The hospital as a third classroom: a qualitative descriptive-interpretive study of situated learning and the hidden curriculum among medical interns

Abstract Background Much medical training occurs through everyday clinical work, where informal teaching and the hidden curriculum shape learning and professional identity. Social pedagogy offers a relational and ethical lens for these processes. We explored interns’ experiences of the hospital as a third classroom: a workplace learning environment alongside university teaching and the formal internship programme. Methods We conducted a qualitative descriptive-interpretive study in an urban private hospital in Ecuador. Twenty-one rotating medical interns from the 2024–2025 cohort completed an anonymous online questionnaire with 10 open-ended questions in July 2025. Responses were examined through complete reading, open inductive coding, identification of meaning units, thematic grouping and a double-entry matrix. Social pedagogy informed interpretation. Reported institutional expectations provided documentary context, rather than a separately reported documentary analysis. Results Three related themes were identified. The hospital functioned as a situated learning community through bedside participation, corridor microteaching, night-shift learning, role modelling and patient and family education. The hidden curriculum and ethical climate influenced whether interns could ask questions, acknowledge uncertainty and develop respectful professional identities. Accessible tutors, interprofessional rounds and humanising practices bridged formal intentions and everyday learning, whereas workload, rigid hierarchy, inconsistent feedback and service-level variation restricted educational opportunities. Together, the themes describe learning opportunities, the relationships governing participation and the organisational conditions supporting or constraining them. Conclusions In this cohort, social pedagogy helped interpret the relational, participatory and ethical dimensions of workplace learning. Protecting brief teaching moments, responding respectfully to uncertainty and reflecting interprofessionally on hidden messages are potential implications for clinical teachers; their feasibility and effects require evaluation.