Science as a 'Way of thinking'
Scientist or science-stuffed? Discourses of science in North American medical eduation. Whitehead C. Medical Education 2013; 47:26-32.
Reviewed by Angela Punnett
What was the study question?
There is an apparent tension within medical education about how to teach both the art and science of medicine (recognizing that basic and clinical sciences continue to develop at an astounding rate). The author of this research study sought to explore the historical context of this tension and its implications for educators.
How was the study done?
The author analyzed medical education articles from the time of Flexner's original publication in 1910 - which called for the development of the scientist-doctor – to 2010. Changes in the way that papers described the 'good doctor' were sought and explored.
What were the results?
Flexner advocated for the 'scientist-doctor' - an enquiring practitioner motivated to seek answers in the course of patient care by drawing on multiple forms of knowledge. Over the past 100 years, the discourse in medical education has changed - science is now viewed as vast curriculum content to be learned, rather than an approach to practice; science is seen as being an almost impossible topic to "fit" into the curriculum; and science is thought to be insufficient to meet the need for developing a broader sociocultural perspective in our future physicians.
What are the implications of these findings?
The reported challenges faced by medical educators today have existed since Flexner's original report and in spite of his initial intentions. As long as we continue to view the amount of science as a problem for our curricula and our students, we deny an opportunity to refocus our education efforts on a holistic approach to patient care, population health and sustainable health care systems. We cannot and do not need to teach everything; our students need to learn the skills to enable life-long learning.
Editor's note: The author notes that "science came to be regarded as an object in the curriculum rather than as a way of thinking". One of the challenges we face as medical educators is how to instill this "way of thinking" into our students. This article is also important for it describes a critical discourse analysis and explains the methodology for such a study (SLB).