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Adapted Girandole framework provides shared language for examining power and cultural norms in health curriculaNew framework helps students reflect on power and culture

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Key Takeaway
Note the Girandole framework as a tool for educators to address power and cultural norms in health curricula.

This perspective piece discusses the adaptation of the Girandole framework for cross-disciplinary social justice reflection. The scope focuses on how the framework can be used by healthcare professional students and educators to examine power relationships, informal norms, professional cultures, and educational omissions within health professions curricula.

Key findings suggest that while domains such as Power, Culture, and Personal and Professional Values were easily connected to learner experiences, other areas like the Hidden Curriculum and EDI Education and Awareness required more practical examples and educational scaffolding. The framework aims to provide a common vocabulary for addressing systemic issues in medical education.

Several limitations are noted, specifically that the framework's impact on EDI literacy, belonging, and meaningful organizational change has not been empirically evaluated. The authors suggest that further student-educator co-production and empirical studies are necessary to validate its effectiveness. The clinical relevance is currently limited to educational methodology and institutional culture rather than direct patient care.

Medical and health students often face complex social dynamics during their training. A new version of the Girandole framework was designed to give these students and their teachers a shared language. It helps them talk openly about things like power relationships, professional cultures, and the informal rules that shape their education.

Students gave feedback on different parts of the framework. They found it easy to connect their own experiences to topics like power, culture, and personal values. However, they noted that some areas, like the hidden curriculum and diversity education, needed clearer language and more practical examples to be fully understood.

While the framework provides a useful tool for reflection, it is still early in its development. Researchers noted that more work is needed to see exactly how it improves student belonging or leads to organizational change. More study is needed to confirm its impact before it can be fully adopted as a standard tool.

What this means for you:
The Girandole framework gives healthcare students a shared language to discuss power and culture in their training.

Common questions

What is the Girandole framework used for?

The framework provides a shared language for students and educators. It helps them examine power relationships, informal norms, professional cultures, and educational omissions within health professions curricula.

What did students think of the framework?

Students found it easy to connect power, culture, and personal values to their experiences. However, they felt that the hidden curriculum and diversity education sections needed clearer language and more practical examples.

Is the framework's impact on student belonging proven?

The impact of the framework on student belonging, diversity literacy, and organizational change has not been empirically evaluated yet. More research and collaboration between students and educators are needed to confirm these results.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
Equality, diversity and inclusion (EDI) are increasingly embedded within the standards and strategic priorities of health professions education. However, persistent inequities, hidden curricula and differences between institutional commitments and learners' lived experiences indicate a need for approaches that move beyond policy compliance towards critical, socially informed reflection. This Perspective paper explores the cross-disciplinary adaptation of the Girandole Framework, originally developed in nursing education, for application across health professions education. The framework uses six interconnected domains—Power, Hidden Curriculum, Professional Values, Personal Values, Culture, and EDI Education and Awareness—to support examination of the individual, cultural and structural influences shaping educational and professional experiences. An exploratory cross-disciplinary workshop involving healthcare professional students informed the adaptation of the framework. Informal discussions suggested that Power, Culture, and Personal and Professional Values were readily connected to learners' experiences. In contrast, Hidden Curriculum and EDI Education and Awareness required clearer language, practical examples and additional educational scaffolding. These insights informed the refinement of the framework's reflective prompts and the development of examples relevant to nursing, pharmacy, biomedical science and transferrable to other health professions. The adapted Girandole offers a shared language through which students and educators can critically examine power relationships, informal norms, professional cultures and educational omissions. Potential future applications include clinical and laboratory placements, professionalism teaching, portfolio-based learning, interprofessional education and curriculum review; however, these applications require empirical evaluation. The framework is intended to complement established reflective models by foregrounding equity and social justice. Further student–educator co-production and empirical evaluation are needed to assess its contribution to EDI literacy, belonging, reflective practice and meaningful organisational change across health professions curricula.
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