The pedagogy of silence: An integrative review on the impact of the hidden curriculum on university bioethics education
DOI:
https://doi.org/10.5281/zenodo.17796082Keywords:
Bioethics, Education, medical, Curriculum, Ethics, professional, Mentoring, Professional identityAbstract
Introduction: Higher education faces a critical contradiction: discrepancy between formally taught ethical values and behaviors observed in real practice. This phenomenon, the hidden curriculum, is associated with empathy erosion and student cynicism. This study aimed to analyze the influence of the hidden curriculum on bioethics and professionalism training, identifying transmission mechanisms and mitigation strategies.
Methods: An integrative review used Whittemore and Knafl (2005). A systematic search in PubMed, Scopus and Google Scholar covered literature published 2015–2025, including quantitative, qualitative and theoretical studies. After eligibility criteria, 23 primary sources were selected and thematically analyzed.
Results: Findings show dissonance between ethical ideals and clinical reality generates moral distress and a fragmented professional identity. Main transmission mechanisms are negative role modeling by seniors and rigid institutional hierarchies imposing “moral silence.” Interventions such as narrative medicine, reflective practice and humanistic mentoring proved effective protective factors against ethical erosion.
Conclusions: The hidden curriculum often undermines formal educational goals as a structural force. The solution requires shifting from individual blame to institutional responsibility, auditing the ethical climate of clinical settings and fostering psychological safety that aligns teaching practice with declared bioethical values.
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Copyright (c) 2025 Marta Isabel Canese de Estigarribia, Lourdes Sánchez, Soledad Cardozo, Gelda Giosa, Nora Rivas Torres, Sheila Parini, Rocío Recalde, Alcides Chaux (Autor/a)
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