Exploring the hidden curriculum in public health: a qualitative study
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Project-Based Learning Guidelines for Health Sciences Students: An Analysis with Data Mining and Qualitative Techniques
Published on: December 9, 2022
Woon Chien Cecilia Teng1,2, Wei Ern Ivan Ng1,2, Pei Xuan Annabeth Lee1,2
1Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Background:
The hidden curriculum refers to the subtle ways that knowledge and behavior are learnt outside formal teaching contexts. Widely studied in clinical healthcare, it remains underexplored in public health. As the scope and function of public health practice differ substantially from clinical practice, the hidden curriculum in public health may be distinct from that in clinical fields. We explored the hidden curriculum in public health through undergraduate interns' experiences.
Methods:
Using a qualitative design, we examined how public health students made sense of their internship experiences in written reflections. The reflection prompts were informed by Gaufberg et al.'s (2010) definition of the hidden curriculum. Reflexive thematic analysis using a deductive-inductive approach was applied on 36 reflection scripts collected between 2024 and 2025.
Results:
We developed three themes (stakeholder engagement as an art, effecting change takes time, and developing effectiveness as a public health professional) comprising ten sub-themes. Positive aspects of the hidden curriculum comprised learning the art of stakeholder engagement, change agency despite constraints, and organizational structure as a necessity, while negative ones included the perceived role of public health in clinical settings, organizational influence on behavior, and mentoring as invalidating. Findings elucidate undercurrents of power and hierarchy in public health practice.
Conclusions:
A multi-ethnic Asian student population extended the hidden curriculum literature beyond its predominantly Western base. Future research incorporating larger, more diverse samples, practitioners' perspectives, and longitudinal designs is needed to more fully characterize the hidden curriculum in public health and strengthen professional training.
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