Part III: Reformers in medical education and practice

2002 ◽  
Vol 10 (3) ◽  
pp. 103-108
Author(s):  
Martin A Entin
Keyword(s):  
Medical Education ◽  
Patient Care ◽  
20Th Century ◽  
Study Design ◽  
Professional Practice ◽  
Medical Practice ◽  
Care Society ◽  
Financial Gain ◽  
John Hunter ◽  
Definition Of

Background Part I (Can J Plast Surg 2000;8:25–29) established that standards of professional practice shift constantly. When a standard falls short of professional expectation, or when a physician becomes more concerned with financial gain than patient care, society needs the action of a reformer. Part II (Can J Plast Surg 2001;9:59–68) continued the study with the contribution of reformer John Hunter (1728–1793), followed with the contributions of seven other reformers, and concluded with Wilder Penfield (1891–1976). Part III extends this project through the greater part of the 20th century. Study Design Reformers were scientists who were selected because they conformed to the definition of ‘reformer’; namely, a person whose action restored, reshaped or changed the structure or ideology of medical practice. Results This survey demonstrated that the reforms were accomplished by scientists who possessed critical judgement and analytical qualities that enabled them to influence the direction of medical education and practice. Conclusion Reforms have been achieved through intuitive leaps, alterations of conventional practice, painstaking research and administrative restructuring.

Part II: Reformers in Medical Education and Practice

2001 ◽  
Vol 9 (2) ◽  
pp. 59-68 ◽  
Author(s):  
Martin A Entin
Keyword(s):  
Medical Education ◽  
Professional Practice ◽  
Medical Practice ◽  
Care Society ◽  
Analytical Quality ◽  
Financial Gain ◽  
John Hunter ◽  
History Of ◽  
Definition Of ◽  
Historical Article

Background Part I was published in Can J Plast Surg 2000;8(1):25–29. It established that standards of professional practice shift constantly. When a standard falls short of professional expectation or when a physician becomes more concerned with financial gain rather than patient care, society needs the action of a reformer. Part II continues the study and begins with the contribution of reformer John Hunter (1728–1793), and follows with the contributions of seven other reformers, concluding with Wilder Penfield (1891–1976). Study Design The reformers were physicians and scientists who were selected throughout the history of medicine: they conformed to our definition of reformers, namely, a person whose action changed the structure or ideology of medical practice. Results The present historical article shows that reforms are produced by people possessing critical judgement and analytical quality who influenced the direction of medical practice. Conclusion Reforms have been achieved through intuitive leaps, alterations of conventional practice, painstaking research or administrative restructuring.

Reformers in Medical Education and Practice

2000 ◽  
Vol 8 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Martin A Entin
Keyword(s):  
Medical Education ◽  
Patient Care ◽  
Professional Practice ◽  
Medical Practice ◽  
18Th Century ◽  
Care Society ◽  
Analytical Quality ◽  
Financial Gain ◽  
History Of ◽  
Definition Of

Background The standards of professional practice are constantly shifting to keep pace with acquired knowledge. When the standards fell short of professional expectations, when the practising physician became more concerned with financial gain than effective patient care, society needed a reformer to evaluate the process and to improve it. Study Design Individual physicians and scientists were selected from throughout the history of medicine until the end of the 18th century, who conformed to our definition of reformers, namely, a person who changed the structure or ideology of medical practice. Results This survey demonstrates that reforms are produced by persons whose minds possess analytical quality and critical judgment. Reformers have influenced the directions of medical practice and teaching. Conclusion The improvement in medical practice has been achieved through intuitive leaps, rejection of conventional practice, painstaking research or administrative restructuring.

The ‘reasonable patient’ of 2025 envisioned (Preprint)

2021 ◽  
Author(s):  
Jack Dowie ◽  
Mette Kjer Kaltoft
Keyword(s):  
Decision Making ◽  
Medical Education ◽  
Medical Research ◽  
Supreme Court ◽  
Integrated Care ◽  
Medical Practice ◽  
Uk Supreme Court ◽  
Definition Of ◽  
The Uk ◽  
Made In

UNSTRUCTURED . The verdict of the UK Supreme court in the case of Bellman versus Boojum-Snark Integrated Care Trust (2025) will have profound implications for all medical practice, medical education and medical research, as well as the regulation of medicine and allied healthcare fields. Major changes will result from the judgment made in favour of Bellman’s negligence claim, reflecting an expanded and more precise definition of informed and preference-based consent, compared with that in Montgomery (2015) and also with the principles laid out in the UK GMC guidance on Decision Making and Consent (2020). (In case of doubt, this is a vision paper.)

Person-Centeredness

2018 ◽  
Author(s):  
J. Donald Boudreau ◽  
Eric J. Cassell ◽  
Abraham Fuks
Keyword(s):  
Nineteenth Century ◽  
Medical Education ◽  
Medical Practice ◽  
Patient Centeredness ◽  
Early Nineteenth Century ◽  
Clinicopathologic Correlation ◽  
Sharp Focus ◽  
Definition Of

The historical roots of the term patient-centeredness are presented. The point is made that, although the term possesses considerable rhetorical power, in reality many institutions that wave the banner of patient-centeredness remain resolutely disease focused. This has been the case since the early nineteenth century, when clinicopathologic correlation became an imperative of medical practice. That the doctor’s primary mandate is to ferret out disease remains a tenacious precept in contemporary medical practice as well as in medical education. This chapter argues that a medicine anchored in a new and bold definition of sickness, one with a laser-sharp focus on a person’s functioning, necessarily opens many avenues for a practice centered on the person.

The Limit Situation And The Narrative Of War (On The Material Of The Novel “My Lieutenant” By Daniil Granin)

2020 ◽  
Vol 6 (1) ◽  
pp. 90-104
Author(s):  
Anatoly S. Kuprin ◽  
Galina I. Danilina
Keyword(s):  
20Th Century ◽  
Scientific Work ◽  
Point Of View ◽  
Continuous Limit ◽  
The Novel ◽  
Term Limit ◽  
Abstract Author ◽  
The Third ◽  
Definition Of

The purpose of this study is the analysis of limit situation in the narrative of war. The material of the study is the novel of Daniil Granin “My Lieutenant” and related texts. In the first part of the paper, the authors explore existing approaches to the term “limit situation” and similar concepts into scientific and philosophical traditions; limits of its applicability in literary studies and its relation to the categories of “narrative instances” and “event”. Proposed a literary-theoretical definition of the limit situation, which can be used in the analysis of fiction texts. Existing approaches to the examination of the situation of war are analyzed: philosophical-existential, psychoanalytic, sociological, literary. In the second part of the paper, the authors propose their method for analyzing limit situations in texts about war, which basis on existing approaches and preserves the text-centric principle of studying the structure of the story. Two interrelated areas of research have been identified: the study of war as a continuous limit situation in the intertextual aspect (the discourse of war); the study of limit situations (death, suffering, guilt, accident) in the narrative of war as part of a specific text. In the third part of the scientific work,the analysis of war as a continuous limit situation results in the study of the concept of “limit” (border) in a fiction text. The role of “limit” (border) concept in the texts about the war is studied, the possible types of limits in the discourse of war are examined. Limit situations in the narrative of war are analyzed on the basis of the novel “My Lieutenant” by Daniil Granin. A review of journalistic and scientific works about the novel revealed both the continuity and the differences between the novel and the “lieutenant” prose of the 20th century. An analysis of the limit situations in the novel revealed their key position in the narrative. These situations are independent of the fiction time, of the fluctuation of the point of view’; the function of the abstract author is to build the narrative as a “directive” immersion of the hero and narrator in these situations.

Generating publicly available progress notes of authentic quality: A crowdsourcing-based approach (Preprint)

2020 ◽  
Author(s):  
Rina Kagawa ◽  
Yukino Baba ◽  
Hideo Tsurushima
Keyword(s):  
Social Capital ◽  
Medical Education ◽  
Medical Practice ◽  
Patient Privacy ◽  
Patient Anxiety ◽  
Physical Status ◽  
High Quality ◽  
Privacy Concerns ◽  
Progress Notes ◽  
Research And Education

BACKGROUND Sharing progress notes as a common social capital is essential in research and education, but the content of progress notes is sensitive and needs to be kept confidential. Publishing actual progress notes are difficult due to privacy concerns. OBJECTIVE This study aims to generate a large repository of pseudo-progress notes of authentic quality. We focused on two requirements for authentic quality: the validity and consistency of the data, from the perspective of medical practice, and the empirical and semantic characteristics of progress notes, such as shorthand styles used for reporting changes in a patient's physical status, long narrative sentences detailing patient anxiety, and interprofessional communications. METHODS We proposed a practical framework that consists of a simulation of the notes and evaluation of the simulated notes. The framework utilized two human cognitive traits: (1) the ability to use imitation to simulate objects with diverse characteristics without background knowledge and (2) the use of comparison as a strategy for deep thinking. This enabled crowd workers to generate a large number of progress notes. Our framework involved three steps. In step 1, crowd workers imitated actual progress notes decomposed into subject data (S), object data (O), and assessment and plan (A/P). These imitated texts were then shuffled and recomposed in S, O, and A/P in order to create simulated progress notes. In step 2, crowd workers identified the characteristics of actual progress notes based on comparisons between actual and dummy progress notes. These characteristics were clustered based on their similarities. Each cluster exhibited the empirical and semantic characteristics of the actual progress notes. Finally, in step 3, the texts from step 1 that exhibited the identified characteristics from step 2 were evaluated as quality-guaranteed progress notes that met the two requirements. All data were preprocessed to protect patient privacy. RESULTS Step 1: By recomposing the 700 imitated texts, 9,856 simulated progress notes were generated. Step 2: 3,938 differences between actual progress notes and dummy progress notes were identified. After clustering, 166 characteristics were evaluated to be appropriate as empirical and semantic characteristics of the actual progress notes. Step 3: 500 crowd workers demonstrated that 83.0% of the simulated progress notes satisfied at least one of the characteristics obtained in step 2. The crowd workers' artificially-reproduced progress notes were evaluated to determine the most realistic, based on four metrics: disease, morpheme, readability, and reality. CONCLUSIONS Our results demonstrated that crowd workers could generate and evaluate highly professional documents. We have made our large repository of high-quality crowdsourced progress notes publicly available, and we encourage their use in the development of medical education and research.

Health, Illness, and Disease

2018 ◽  
Author(s):  
J. Donald Boudreau ◽  
Eric J. Cassell ◽  
Abraham Fuks
Keyword(s):  
Medical Education ◽  
Practice Of Medicine ◽  
Definition Of ◽  
Contemporary Practice ◽  
Illness And Disease ◽  
Negative Sense

This introduction discusses traditional meanings of the following concepts: health, sickness, disease, suffering, and healing. The point is made that “disease” is an abstract phenomenon, albeit one that is critically important to the contemporary practice of medicine. Unfortunately, the term disease has often come to occupy the center of physicians’ preoccupations. Currently, health is considered in a negative sense, as an “absence of disease.” This chapter proposes a new and bold definition of sickness, one that revolves around the notion of function. This opens up possibilities for the goals of physicians and for medical education to be truly person centered.

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