Morality and philosophy of medicine and education (Selection (Trustworthy…
Morality and philosophy of medicine and education
Medicine and education as social "goods"; i.e. both aim to do good (as opposed to evil) in the world
Aim of selection - to choose people with a high probability of being "good" to society
The execution of this good is a mixture of art and science
Ethical and moral principles
Principled autonomy (O'Neill)
"Establishing and maintaining an environment for medical education in conjunction with good medical practice relies on a culture that places a high regard on both trustworthiness and a 'kindness' which protects the most vulnerable."
Interdependence and trust in medical education
Respect for the task of learning
Trust between teachers and learners
Key issues in clinical education:
Safety of patients
Maintenance of a developmental trajectory towards enhanced capability (growth mindset)
Judging whether the standard achieved is sufficient for progress
The patient's role in medical education
Expectation to contribute to medical education and the greater good?
Promote patients' sense of responsibility for learning
Students' "right to learn"
Needs for learning opportunities should not override needs and rights
Medicine and the law
Defensive v defensible practice
Concept of being present and actively observing but not acting upon a patient - actually an expression of empathy
Professional autonomy - often forgotten. Acquience to a requested intervention against own clinical or ethical judgement = abrogation of duty
Emergence of a doctor from a complex system
Interaction between possibilities of genetic endowment and possibilities of physical and relational environments
Concept of self-organisation from complexity theory
Participative emergence of form
Concept of self-directed learning
Tension between selfish and self in the service of others
pleasure from novelty and learning
altruistic desires to make a difference
pleasure in learning alongside others
Primary, shared focus of education is engagement with the learning-directed self in order to produce "fit-for-purpose" health and sickness care providers
Cannot measure trust
"truly virtuous physicians are those who can be trusted to do what is right and good for patients even when no one is measuring"
Inherent biases in selection - whether academic, etc...
Proposed random allocation of people meeting a minimum academic threshold (Dutch model)
Should medical schools only produce graduates for local conditions or for the wider world?
Reflective practice is iterative, formative assessment
Assessment influences learning, esp for strategic learners