Modern healthcare: a technical giant, yet an ethical child?

Miles, Andrew; Asbridge, Jonathan

doi:10.5750/ejpch.v2i2.886

Cited by 20 publications

(49 citation statements)

References 32 publications

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“…But the disease is part of the patient and not the patient part of the disease, necessitating an approach to assessment and treatment that is as concerned with the patient's subjective experience of illness as it is with objective clinical and laboratory examination. Indeed, patients present for assistance not as a collection of organ systems, one or more of which may be dysfunctional requiring scientifically indicated technical and pharmacological interventions, but rather as integral human beings with narratives, values, preferences, psychology and emotionality, spiritual and existential concerns, a cultural situation, possible difficulties with sexual, relational, social and work functioning, possible alcohol and substance abuses and addictions, worries, anxieties, fears, hopes, goals and ambitions -and more [28]. As persons, patients exist not in isolation, but in relationship and community, therefore requiring not simply an analysis of their genomics, proteomics, pharmacogenomics, metabolomics and epigenomics, but a proper understanding also of their social situation and the extent to which this mediates an adequate, good or poor response to biological and related interventions [41,42].…”

Section: The Ethical/professional Justificationmentioning

confidence: 99%

“…Leading commentators, reflecting on the same, have lamented the loss of doctors' abilities to care for their patients as integral human beings, warning that a continued depersonalisation of clinical practice risks an essential "failure" of healthcare provision [52] and a maintenance of patients' complaints that they are treated not as persons, but rather 'dealt with' as subjects, objects or complex biological machines [28,42,48].…”

Section: The Ethical/professional Justificationmentioning

confidence: 99%

“…In doing so, PCH seeks to elevate current modes of practice to an altogether higher order of skill, replacing basic legal competence with the clinical excellence to which all clinicians should rightly aspire. The need to re-sensitize modern medicine and healthcare to the humanity required of the clinical encounter and thus to return to clinicians and healthcare systems an ambition to treat patients as persons, illustrates the basis of the ethical/professional justification for 'doing' PCH [28].…”

Section: The Ethical/professional Justificationmentioning

confidence: 99%

“…Attempts to marginalise or ignore the patient's voice in its highlighting of the deficits in care, compassion and general lack of responsiveness within modern health services, are no longer sustainable. Indeed, the argument that personcentered care is an imperative, not an option, possibly constituting a human right, is gaining increasing traction [27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

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Person-Centered Healthcare - moving from rhetoric to methods, through implementation to outcomes

Miles¹,

Asbridge²

2017

EJPCH

Self Cite

106

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Section: The Ethical/professional Justificationmentioning

confidence: 99%

Section: The Ethical/professional Justificationmentioning

confidence: 99%

Section: The Ethical/professional Justificationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Person-Centered Healthcare - moving from rhetoric to methods, through implementation to outcomes

Miles¹,

Asbridge²

2017

EJPCH

Self Cite

106

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“…Indeed, it has been contended that if modern Society continues to tolerate this crisis of disregard sad juncture in human history indeed [4][5][6][7] . So what is to be done?…”

Section: Introductionmentioning

confidence: 99%

Towards a person-centered medical education: challenges and imperatives (I)

Miles

Asbridge²,

Caballero

2015

Educación Médica

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It is increasingly claimed that modern medicine has entered into crisis -a crisis of knowledge (uncertainty over what counts as "evidence" for decision-making and what does -glect, iatrogenic injury, malpractice, excess deaths), economic costs (which threaten to bankrupt health systems worldwide) and clinical and institutional governance (a failure of basic and advanced management, inspirational and transformational leadership). We believe such a contention to be essentially correct. In the current article, we ask how the delineated components of the crisis can be individually understood in order to allow them to be collectively addressed. We ask how a transition can be effected away from impersonal, decontextualized and fragmented services in the direction of newer models of service provision that are personalized, contextualized and integrated. How, we ask, can we improve healthcare outcomes while simultaneously containing or lowering their costs? In initial answer to such questions -which are of -come necessary, particularly in the context of the current epidemic of multi-morbid and socially complex long term illness. This new approach, we argue, is represented by the development and application of the concepts and methods of person-centered healthcare (PCH), a philosophy and technique in the care of the sick that enables clinicians and health systems to thereby restoring to medicine the humanism it has lost in over a century of empiricism. But the delivery of a person-centered healthcare within health systems requires a person-centered education and training. In this article we consider, then, why person-centered teaching innovations -ress in the integrity of modern undergraduate medical education. Without such innovations, we do not believe that suitable foundations for subsequent innovations in postgraduate training can 26 A. Miles et al.

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Patterns of Change in Approaches to Learning and Their Impact on Academic Performance Among Medical Students: Longitudinal Analysis

Piumatti

Abbiati

Gerbase

et al. 2020

Teaching and Learning in Medicine

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Theory: Several medical education studies suggest that deep approaches to learning (DA) are associated with better academic performance, whereas surface approaches (SA) are associated with worse academic performance. However, no study has assessed how these approaches change at the individual level during undergraduate medical training and how these trajectories contribute to academic performance. We assessed individual patterns of change in learning approaches throughout five years of medical training to determine whether and how DA and SA evolve during the curriculum and whether initial levels and rates of change predict performance in Year 5.Hypotheses: We hypothesized that (1) medical students have a higher preference for DA in comparison with SA; (2) these preferences change along the medical curriculum; and(3) DA predicts better academic performance.Method: Participants were 268 Geneva medical students (59% female) who completed the revised two-factor study process questionnaire in Years 1, 2, 3, and 5 of their 6-year curriculum. Student academic performance was registered in Year 5. Multivariate latent growth modeling was used to assess individual trajectories in learning approaches and test their associations with performance in Year 5.Results: Medical students were inclined to use DA rather than SA. Nevertheless, from Year 2 onward their use of DA decreased while their use of SA increased. Students with higher initial levels of DA tended to have lower initial levels of SA. Moreover, increases in SA were significantly associated with decreases in DA. However, only initial levels of DA and non-repeater status in Year 1 were positive and significant predictors of academic performance in Year 5. Conclusions:Although students tended to use DA rather than SA when entering medical school, their preferences for DA tended to decline throughout medical training while 3 increasing for SA. Learning approaches during early study years, characterized by engagement and meaningful learning, predicted later academic performance. DA should be promoted during the early years of medical studies to foster student learning and to improve academic performance.

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Modern healthcare: a technical giant, yet an ethical child?

Cited by 20 publications

References 32 publications

Person-Centered Healthcare - moving from rhetoric to methods, through implementation to outcomes

Person-Centered Healthcare - moving from rhetoric to methods, through implementation to outcomes

Towards a person-centered medical education: challenges and imperatives (I)

Patterns of Change in Approaches to Learning and Their Impact on Academic Performance Among Medical Students: Longitudinal Analysis

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