Is Evidence-based medicine about democratizing medical practice?

Thorgaard, Keld

doi:10.7146/ocps.v15i1.15827

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…We found that, in order for conversation to nurture trust, there is need for the student to lead the way, but not with the kind of paternalistic authority that medical doctors traditionally have adhered to. 13,38 For decades, faculty, researchers and doctors have taken such authority for granted. This is based on the assumption that “doctors have intrinsically superior insights and that patients should defer to their edicts.” 13 The patients of our study crave an alternative.…”

Section: Discussionmentioning

confidence: 99%

‘If you had taken the lead…’ – a qualitative study of patients with chronic conditions and their perspective in clinical encounters with medical students

et al. 2022

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Objectives To explore what patients with chronic conditions emphasize as important in the patient-medical student conversation, and how the patients’ experiences relate to trust. Methods Twenty-one video-recorded sessions of patients’ feedback in simulation-based communication courses for medical students were observed, transcribed, analyzed inductively and organized into three themes. Results In the patients’ feedback, three aspects were emphasized as important relating to trust: a) when the medical student relates medical information to the patient's lifeworld, b) when the student leads the patient throughout the conversation, and c) when the patient gets emotional support from the student. The patients felt that being met this way by the students grows trust and allows them to lean into the uncertainties they experience while still feeling safe. Discussion The patients emphasize three aspects of importance in conversations with the medical students that grow trust. We argue that these aspects cannot be found in the traditional authority-led practice but can be found in leadership, which imply empathy and willingness to learn from patients. We suggest that students should learn that to effectively communicate with patients infers such leadership. By doing so, medical students can walk alongside their patients to build a relationship and nurture trust.

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Section: Discussionmentioning

confidence: 99%

‘If you had taken the lead…’ – a qualitative study of patients with chronic conditions and their perspective in clinical encounters with medical students

et al. 2022

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Andrew Feenberg and the Distorted Democratization of Technology: Covid-19 and the Case of Hydroxychloroquine

Sikka

2022

Philosophy of Engineering and Technology

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Who cares? The lost legacy of Archie Cochrane

2016

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Over the last 20 years, the evidence-based medicine (EBM) movement has sought to develop standardised approaches to patient treatment by drawing on research results from randomised controlled trials (RCTs). The Cochrane Collaboration and its eponym, Archie Cochrane, have become symbols of this development, and Cochrane's book from 1972 is often referred to as the first sketch of what was to become EBM. In this article, we claim that this construction of EBM's historical roots is based on a selective reading of Cochrane's text. Through a close reading of this text, we show that the principal aim of modern EBM, namely to warrant clinical decisions based on evidence drawn from RCTs, is part of Cochrane's original project. He had more modest ambitions for what RCTs can accomplish, and, more importantly, he was more concerned with care and equality than are his followers in the EBM movement. We try to reconstruct some of Cochrane's lost legacy and to articulate some of the important silences in From these clues it might be possible, we argue, to remodel EBM in a broader, more pluralistic, more democratic and less authoritarian manner.

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Is Evidence-based medicine about democratizing medical practice?

Cited by 3 publications

References 17 publications

‘If you had taken the lead…’ – a qualitative study of patients with chronic conditions and their perspective in clinical encounters with medical students

‘If you had taken the lead…’ – a qualitative study of patients with chronic conditions and their perspective in clinical encounters with medical students

Andrew Feenberg and the Distorted Democratization of Technology: Covid-19 and the Case of Hydroxychloroquine

Who cares? The lost legacy of Archie Cochrane

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