The hidden curriculum in health care academia: An exploratory study for the development of an action plan for the inclusion of diverse trainees

The Art of NOW: Mentoring to Address Hidden Curriculum in Undergraduate Neuroscience Education

Hidden curriculum, which consists of the implicit norms and values embedded within institutions, impacts how students navigate their experiences in higher education. While the formal curriculum provides structured learning objectives and content, the hidden curriculum shapes students' socialization, sense of belonging, and access to opportunities within academic settings. For diverse students, hidden curriculum often reinforces existing power dynamics and inequities, creating additional barriers to their success. In many cases, the norms and expectations embedded within the hidden curriculum reflect dominant cultural norms, leaving students from marginalized backgrounds feeling alienated or intentionally excluded. Mentors and academic institutions play crucial roles in helping diverse students navigate the hidden curriculum of educational institutions by providing mentorship and resources to address the challenges of hidden curricula. In this paper, we introduce the importance of "NOW": 1) Nomenclature - What is Hidden Curriculum, 2) Opportunity - Opportunities to Address Hidden Curriculum in Higher Education, and 3) Willingness - Fostering an action plan for success in higher education. This paper will introduce a socioecological model for mentoring to address hidden curriculum at the individual, interpersonal, and institutional levels. At the individual and interpersonal level, we will discuss actions students and their mentors can take to develop their mentoring relationships. At the institutional level, we will identify opportunities to support diverse students and their mentors.

Proceedings of the 2023 Faculty for Undergraduate Neuroscience Workshop at Western Washington University, Bellingham, WA, July 27-30, 2023

In July of 2023, the Faculty for Undergraduate Neuroscience (FUN) held a Summer Workshop at Western Washington University. This workshop was the first in-person workshop since 2017. This article provides a brief account of the Workshop themes of inclusive pedagogy, student and faculty mindsets, integrative STEM, and decolonization of neuroscience. The presentations and events that took place were attended by a vibrant community of close to 100, who engaged fully in the discussions and social opportunities. In addition, we review the workshop planning process to guide future FUN Summer Workshop committees and hosts.

Outlining the Hidden Curriculum: Perspectives on Successfully Navigating Scientific Conferences

Scientific conferences and meetings are valuable opportunities for researchers to network, communicate, and develop knowledge. For early career scientists, conferences can also be intimidating, confusing, and overwhelming, especially without having adequate preparation or experience. In this Perspective, we provide advice based on previous experiences navigating scientific meetings and conferences. These guidelines outline parts of the hidden curriculum around preparing for and attending meetings, navigating conference sessions, networking with other scientists, and participating in social activities while upholding a recommended code of conduct.

Interventions to support fellowship application success among predoctoral physician-scientists

A critical element of physician-scientist training is the development and practice of core competencies that promote success in research careers. The ability to develop compelling training and research proposals is one such foundational skill. The NIH Ruth L. Kirschstein National Research Service Award (NRSA) individual fellowship for dual-degree students (F30, F31, or F31-Diversity) creates an ideal opportunity to provide formal instruction in grant-writing skills to physician-scientists early in training. In the guided process of preparing a predoctoral fellowship application, students learn to formulate clear short- and long-term research and training goals; construct a comprehensive, well-reasoned, and rigorous proposal; become familiar with funding agency priorities; and gain strategic insights into the peer review system. Beyond building scientific writing skills, the application process for an NRSA F30 or F31 is an opportunity for trainees to strengthen mentor-mentee relationships, identify learning opportunities key to their scientific development, and build effective research and mentoring teams. These skills also apply to developing future postdoctoral mentored K applications or faculty research program grants. Here, we outline key features of the structured proposal development training developed for students in the Yale MD-PhD Program and review outcomes associated with its implementation.

Lessons learned from implementing a diversity, equity, and inclusion curriculum for health research professionals at a large academic research institution

Objective

Despite advances in incorporating diversity and structural competency into medical education curriculum, there is limited curriculum for public health research professionals. We developed and implemented a four-part diversity, equity, and inclusion (DEI) training series tailored for academic health research professionals to increase foundational knowledge of core diversity concepts and improve skills.

Methods

We analyzed close- and open-ended attendee survey data to evaluate within- and between-session changes in DEI knowledge and perceived skills.

Results

Over the four sessions, workshop attendance ranged from 45 to 82 attendees from our 250-person academic department and represented a mix of staff (64%), faculty (25%), and trainees (11%). Most identified as female (74%), 28% as a member of an underrepresented racial and ethnic minority (URM) group, and 17% as LGBTQI. During all four sessions, attendees increased their level of DEI knowledge, and within sessions two through four, attendees' perception of DEI skills increased. We observed increased situational DEI awareness as higher proportions of attendees noted disparities in mentoring and opportunities for advancement/promotion. An increase in a perceived lack of DEI in the workplace as a problem was observed; but only statistically significant among URM attendees.

Discussion

Developing applied curricula yielded measurable improvements in knowledge and skills for a diverse health research department of faculty, staff, and students. Nesting this training within a more extensive program of departmental activities to improve climate and address systematic exclusion likely contributed to the series' success. Additional research is underway to understand the series' longer-term impact on applying skills for behavior change.

Development and use of a novel tool for assessing and improving researcher embeddedness in learning health systems and applied system improvements

This paper outlines the development, deployment and use, and testing of a tool for measuring and improving healthcare researcher embeddedness - i.e., being connected to and engaged with key leverage points and stakeholders in a health system. Despite the widely acknowledged importance of embeddedness for learning health systems and late-stage translational research, we were not aware of useful tools for addressing and improving embeddedness in scholar training programs. We developed the MN-LHS Embeddedness Tool covering connections to committees, working groups, leadership, and other points of contact across four domains: patients and caregivers; local practice (e.g., operations and workflows); local institutional research (e.g., research committees and agenda- or initiative-setting groups); and national (strategic connections within professional groups, conferences, etc.). We used qualitative patterns and narrative findings from 11 learning health system training program scholars to explore variation in scholar trajectories and the embeddedness tool's usefulness in scholar professional development. Tool characteristics showed moderate evidence of construct validity; secondarily, we found significant differences in embeddedness, as a score, from baseline through program completion. The tool has demonstrated simple, practical utility in making embeddedness an explicit (rather than hidden) part of applied and learning health system researcher training, alongside emerging evidence for validity.

Structural Racism in Psychiatric Research Careers: Eradicating Barriers to a More Diverse Workforce

Investigators from minoritized backgrounds are underrepresented in psychiatric research. That underrepresentation contributes to disparities in outcomes of access to mental health care. Drawing on lived experience, scholarly qualitative reports, and empirical data, the authors review how the underrepresentation of minoritized researchers arises from interlocking, self-reinforcing effects of structural biases in our research training and funding institutions. Minoritized researchers experience diminished early access to advanced training and opportunities, stereotype threats and microaggressions, isolation due to lack of peers and senior mentors, decreased access to early funding, and unique community and personal financial pressures. These represent structural racism-a system of institutional assumptions and practices that perpetuates race-based disparities, in spite of those institutions' efforts to increase diversity and in contradiction to the values that academic leaders outwardly espouse. The authors further review potential approaches to reversing these structural biases, including undergraduate-focused research experiences, financial support for faculty who lead training/mentoring programs, targeted mentoring through scholarly societies, better use of federal diversity supplement funding, support for scientific reentry, cohort building, diversity efforts targeting senior leadership, and rigorous examination of hiring, compensation, and promotion practices. Several of these approaches have empirically proven best practices and models for dissemination. If implemented alongside outcome measurement, they have the potential to reverse decades of structural bias in psychiatry and psychiatric research.

Leadership Development in Early Career Scientists: Themes and Feedback from Executive Coaching and Mindful Leadership Training

Background: Career development is essential for all academic stages, but particularly critical for the growth and retention of early career scientists. In addition to scientific technical training, professional skill development is crucial for the upward transition from postdoctoral trainee to early faculty member and beyond. Building leadership skills, specifically, is an important component of professional development, and the evaluation and reporting of professional development are important to improve and enhance the impact of programs. Methods: The purpose of this article is to share the program evaluation performed on leadership development activities, including executive coaching and mindful leadership training provided to a small group of early career scientists who participated in the National Institutes of Health (NIH)-funded Mayo Clinic Specialized Center of Research Excellence (SCORE) in Sex Differences Career Enhancement Core and Building Interdisciplinary Research Careers in Women's Health (BIRCWH) K12 programs during 2020-2022. Results: Eighty-seven percent of participants rated their satisfaction with the executive coaching program as "Very Satisfied" or "Satisfied," and 75% of participants were "Very Satisfied" or "Satisfied" with the mindful leadership training program. The findings of this program evaluation highlight the value of communication skills for navigating precarious situations, building self-efficacy and intentionality in making and holding boundaries for an individual's time and energy. Further, the individualized small group format of the activities allowed for deeper introspection and peer to peer connection. Conclusion: The identification of common themes within the Mayo Clinic program provides guidance to other academic environments on areas where they can support their early career scientists.

Changing the face of academic medicine: an equity action plan for institutions

In recent years, there have been concerted efforts to better recruit, support, and retain diverse faculty, staff, and trainees in academic medicine. However, many institutions lack comprehensive and strategic plans to provide support to retain and recruit individuals from historically underrepresented groups. In this article, we itemize specific mechanisms through which institutions can support diverse individuals with the goal of improving inclusion and belonging in the workforce to better reflect the diversity of the intended patient and research participant population.