The hidden curriculum in health professions education: Associations with clinical competencies among nursing and allied health students.
INTRODUCTION The hidden curriculum, which includes implicit messages and norms within educational environments, plays a significant role in shaping professional development in health professions education. This study examines associations between the hidden curriculum and clinical competencies, focusing on nursing care planning and educational leadership skills among nursing and allied health students. METHODS We conducted a cross-sectional study with 263 undergraduate nursing, operating room, and emergency medicine students at Ardabil University of Medical Sciences in Iran. Participants were selected via stratified random sampling. Data were collected using the Hidden Curriculum Evaluation Scale (HCES-N), the Student Survey on Writing Nursing Care Plan (SSW-NCP), and the Educational Leadership Scale for Nursing Students. Hierarchical multiple regression was used to examine factors associated with hidden curriculum perceptions. RESULTS The mean hidden curriculum score was 93.10 ± 9.33, indicating a moderate-to-high level. Significant positive correlations were found between the hidden curriculum and nursing care planning (r = 0.43, p < 0.001) and educational leadership (r = 0.18, p < 0.01). Hierarchical regression analysis revealed that satisfaction with patient care performance (β = 0.485, p < 0.001), nursing care planning competencies (β = 0.267, p < 0.001), and educational leadership skills (β = 0.107, p = 0.040) were significant positive associations with hidden curriculum perceptions. Collectively, these variables explained 34.5% of the variance in hidden curriculum scores. CONCLUSIONS The hidden curriculum is associated with clinical competencies and leadership attributes among nursing and allied health students. These findings suggest that students' perceptions of the hidden curriculum are associated with important professional competencies; however, due to the cross-sectional design, causal relationships cannot be inferred. Longitudinal and multi-institutional studies are needed to further examine the direction and nature of these associations.