicit curriculum effectively teaches residents practical "how things work" knowledge.
• Over 90% of explicit objectives were met through implicit learning opportunities.
• The implicit curriculum was unstructured, primarily focused on patient care, and not formally recognized.

Conclusions:

• Aligning the representation of competency domains with implicit learning experiences can improve awareness of residents' full educational journey.
• Formal recognition of the implicit curriculum's role is needed within competency-based medical education.
• Visualizing the convergence of implicit and explicit curricula can enhance resident learning.