好色先生

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Abstract Details

Balancing Growth and Performance: Student Experiences with Hidden Curriculum and Psychological Safety in a Neurology Clerkship
好色先生, Research, and Methodology
P7 - Poster Session 7 (5:00 PM-6:00 PM)
5-002

To explore medical students’ experiences during the Neurology clerkship, focusing on hidden expectations, psychological safety, and the tension between growth versus performance-oriented learning within a tiered grading schema.

This study investigates how assessment structures and the pressures of performance influence growth, psychological safety, and authentic learning on the Neurology clerkship, informed by students’ firsthand narratives.

We surveyed students who completed the Neurology clerkship at our institution between 2022-24. An anonymous survey included multiple-choice and free-response items. Quantitative data were analyzed for response distribution.  Qualitative responses were categorized by two readers who identified recurring sub-themes and representative quotes.
The survey yielded 28 responses, with 17 fully completed. Thirty-nine percent of respondents encountered unspoken expectations “often or almost all of the time”. Students highlighted discrepancies in clarity of expectations between attendings and residents and how preferences for oral presentations were inconsistently communicated beforehand. Regarding psychological safety, 40% of students felt comfortable expressing concerns “once in a while or almost never”, while 60% felt comfortable asking questions or identifying improvement areas often or most of the time. Grading processes, resident dynamics witnessed in shared workspaces, and faculty interactions impacted students' sense of safety; many cited fear of negative evaluations discouraging authentic engagement. Seventy percent of students were encouraged to seek novel experiences “often or almost all of the time”; 25% avoided tasks aimed at growth in favor of demonstrating competence. However, many felt grading prioritized performance, with 65% feeling narrative evaluations inadequately reflected their skill development. Students identified barriers to clinical growth including anchoring on initial performance, lack of time spent with any one evaluator, and lack of growth as a standardized evaluation metric.
We found that micro-interactions, grading structures, and evaluation pressures significantly shape the Neurology clerkship’s learning culture, influencing students’ decision-making in balancing these tensions.
Authors/Disclosures
Ashlee Joan Macalino
PRESENTER 		Ms. Macalino has nothing to disclose.
Meredith Pescatello (University of Rochester) Mrs. Pescatello has nothing to disclose.
Robert I. Thompson-Stone, MD, FAAN (University of Rochester) Dr. Thompson-Stone has received personal compensation in the range of $500-$4,999 for serving as a Krabbe Disease expert with Advisory Committee on Heritable Disorders in Newborns and Children (ACHDNC). Dr. Thompson-Stone has a non-compensated relationship as a Editorial Board Member with Neurology: 好色先生 Journal that is relevant to AAN interests or activities.
Christopher J. Mooney, PhD Dr. Mooney has nothing to disclose.