"Good" "Mistakes" and "How" in Medical Education and Practice
I found a written paper which clearly summarizes in a relatively few words much of what I have posted since July of last year about medical education and the practice of medicine. The paper is by Ladislav Šoltés and it is titled
Medical ethics in Slovakia. Go to the website to read the full article including the portion on Slovakian medical ethics. I fully agree with the view of medicine as presented below by Ladislav. I also want to point out an important point he makes: "'How to learn' rather than 'what' you to learn, is the critical issue."
I can give an example from my medical school teaching activities. What is most important is for the students faced with a myriad of accumulated diagnoses they have studied, to learn how to think out a differential diagnosis of a sick patient. Just knowing a lot of diseases is not good enough. ..Maurice.
My paper is divided in two different (but in reality) related aspects. In the first part 1 would like to analyse some aspects of medical and ethical educations from our point of view and, in the second, Slovak experiences in establishing ethics in medicine and health care and legal support for medical ethics.
The universal nature and meaning of medicine itself proves that medicine is inherently ethical. In every cultural context medicine is needed, recognized and valued by all. ( ucha, J., 1997) That medical education which aims at making its students and physicians good doctors is not an individualistic task, (me and my students, my colleagues, etc.), it takes place within a context of medical practise, a medical community, that although concrete in particular place and time, is also of universal significance.
The moral integrity of health professionals should be saved by permanent ethical education and training and by developing and strengthening their up to date professional competence.
What is a good medicine? What makes for a "good" doctor? But the essential underlying question is: "who has the competence to judge what is good or bad; whether the doctor is good or not?" To claim this competence is audacious. The physician plays many roles, not only one. And to be good as a diagnostic, a therapist, a head of department, a confessor or husband and father, is not a state, rather,' it is a process. A physician maintains, increases his goodness by improvement: he must maintain and defend it, or he may regress and loose lt. To be a good means to endeavour to become good and to continue that goodness.
Albert Schweitzer (who became a physician in order to become the better theologian), pointed out the ethics of respect to life, to the ethics and to science. In this sense, science and life, in medical praxes, go together and their relation is like the relationship between a good coalition and a good opposition. The process to become a good doctor is an education of self-awareness.
The relation between professional and private life can not be one of independence in relationship to each other. The one who is fighting for rights, liberty and justice, must not be a despot in his own family, cannot mislead his nearests and has to be fair also in his own family. In reforming the surrounding world we may not neglect ourselves. It is the testimony to the values, in the name of which we are acting. (~olt6s, L., 1997)
Frustration, deprivation and mistakes are on all sides in a professional life. Physicians should be sensitive to their mistakes. The mistakes seduce. Every man who contemplates his mistakes knows how success is manipulated by his own mistakes. To face, no confront our own mistakes and the limitations of mistakes of the others is very difficult. The myth of seducer and temptater is one of the central myths of humanity. Certainty is not by chance. To be aware of mistakes is not only the rule of the scientific analysis but also an ethical imperative. To be good is a lifelong process. (bolts, L., 1995)
"How to learn" rather than "what" you to learn, is the critical issue. It is a fact that of the three basic questions in the teaching process, (i.e., the Why, What and How), the latter is often neglected.(Kou ilea, M., 1997)
Briefly, the "How" is the rationale, a set of organizational and operational principles and strategies underlying those processes which facilitate acquisition.
The basic premise is that the learning process must be selective and integrating rather than discrete. Our aim is meaningful learning: learning by understanding that is both selective and organizing. Efficient dealing with the information burden is one of the most urgent challenges in the world of both business and science. The renowned news agency, Reuters, has recently organized a conference in London addressing the questions :
a. How does the information overload affects our mental and physical health ? and,
b. How to survive the information deluge ?
A monster has been created which makes us feel inferior, incompetent, lost, and affected by " Information Fatigue Syndrome" causing physical illness and mental anguish. Paradoxically, one symptom is an addictive drive to seek even further information being obsessed by a fear of missing something important. The result is paralyses of analysis, characterized by distorted judgment, wrong decisions, flawed conclusions and even serious blunders. This carries ethical implications to our approach to our present and future problems.