Showing 121 - 130 of 260 annotations tagged with the keyword "Medical Education"
Dr. Pauline Chen is a transplant surgeon and hence highly trained in the surgical care of desperately ill patients. She found, however, that although she had intensive and first rate training, time and again the message she received from her mentors and peers encouraged a distance from frank discussions about dying with patients who were clearly dying. Dr. Chen successfully suppressed her urges to reflect on the meaning of illness and death. Years into her training, she finally witnessed an attending surgeon stay with a patient and the patient's wife until the patient passed away. The widow sent a thank you note to Dr. Chen for allowing a "dignified and peaceful death." (p. 101) Chen notes that observing her attending stand with the patient during death changed her profoundly: "...from that moment on, I would believe that I could do something more than cure. This narrative, then, is my acknowledgment to him." (p. 101)
Final Exam chronicles Chen's journey from medical student to attending surgeon and examines her experiences with death and serious illness - of patients, family members, friends. The memoir contains three parts: Principles, Practice, and Reappraisal - each with three chapters. The book is chronologically arranged, beginning with anatomy dissection at the start of medical school and ending with Chen as an attending arranging for hospice, thus honoring a patient's desire to die at home rather than in hospital. Chen skillfully weaves her stories around commentary on the social, cultural and philosophical issues surrounding death and the medical response to death. An introduction and epilogue bookend the text and 46 pages of extensive notes and bibliography complete the book.
Although Chen claims to have slowly and painfully awakened to the fact that patient needs extend well beyond good technical care, in fact one sees Chen emerge as a caring physician even from her initial patient contacts in medical school. Chen speaks more to her role as an Asian-American than to being a woman in a male-dominated field, but she clearly has what it takes to succeed in this extremely competitive field, including a good dose of compulsiveness and an incredible work ethic.
Summary:This 2002 DVD, copyrighted by WHYY in Philadelphia and narrated by Blythe Danner, consists of a one-hour documentary about Philadelphia-born painter, photographer, and sculptor Thomas Eakins (1844-1916) and eight short films about different facets of his life and work. Photographs by and of Eakins, his paintings, letters, and sketches are interspersed with commentary by his biographer Elizabeth Johns, and by art historians and historians. The DVD describes Eakins’s training, art production, and aspects of his personal life.
The authors analyze developments in the scientific article in Europe from the seventeenth century to the present. They devote a chapter to "style and presentation" in each century, and a separate chapter to "argument" more specifically in each century, in French, German, and English examples. They find a remarkable similarity of style already evident in seventeenth-century examples, demonstrating that scientific authors were already addressing an international audience. Seventeenth-century articles show an "impression of objectivity" and "a movement toward a more impersonal style" (47), although the English examples were somewhat more personal, less quantitative, and less interested in explanation than were the French examples, and the prose overall is hardly what we would currently expect from a scientific article.
Although the eighteenth-century examples should, perhaps, be considered part of a larger period that included the seventeenth century, Gross et al do track a movement from impersonal to personal style, nominal to verbal style, and minimal presentation to more elaborate presentation during this period. Also, the French examples continue to approximate more closely to twentieth-century norms of scientific style, reflecting their more professionalized community. Overall, the authors characterize much of the eighteenth century as a period of "consolidation and altered emphasis," with "relative stability" of style (116), although the last quarter of the eighteenth century showed a sharp rise in standardization and standards for accuracy and precision.
Gross et al note that nineteenth-century prose still addresses amateurs as well as professionals, and they comment on its persistent difference from "the highly compressed, neutral, monotonal prose" of late-twentieth-century science(137). However, the English and German examples do become more professional in their use of impersonal style, and examples demonstrate a consolidation toward a more "homogeneous communicative style" (138). They also note that the nineteenth century exhibits a "master presentation system approaching maturity," with "title and author credits, headings, equations segregated from text, visuals provided with legends, and citations standardized as to format and position," as well as standardized introductions and conclusions (138).
They find that the combination of an increasing "passion for factual precision" and systematization produces more careful theorizing generally in science during this period, even as individual sciences specialize and diverge (158). Increased attention is given to the process by which facts are linked to theory, and to the role of evidence, governed by an "overriding need for explicitness" (160).
Twentieth-century examples include shorter sentences with more information packed into each by way of "complex noun phrases with multiple modifications in the subject position, noun strings, abbreviations, mathematical expressions, and citations" (186). The scientific article is now generally marked by high incidence of passive voice and low incidence of personal reference, along with a "master finding system" made up of "headings, graphic legends, numbered citations, numbered equations, and so on" (186). They argue that the current state of the scientific article reflects an evolutionary process whereby "current practices are a consequence of the selective survival of practices that were, persistently, better adapted to the changing environments of the various scientific disciplines over time" (212).
The book opens with a thought "exercise": thirteen short essays, each in a different national voice and beginning "We, the people of a nation . . . " The honest, intelligent "speakers" love their countries and traditions; however, they try to express the ugly truths about their homelands as challenges for the future.
For example, American smugness over its know-how and wealth combines with American failure to recognize the resentment sparked elsewhere by these same attributes. Similarly, the mutual intolerance of Canada's linguistic and religious duality is portrayed as a grotesque irony. The U.S.S.R. has exchanged an old tyranny for a new; Japan must face the issue of controlling its population, if it is to control its impulse to aggression.
Chisholm then returns to his role as a socially committed psychiatrist who hopes to avert a war that could annihilate the human species. World aggression, he writes, is caused by the "anxiety" that emerges from intolerance typifying narrow parental guidance and even narrower systems of education and religion. People must learn to be comfortable with differences in population, race, language, and wealth. The message is simple: "anxiety" leads to "aggression." The book ends with a ideal curriculum for "world citizenship," surprisingly different from any currently in use.
Summary:A collection of short stories loosely connected to each other by centering on the experiences of four people from their first encounters during medical school and continuing into young middle age.
As the two physician-authors suggest, this book is kind of a primer for medical educators who plan to integrate medial humanities materials and approaches into curricula for healthcare providers and trainees. It is a "how-to" manual for teaching medical humanities content to clinicians.
The book's Introduction asks "why use the arts In medical education?" and identifies their utility in understanding the patient's unique and personal experience of illness, and the effects of patients' social locations and psychological responses to their disease and to the healthcare professionals who care for them. And further, the arts offer a way for healthcare professionals to explore and reflect emotionally on their personal interactions with patients, to think creatively and practice empathetically.
The next chapter provides a model of "how to teach the arts" using a non-didactic, interactive approach as a series of questions around the work of art. Illustrative examples are included at each step. In the subsequent chapters, each focuses on an individual art forms-- literature, visual art, sculpture, photographs, music and drama-- with specific examples, exercises and activities for learners that have been piloted by the authors. For the music chapter, a CD with examples is included.
Summary:Poe asks why science preys on the poet. Science is peering, destructive and interested only in cold realities. It will not allow the poet to soar in fantasy or even to sit peacefully dreaming beneath a tree.
Richard Selzer’s memoir is subtitled “A Doctor Comes of Age.” The book is structured around childhood memories, interspersed with stories from more recent times. Selzer’s father, a general practitioner in Troy, New York, serves as the focal point for most of his early memories--a commanding figure of warmth and goodness in his son’s life: “If I have failed to describe father… it is because none of his features did him justice. I should have had to mention wings in order to do that.” (p. 152)
While his father brought science into Selzer’s life, his mother represented the world of art. She was an amateur singer with a “small pure soprano voice” (p. 15), as well as being the doctor’s wife. After the doctor’s death from a massive heart attack when Selzer was 12 years old, his mother had numerous suitors, at least some of whom she eventually married. When he went to college, she began a life-long practice of writing her younger son (Selzer has an older brother William) weekly letters, including such advice as “Rise and flee the reeling faun,” “You do not take enough chances” and “You must learn to be absurd.” (p.227)
Toward the end of Down from Troy, Selzer writes of his parents, “Of all the satisfactions of my life, the greatest is that I have at last fulfilled each of their ambitions.” (p. 251) This is in reference to his having practiced both surgery and writing. He goes on to enumerate the many unexpected similarities between the two professions. The book ends with a narrative that brings together narrative and medicine, the story of a retired surgeon who reaches out to help a young man dying of AIDS.
Winter surveys the rise and fall of mesmerism in Victorian Britain, from animal magnetism to hypnotism, including electrobiology (a form of group hysteria), table-turning, and other fads. The book offers rich detail about the different stages of the use of mesmerism in medicine: its initial appearance in staged experiments; its uncertain status and the struggle to locate the boundary demarcating alternative medicines; its performance by professional medical men as well as travelers and quacks; its importance in the development of anesthesia; and its role in prompting skeptical scientists to consider the possibility of mental reflexes as one way to explain away mesmeric phenomena.
Winter argues that mesmerism was not "illegitimate" so much as it brought "legitimacy" itself - of medical authority, of evidence, of knowledge -- into question. Thus, she argues, mesmerism crucially inspired many of the considerable changes in nineteenth-century medicine as well as the reorganization of science and the educational reforms of the later nineteenth century. The book also discusses mesmerism as a form of religion, as a conduit for spiritualism and communication with the dead, as a catalyst in orchestral conducting, and as a model for liberal political consensus.
Antonia Redmond is a young Harvard-trained doctor who has returned to the East African village where she was raised by American parents to establish a medical practice. Her efforts are frustrated by inadequate supplies and funding, an under-trained staff, and patients whose superstitions and mistrust make diagnosis and treatment difficult. She deals daily with a conflict of cultures, trying to maintain her medical methods and standards in an environment where she competes with the authority of native healers.
Esther, daughter of a native healer who has some familiarity with and respect for Western medicine, envies and longs for Antonia’s Western training and attaches herself to her as a disciple. In her encounters with patients, Esther finds that she has an inexplicable gift for healing which baffles her as well as Antonia and complicates their already tenuous relationship. Esther’s gift forces Antonia to reexamine some of her most basic assumptions about what constitutes healing.