Uncovering the hidden medical curriculum through a pedagogy of discomfort.

What lies beneath the formal or overt curriculum may impair students' professional growth and development, including their ability to foster genuine relationships with patients and others, and may contribute to the inadvertent, often negative attitudes, beliefs, and behaviors expressed by medical students and witnessed by educators within and external to the classroom environment. To understand the impact a hidden medical curriculum has on both students and educators, I look at one particular model often used in medical education--the physician-patient relationship. I show how this therapeutic relationship ought to be understood through a pedagogy of discomfort, a model developed by Megan Boler (Feeling Power; Emotions and Education, 1999), as a way to uncover the hidden curriculum as it engages students in a collective, critical discourse through which their sense of self in relation to others becomes the groundwork for their professional and moral development. Understanding the physician-patient relationship through a pedagogy of discomfort also teachers students how to critically think about the different values and beliefs held by physicians and patients and how to begin to recognize themselves as physicians in relation to their patients and others.