What we don't know we are teaching - Unveiling the hidden curriculum

In addition to the intentional teaching of knowledge and skills by surgeons to their trainees and proteges is the unintended, often unrealized transmission of implicit beliefs, attitudes, and behaviors through a process called the hidden curriculum. The hidden curriculum is a function of implicit values held by the institution as a whole, and the individual surgical educators and allied health professionals working in the trainee's learning environment. It has been argued the hidden curriculum plays a central role in the development of professionalism, but it may also play an important role in inadvertently deterring good candidates from considering orthopaedic surgery as a career. We review the importance of attending to the messages we transmit to our trainees, proteges, and junior colleagues as we strive to develop professional competency and recruit the best into the field.