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Volume 18, Issue 3 (2025)
JMED 2025, 18(3): 99-108 |
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Abushouk S, Hamad B, Arbab A. Perceptions of dental students regarding the practice and impact of the hidden curriculum at Al-neelain University, Sudan. JMED 2025; 18 (3) :99-108
URL: http://edujournal.zums.ac.ir/article-1-2278-en.html
URL: http://edujournal.zums.ac.ir/article-1-2278-en.html
1- Department of Restorative Dentistry, Khartoum Dental Teaching Hospital, Khartoum State, Sudan & Sudan Medical Specialization Board, Khartoum State, Sudan
2- Faculty of Medicine, International University of Africa, Khartoum, Sudan & Sudan Medical Specialization Board, Khartoum State, Sudan
3- Department of Pharmacognosy, Faculty of Pharmacy, University of Khartoum, Khartoum State, Sudan & Sudan Medical Specialization Board, Khartoum State, Sudan ,arbabssn@gmail.com
2- Faculty of Medicine, International University of Africa, Khartoum, Sudan & Sudan Medical Specialization Board, Khartoum State, Sudan
3- Department of Pharmacognosy, Faculty of Pharmacy, University of Khartoum, Khartoum State, Sudan & Sudan Medical Specialization Board, Khartoum State, Sudan ,
Abstract: (701 Views)
Background & Objective: The Hidden Curriculum (HC) represents the cultural process of medical training, where students acquire attitudes and values. Understanding the HC enables educators to develop more impactful learning experiences. Therefore, this study aims to assess the perceptions of Al-Neelain University dental students regarding the frequency and impact of positive and negative aspects of the HC.
Materials & Methods: A cross-sectional study was conducted among a randomly selected sample of fifth-year dental students at Al-Neelain University (Sudan). Data were collected using the self-administered Hidden Informal Curriculum Assessment Tool (HICAT). The data were analyzed using the Mann-Whitney U test, Kruskal-Wallis test, and McNemar test.
Results: The response rate was 100% (81 out of 81), with 70.3% of respondents identifying as female. Approximately 53% of the respondents were single, and 86.4% were citizens. The most commonly reported positive scenario was a satisfactory patient-doctor consultation, noted by 60% of participants. In contrast, the least frequently observed positive scenario was the presence of high professional standards in their learning environments, reported by only 25%. On the negative side, the most frequently cited issue was discriminatory attitudes in learning environments, affecting 52% of respondents. Conversely, ethnic discrimination and gender discrimination were the least frequently reported negative scenarios, at 7% and 9%, respectively. Data revealed a statistically significant association between perceptions of certain HC scenarios and gender (p = 0.047), Citizenship (p = 0.045), and social status (p = 0.003). The top two influential scenarios identified were having a positive role model doctor and developing strong patient-doctor skills.
Conclusion: Respondents frequently reported positive patient-doctor consultations, while discriminatory attitudes in learning environments were the most common negative scenario. Understanding students' perceptions of healthcare is essential, as it can help reinforce positive aspects and improve negative ones in the future.
Materials & Methods: A cross-sectional study was conducted among a randomly selected sample of fifth-year dental students at Al-Neelain University (Sudan). Data were collected using the self-administered Hidden Informal Curriculum Assessment Tool (HICAT). The data were analyzed using the Mann-Whitney U test, Kruskal-Wallis test, and McNemar test.
Results: The response rate was 100% (81 out of 81), with 70.3% of respondents identifying as female. Approximately 53% of the respondents were single, and 86.4% were citizens. The most commonly reported positive scenario was a satisfactory patient-doctor consultation, noted by 60% of participants. In contrast, the least frequently observed positive scenario was the presence of high professional standards in their learning environments, reported by only 25%. On the negative side, the most frequently cited issue was discriminatory attitudes in learning environments, affecting 52% of respondents. Conversely, ethnic discrimination and gender discrimination were the least frequently reported negative scenarios, at 7% and 9%, respectively. Data revealed a statistically significant association between perceptions of certain HC scenarios and gender (p = 0.047), Citizenship (p = 0.045), and social status (p = 0.003). The top two influential scenarios identified were having a positive role model doctor and developing strong patient-doctor skills.
Conclusion: Respondents frequently reported positive patient-doctor consultations, while discriminatory attitudes in learning environments were the most common negative scenario. Understanding students' perceptions of healthcare is essential, as it can help reinforce positive aspects and improve negative ones in the future.
Article Type : Orginal Research |
Subject:
Medical Education
Received: 2024/09/17 | Accepted: 2025/08/31 | Published: 2025/10/1
Received: 2024/09/17 | Accepted: 2025/08/31 | Published: 2025/10/1
References
1. Prideaux D. ABC of learning and teaching in medicine: Curriculum design. BMJ. 2003;326(7383):268-70. [DOI:10.1136/bmj.326.7383.268] [PMID] []
2. Wilson LO. Types of curriculum-detailed explanations of the multiple types of curriculum [Internet]. The Second Principle; 2015. Available from: [cited 2021 Aug 2].
3. Mossop L, Dennick R, Hammond R, Robbé I. Analysing the hidden curriculum: use of a cultural web. Med Educ. 2013;47(2):134-43. [DOI:10.1111/medu.12072] [PMID] []
4. Lawrence C, Mhlaba T, Stewart KA, Moletsane R, Gaede B, Moshabela M. The hidden curricula of medical education: a scoping review. Acad Med. 2018;93(4):648-56. [DOI:10.1097/ACM.0000000000002004] [PMID] []
5. Assor A, Gordon D. The implicit learning theory of hidden‐curriculum research. J Curric Stud. 1987;19(4):329-39. [DOI:10.1080/0022027870190404]
6. Boldizar JP. Assessing sex typing and androgyny in children: the children's sex role inventory. Dev Psychol. 1991;27(3):505. [DOI:10.1037/0012-1649.27.3.505]
7. Maccoby EE. Social development: psychological growth and the parent-child relationship. New York: Harcourt Brace Jovanovich; 1980.
8. Bloom BS. Bloom, Benjamin S., "Innocence in Education," School Review, 80 (May, 1972), 333-352 [Internet]. 1972. Available from: [cited 2021 Sep 10]. [DOI:10.1086/443036]
9. Nami Y, Marsooli H, Ashouri M. Hidden curriculum effects on university students' achievement. Procedia Soc Behav Sci. 2014;114:798-801. [DOI:10.1016/j.sbspro.2013.12.788]
10. Bandini J, Mitchell C, Epstein-Peterson ZD, Amobi A, Cahill J, Peteet J, et al. Student and faculty reflections of the hidden curriculum: how does the hidden curriculum shape students' medical training and professionalization? Am J Hosp Palliat Care. 2017;34(1):57-63. [DOI:10.1177/1049909115616359] [PMID]
11. Lempp H, Seale C. The hidden curriculum in undergraduate medical education: qualitative study of medical students' perceptions of teaching. BMJ. 2004;329(7469):770-3. [DOI:10.1136/bmj.329.7469.770] [PMID] []
12. Hendelman W, Byszewski A. Formation of medical student professional identity: categorizing lapses of professionalism, and the learning environment. BMC Med Educ. 2014;14:1-10. [DOI:10.1186/1472-6920-14-139] [PMID] []
13. Witman Y. What do we transfer in case discussions? The hidden curriculum in medicine. Perspect Med Educ. 2014;3(2):113-23. [DOI:10.1007/S40037-013-0101-0] [PMID] []
14. Brown MEL, Coker O, Heybourne A, Finn GM. Exploring the hidden curriculum's impact on medical students: professionalism, identity formation and the need for transparency. Med Sci Educ. 2020;30(3):1107-21. [DOI:10.1007/s40670-020-01021-z] [PMID] []
15. Monrouxe LV. Identity, identification and medical education: why should we care? Med Educ. 2010;44(1):40-9. [DOI:10.1111/j.1365-2923.2009.03440.x] [PMID]
16. Jerald CD. School culture [Internet]. Center for Comprehensive School Reform and Improvement; 2006 Dec. Available from: [cited 2024 Sep 3].
17. Dean AG, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version [Internet]. 2013. Available from: [cited 2024 Aug 19].
18. McGurgan P, Carmody D, Tregonning A. Measuring the "iceberg"-quantifying the hidden and informal curriculum in clinical rotations using the hidden informal curriculum assessment tool (HICAT). MedEdPublish. 2015;5(2):1-9. [DOI:10.15694/mep.2015.005.0002]
19. Afridi A, Sethi A, Ahmed F, Kashif L. Assessment of hidden curriculum during clinical rotations of year 4 mbbs students using hidden informal curriculum assessment tool (HICAT). J Med Sci. 2020;28(4):352-5. [DOI:10.52764/jms.20.28.4.10]
20. Shakerinejad M, Gholamnia-Shirvani Z, Khodadadi E, Nikpour M. Dental students' experience of hidden curriculum: a qualitative study. J Med Educ Dev. 2024;17(54):31-43. [DOI:10.61186/edcj.17.54.31]
21. Iramaneerat C. Instruction and assessment of professionalism for surgery residents. J Surg Educ. 2009;66(3):158-62. [DOI:10.1016/j.jsurg.2009.03.031] [PMID]
22. Kirk LM. Professionalism in medicine: definitions and considerations for teaching. In: Proceedings of Baylor University Medical Center; 2007 Jan 1; 20(1):13-16. Dallas: Baylor University Medical Center. [DOI:10.1080/08998280.2007.11928225] [PMID] []
23. Alipour F, Shahvari Z, Asghari F, Samadi S, Amini H. Educational system defects and observing professional behavior: a qualitative study. J Educ Health Promot. 2019;8:162. [DOI:10.4103/jehp.jehp_22_19] [PMID] []
24. Sotto-Santiago S, Mac J, Slaven J, Maldonado M. A survey of internal medicine residents: their learning environments, bias and discrimination experiences, and their support structures. Adv Med Educ Pract. 2021;23:697-703. [DOI:10.2147/AMEP.S311543] [PMID] []
25. Bedri AM. Reflections on the struggle for girls' education in Sudan. In: Karlsson J, Msibi T, editors. Gendered voices: reflections on gender and education in South Africa and Sudan. Rotterdam: SensePublishers; 2013. p. 25-40. [DOI:10.1007/978-94-6209-137-5_3]
26. Monrouxe LV, Grundy L, Mann M, John Z, Panagoulas E, Bullock A, et al. How prepared are UK medical graduates for practice? A rapid review of the literature 2009-2014. BMJ Open. 2017;7(1):e013656. [DOI:10.1136/bmjopen-2016-013656] [PMID] []
27. Yu SR, Cheng YC, Tseng HM, Chang YC, Ma SD, Huang CD, et al. Undergraduates' preparedness for practice is associated with professional identity and perception of educational environment: a validation study. Biomed J. 2021;44(4):495-503. [DOI:10.1016/j.bj.2020.04.009] [PMID] []
28. Goldacre MJ, Taylor K, Lambert TW. Views of junior doctors about whether their medical school prepared them well for work: questionnaire surveys. BMC Med Educ. 2010;10(1):78. [DOI:10.1186/1472-6920-10-78] [PMID] []
29. Chou JY, Chiu CH, Lai E, Tsai D, Tzeng CR. Medical education in Taiwan. Med Teach. 2012;34(3):187-91. [DOI:10.3109/0142159X.2012.652238] [PMID]
30. Nikendei C, Weyrich P, Jünger J, Schrauth M. Medical education in Germany. Med Teach. 2009;31(7):591-600. [DOI:10.1080/01421590902833010] [PMID]
31. Dezee KJ, Artino AR, Elnicki DM, Hemmer PA, Durning SJ. Medical education in the United States of America. Med Teach. 2012;34(7):521-5. [DOI:10.3109/0142159X.2012.668248] [PMID]
32. Gillborn D. Citizenship, 'Race' and the hidden curriculum. Int Stud Sociol Educ. 1992;2(1):57-73. [DOI:10.1080/0962021920020104]
33. Phelan SM, Burke SE, Cunningham BA, Perry SP, Hardeman RR, Dovidio JF, et al. The effects of racism in medical education on students' decisions to practice in underserved or minority communities. Acad Med. 2019;94(8):1178-89. [DOI:10.1097/ACM.0000000000002719] [PMID]
34. de Araujo AA. Adjustment issues of international students enrolled in American colleges and universities: a review of the literature. High Educ Stud. 2011;1(1):2-8. [DOI:10.5539/hes.v1n1p2]
35. Martirosyan NM, Bustamante RM, Saxon DP. Academic and social support services for international students: current practices. J Int Stud. 2019;9(1):172-91. [DOI:10.32674/jis.v9i1.275]
36. Swick HM, Szenas P, Danoff D, Whitcomb ME. Teaching professionalism in undergraduate medical education. JAMA. 1999;282(9):830-2. [DOI:10.1001/jama.282.9.830] [PMID]
37. Wright S. Examining what residents look for in their role models. Acad Med. 1996;71(3):290-2. [DOI:10.1097/00001888-199603000-00024] [PMID]
38. Wright S, Wong A, Newill C. The impact of role models on medical students. J Gen Intern Med. 1997;12:53-6.
https://doi.org/10.1007/s11606-006-0007-1 [DOI:10.1046/j.1525-1497.1997.12109.x] [PMID] []
39. Paice E, Heard S, Moss F. How important are role models in making good doctors? BMJ. 2002;325(7366):707-10. [DOI:10.1136/bmj.325.7366.707] [PMID] []
40. Chipidza FE, Wallwork RS, Stern TA. Impact of the doctor-patient relationship. Prim Care Companion CNS Disord. 2015;17(5):27354.
https://doi.org/10.4088/PCC.15m01840 [DOI:10.4088/PCC.15f01840]
41. Riedl D, Schüßler G. The influence of doctor-patient communication on health outcomes: a systematic review. Z Psychosom Med Psychother. 2017;63(2):131-50. [DOI:10.13109/zptm.2017.63.2.131] [PMID]
42. Wright SM, Carrese JA. Serving as a physician role model for a diverse population of medical learners. Acad Med. 2003;78(6):623-8. [DOI:10.1097/00001888-200306000-00013] [PMID]
43. Kusnoor AV. Cheating in medical school: the unacknowledged ailment. South Med J. 2013;106(8):479-83. [DOI:10.1097/SMJ.0b013e3182a14388] [PMID]
44. Osmosis. The negative effects of competition amongst medical students and 5 tips to overcome them [Internet]. 2022. Available from: [cited 2025 Jan 10].
45. Kirsch J, Spreckelsen C. Caution with competitive gamification in medical education: unexpected results of a randomised cross-over study. BMC Med Educ. 2023;23(1):259. [DOI:10.1186/s12909-023-04258-5] [PMID] []
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