Teaching, digression, and implicit curriculum

Background: Although medicine resides within contexts that have historical, cultural, and societal determinants, these are rarely addressed explicitly in current medical teaching. Summary: The article describes a method of teaching in which mainstream biomedical learning is linked to digressions, which serve as the medium for considering the contexts of medicine, unmasking hidden messages, and broadening the scope of medical instruction. Conclusion: Teaching by digression encourages students to learn core clinical science while considering such otherwise neglected areas such as medical values, contexts, habits, and history. Integrating this consideration of the hidden assumptions of medical practice into mainstream medical learning allows students to understand modern biomedicine as a system that is historically, culturally, and socially conditioned. Copyright (C) 2004 by Lawrence Erlbaum Associates, Inc.