The Author(s) 2013. This article is published with open access at Springerlink.com Medical studen... more The Author(s) 2013. This article is published with open access at Springerlink.com Medical students and junior doctors learn according to the formal curriculum, but they also learn unwritten rules, the specific logic of the medical world, through a socialization process called ‘the hidden curriculum’. The result of the process seems to be an exclusive professional identity, the medical habitus. This article underlines the importance of the hidden curriculum in medicine, especially in meetings where patients are discussed. These case discussions, common daily rituals in medical practice, demonstrate the dynamic interaction of learning and practice within the medical world. The article illustrates how medical core values are transferred informally and implicitly, and the role of power relations in this process. Not only are residents being assessed and trained in case discussions, but also staff are assessing each other and learning continuously. Therefore, these meetings might signif...
In the current system for guaranteeing quality of care, emphasis is placed firmly on external con... more In the current system for guaranteeing quality of care, emphasis is placed firmly on external control of professionals. We looked for a way to appeal to the intrinsic motivation of medical professionals and to discover what they mean by 'good work'. This was achieved with the aid of reflective sessions using the toolkit 'Good Work': in four sessions three different groups of medical professionals (medical department chairs, residents and interns) from a Dutch university hospital reflected on the topics 'excellence', 'moral responsibility' and 'personal engagement'. The participants exchanged practice-based stories during the sessions. The most important theme was moral responsibility, with its accompanying dilemmas. The sessions gave rise to feelings of mutual acknowledgement, recognition, inspiration and motivation. Sharing meaningful practice-based stories can be considered as a 'moment of learning', strengthening professional identi...
The article examines the leadership of department heads in a university hospital in day-to-day pr... more The article examines the leadership of department heads in a university hospital in day-to-day practice. These ‘doctors in the lead’ bridge the medical and the management world in the hospital organization.They are better able to influence their colleagues’ clinical activities than a non-medical manager. This is, however not a trouble-free task. The concepts of Pierre Bourdieu—habitus, field and capital—guide the analysis of empirical material. The medical habitus influences the questions and dilemmas department heads face, as well as the ways in which they can exert influence on their colleagues. ‘Janus-faced’ they look at the medical and the management world with their two different logics. Sometimes they display managerial behaviour, but the medical habitus remains their second nature. Based on these findings we argue that the formal hierarchy of the hospital organization should be brought more in line with the informal professional hierarchy.
The article examines the leadership of department heads in a university hospital in day-to-day pr... more The article examines the leadership of department heads in a university hospital in day-to-day practice. These ‘doctors in the lead ’ bridge the medical and the management world in the hospital organization. They are better able to influence their colleagues ’ clinical activities than a non-medical manager. This is, however not a trouble-free task. The concepts of Pierre Bourdieu—habitus, field and capital—guide the analysis of empirical material. The medical habitus influences the questions and dilemmas department heads face, as well as the ways in which they can exert influence on their colleagues. ‘Janus-faced ’ they look at the medical and the management world with their two different logics. Sometimes they display managerial behaviour, but the medical habitus remains their second nature. Based on these findings we argue that the formal hierarchy of the hospital organization should be brought more in line with the informal professional hierarchy.
EDITORDoctors and managers obviously need to work together. To have two powerful groups not work... more EDITORDoctors and managers obviously need to work together. To have two powerful groups not working together is likely to frustrate the efforts of both and to damage the service offered to patients. Why then is the relationship between doctors and managers often strained ...
The Author(s) 2013. This article is published with open access at Springerlink.com Medical studen... more The Author(s) 2013. This article is published with open access at Springerlink.com Medical students and junior doctors learn according to the formal curriculum, but they also learn unwritten rules, the specific logic of the medical world, through a socialization process called ‘the hidden curriculum’. The result of the process seems to be an exclusive professional identity, the medical habitus. This article underlines the importance of the hidden curriculum in medicine, especially in meetings where patients are discussed. These case discussions, common daily rituals in medical practice, demonstrate the dynamic interaction of learning and practice within the medical world. The article illustrates how medical core values are transferred informally and implicitly, and the role of power relations in this process. Not only are residents being assessed and trained in case discussions, but also staff are assessing each other and learning continuously. Therefore, these meetings might signif...
In the current system for guaranteeing quality of care, emphasis is placed firmly on external con... more In the current system for guaranteeing quality of care, emphasis is placed firmly on external control of professionals. We looked for a way to appeal to the intrinsic motivation of medical professionals and to discover what they mean by 'good work'. This was achieved with the aid of reflective sessions using the toolkit 'Good Work': in four sessions three different groups of medical professionals (medical department chairs, residents and interns) from a Dutch university hospital reflected on the topics 'excellence', 'moral responsibility' and 'personal engagement'. The participants exchanged practice-based stories during the sessions. The most important theme was moral responsibility, with its accompanying dilemmas. The sessions gave rise to feelings of mutual acknowledgement, recognition, inspiration and motivation. Sharing meaningful practice-based stories can be considered as a 'moment of learning', strengthening professional identi...
The article examines the leadership of department heads in a university hospital in day-to-day pr... more The article examines the leadership of department heads in a university hospital in day-to-day practice. These ‘doctors in the lead’ bridge the medical and the management world in the hospital organization.They are better able to influence their colleagues’ clinical activities than a non-medical manager. This is, however not a trouble-free task. The concepts of Pierre Bourdieu—habitus, field and capital—guide the analysis of empirical material. The medical habitus influences the questions and dilemmas department heads face, as well as the ways in which they can exert influence on their colleagues. ‘Janus-faced’ they look at the medical and the management world with their two different logics. Sometimes they display managerial behaviour, but the medical habitus remains their second nature. Based on these findings we argue that the formal hierarchy of the hospital organization should be brought more in line with the informal professional hierarchy.
The article examines the leadership of department heads in a university hospital in day-to-day pr... more The article examines the leadership of department heads in a university hospital in day-to-day practice. These ‘doctors in the lead ’ bridge the medical and the management world in the hospital organization. They are better able to influence their colleagues ’ clinical activities than a non-medical manager. This is, however not a trouble-free task. The concepts of Pierre Bourdieu—habitus, field and capital—guide the analysis of empirical material. The medical habitus influences the questions and dilemmas department heads face, as well as the ways in which they can exert influence on their colleagues. ‘Janus-faced ’ they look at the medical and the management world with their two different logics. Sometimes they display managerial behaviour, but the medical habitus remains their second nature. Based on these findings we argue that the formal hierarchy of the hospital organization should be brought more in line with the informal professional hierarchy.
EDITORDoctors and managers obviously need to work together. To have two powerful groups not work... more EDITORDoctors and managers obviously need to work together. To have two powerful groups not working together is likely to frustrate the efforts of both and to damage the service offered to patients. Why then is the relationship between doctors and managers often strained ...
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