The ‘worthy’ patient: rethinking the ‘hidden curriculum’ in medical education

作者：Robin T. Higashi, Allison A. Tillack, Michael Alan Steinman, C. Bree Johnston, G. Michael Harper · 发表于：Anthropology and Medicine · 年份：2013 · DOI：10.1080/13648470.2012.747595 · 被引用次数：95 · 研究领域：Innovations in Medical Education、Empathy and Medical Education、Ethics in medical practice

This paper examines how physicians determine the quality and quantity of time to devote to each patient, and how these decisions are taught to physicians-in-training as part of the 'hidden curriculum' in medical education. The notion of moral economy is used to analyze how judgments of patient worth come to guide and influence interactions among physicians and physicians-in-training and patients, and how these interactions impact medical care. However, this paper also questions the notion of the hidden curriculum as a static or reified concept. Instead, the paper uses participant narratives to show how physicians-in-training are not simply passive recipients of the hidden curriculum but also actively resist judging patients based on perceptions of worth, even as they learn to operate within a moral economy of care.