Reflection has been proclaimed as a means to help physicians deal with medicine’s inherent complexity and remedy many of the shortcomings of medical education. Yet, there is little agreement on the nature of reflection nor on how it should be taught and practiced. Emerging neuroscientific concepts suggest that human thought processes are largely nonconscious, in part inaccessible to introspection. Our knowledge of the world is fraught with uncertainty, ignorance and indeterminacy, and influenced by emotion, biases and illusions, including the illusion (...) of not having illusions. Neuroscience also documents that lifelong learning processes may hone nonconscious cognition to high levels of sophistication, allowing rapid and precise perceptions, judgments and actions in complex situations. We argue that knowledge of mechanisms underlying human thought may be useful in designing educational programs to foster desired attributes such as curiosity, critical self-awareness and intuitive acumen in medical professionals. The juxtaposition of neuroscientific insights with ideas from Kant on reflective judgement, van Manen on tact, and Aristotle on phronésis, supports a concept of reflection that manifests as wise practice. We suggest that reflection in medical education should be an imperative for educators seeking to guide learners to manage the complexity and “messiness” of medical practice, and a role-modelling mode of medical practice characterized by self-correcting behaviors that culminate in good and right professional actions. An example illustrates reflective practice in the teaching and learning of physicianship. (shrink)

Background:The theoretical framework of Jϋrgen Habermas suggests that effective communication requires competent participants with an objective attitude that complies with the rules and worlds designated as objective, social and subjective. This situation determines communicative action, which stimulates the search for mutual understanding and results in a process of interaction that promotes self-determination.Objectives:In this study, the discharge letters of patients with myocardial infarction were explored regarding the provision of information. The patient’s right to information and the duty of informing were analysed (...) according to the perspective of Jϋrgen Habermas.Research design:This was a cross-sectional analysis of all discharge letters that were directly related to nursing interventions regarding the provision of information to 106 patients. In this major study, the difficulties faced by patients who experienced a myocardial infarction and the changes in their lifestyles were analysed based on the type of information received.Ethical considerations:The hospital Ethics Committee approved the study, which complied with ethical principles and required informed consent.Findings:In the nursing letters, interventions related to the provision of information were conducted at an average of 3.59 interventions per patient. For 8.5% of the patients, however, no interventions related to the provision of information were performed. The most common area of information during hospitalisation was related to the management of signs and symptoms and applied to 90.6% patients.Discussion:The nursing interventions did not cover patient education, transition processes or awareness of the disease. Thus, the right to information can be questioned.Conclusion:Information is a right, and communication is extremely important. Health professionals should be aware of this importance regarding both care management and the satisfaction guarantee. The sharing of information by health professionals based on their competency is essential for patients to exercise their right to self-determination and decision-making. (shrink)

ABSTRACTDespite the extensive literature on what questionable research practices are and how to measure them, the normative underpinnings of such practices have remained less explored. QRPs often fall into a grey area of justifiable and unjustifiable practices. Where to precisely draw the line between such practices challenges individual scholars and this harms science. We investigate QRPs from a normative perspective using the theory of communicative action. We highlight the role of the collective in assessing individual behaviours. Our contribution is a (...) framework that allows identification of when particular actions cross over from acceptable to unacceptable practice. Thus, this article provides grounds for developing scientific standards to raise the quality of scientific research. (shrink)

The Habermasian concept of ‘interest’ has had a profound effect on the characterization of scientific disciplines. Going beyond issues unrelated to the theory itself, intra‐theoretical interest characterizes the specific ways of approaching any science‐related discipline, defining research topics and methodologies. This approach was developed by Jürgen Habermas in relation to empirical–analytical sciences, historical–hermeneutics sciences, and critical sciences; however, he did not make any specific references to health sciences. This article aims to contribute to shaping a general epistemological framework for health (...) sciences, as well as its specific implications for the medical and nursing areas, via an analysis of the basic knowledge interests developed by Habermas. (shrink)