The thesis is examined that medical schools tend to recruit those who, because of a single-minded pursuit of admission, lack the breadth of interest and the social experience necessary for the development of a socially sensitive and emotionally mature personality. This negative characterization, labeled “the premed syndrome,” has been linked to a perceived lack of physician concern for patients, interpersonal warmth, and humanitarian care. This paper reviews the various published arguments advanced by proponents and opponents of this view, analyzing the (...) presumed roots and implications and proposed remedies. (shrink)

Identification of those who have the potential to become knowledgeable, skilled, and compassionate physicians, and determining how best to prepare them for medical education has been an on ongoing challenge since the mid-1800s (Ludmerer 1985). When medical education was almost exclusively proprietary, the primary consideration for admission was having adequate financial resources. However, in the late 1800s, two men became the driving forces for structuring medical and premedical education in the United States. Daniel Coit Gilman, of (...) Yale and the University of California, later the founding President of Johns Hopkins University, and Charles W. Eliot, President of Harvard, articulated two radical objectives that .. (shrink)

Narrative analysis, creative writing, and interactive reflective writing have been identified as valuable for professional identity formation and resilience among medical and premedical students alike. This study proposes that medical student blogs are novel pedagogical tools for fostering peer-to-peer learning in academic medicine and are currently underutilized as a near-peer resource for premedical students to learn about the medical profession. To evaluate the pedagogical utility of medical student blogs for introducing core themes in the medical humanities, the authors (...) conducted qualitative analysis of one hundred seventy-six reflective essays by baccalaureate premedical students written in response to medical student-authored narrative blog posts. Using an iterative thematic approach, the authors identified common patterns in the reflective essays, distilled major themes, coded the essays, and conducted narrative analysis through close reading. Qualitative analysis identified three core themes and one overarching theme. The premedical students’ essays demonstrated significant self-reflection in response to near-peer works, discussed their perceptions of medical professionalism, and expressed concerns about their future progress through the medical education system. The essays consistently attributed the impact of the medical student narratives to the authors’ status as near-peers. The authors conclude that reading and engaging in reflective writing about near-peer blog posts encourages premedical students to develop an understanding of core concepts in the medical humanities and promotes their reflection on the profession of medicine. Thus, incorporating online blogs written by medical trainees as narrative works in medical humanities classrooms is a novel pedagogical method for fostering peer-to-peer learning in academic medicine. (shrink)

One hundred years ago, Flexner emphasized the role of science in medical education. With a 21st-century perspective, the question may be posed anew: is science relevant to medical education and practice? If so, then which areas of science are fundamental to learning and making ongoing decisions in medicine? The answers to these questions should determine what is needed in the preparation of an undergraduate student for medical school.Educators and students alike question the relevance of current premedical requirements, (...) and there is concern that these in fact diminish student interest in medical or biomedical research careers. For example, premedical science courses are viewed by many students (including those who .. (shrink)

As the world held its breath for news surrounding COVID-19 and hunkered down amidst stay-at-home orders, medical students across the U.S. wondered if they would be called to serve on the front lines of the pandemic. Medical school administrators faced the challenge of protecting learners while also minimizing harm to their medical education. This balancing act raised critical questions in medical education as institutions reacted to changing guidelines. COVID-19 has punctuated already contentious areas of medical education and (...) has forced institutions and organizations to take quick action. From the perspectives of a recent medical school graduate and current resident and a practicing clinician-educator, we examine the pandemic’s impact on undergraduate medical education through an ethical lens. First, we explore the value of medical education, what drives this value, and how COVID-19 may alter it. We next consider student choice and how shifts toward utilitarianism in healthcare during a pandemic may affect learning and career exploration. Then, we inquire how access to technology may impact the experience of medical students from diverse backgrounds and varied institutions during a rapid shift to socially distanced learning. We identify vulnerabilities for students at several phases of the journey: premedical, preclinical, clinical, and preparation for residency. Finally, we address the hidden curriculum of COVID-19, its potential erosion of empathy among current medical students, and possible long-term consequences for future physicians and patients. (shrink)

We identified nearly 180 Black women who earned medical degrees prior to the start of the Second World War and found information regarding their family and social connections, premedical and medical educations, and internship experience or lack thereof for many of these women. Through their collective history, we observed large-scale trends, especially regarding the importance of “separatist” medical education and declining medical school attendance among African American women in the 1910s as medicine became an increasingly exclusionary profession. While (...) our research uncovered trends specific to Black women physicians, the implications of our research can be applied far more widely to other historically marginalized scientific practitioners. This research reminds us of the longstanding and shifting presence of Black women in science and medicine, despite the enduring popular belief that white men represent who participates in science, both historically and today. (shrink)

This reflective essay is an attempt to organize trends in feedback I have observed during ten years of coursework, conversations, and correspondence with former students associated with the Medical Humanities Program at Baylor University. Over the years, recurrent themes arise when speaking with alumni about whether and how their medical humanities experience intersects with their current training. I have identified five particular domains in which baccalaureate medical humanities training affects students’ subsequent healthcare professions training and practice: context and complementarity, clinical (...) relevance, reflective practice, professional preparedness and vocational calling. I created an instrument of open-ended questions for each of these categories and posted it to social media with an invitation for alumni to respond. This informal survey was conceived as an exploratory exercise with the intent to help generate a foundation for more formal qualitative research in these five domains. In this essay, I offer my own reflections together with those of former students on the impact of baccalaureate-level medical humanities training in order to illustrate the benefits in each domain for subsequent healthcare training and practice. The need for qualitative research that explores the impact of baccalaureate medical humanities merits collaboration between multiple centers of investigation across many disciplines, and across the divide between premedical and medical educators. (shrink)

This essay argues that service-learning pedagogy is an important tool in pre-health humanities education that provides benefits to the community and produces more compassionate, culturally competent, and community-responsive future healthcare professionals. Further, beginning this approach at the baccalaureate level instills democratic and collaborative values at an earlier, crucial time in the career socialization process. The discussion focuses on learning outcomes and reciprocity between the university and community in a Medical Humanities course for junior and senior premedical students, an (...) elective in the premedical curriculum. The course includes an experiential learning element in which students shadow physicians and a service-learning component in which students complete medically-relevant service work, working with partners such as the veteran’s hospital, a hospice home, and organizations that serve individuals with disabilities. We cover topics such as narrative medicine, ethics, cross-cultural medicine, patient/practitioner relationships, the human life cycle, and the illness experience, and the writing, discussion, and reflection we engage in is enriched by the real-world experiences from which the students are able to draw. The shadowing and service experiences and the classroom texts and topics combine to form a symbiosis that leads to especially meaningful teaching and learning outcomes. (shrink)

Much has been said about the formative process that occurs via the “hidden curriculum” of medical education during which many students experience a disconnect between the professional values espoused within the formal curriculum and the implicit values communicated through interactions with peers and mentors. Less attention, however, has been paid to the formation of the future medical self that takes place during students’ premedical years, a time in which many undergraduate students seek out immersive clinical experiences —such as (...) medical scribing— before applying to medical school. Despite the fact that medical scribes undoubtedly are affected by their clinical experiences, scribes are rarely offered opportunities to reflect on them. The authors contend that the developmental processes of medical scribes, especially those who intend on pursuing a career in the health professions, ought to be supported. This can be achieved, at least in part, through engaging in well-designed reflective sessions with other scribes. Encouraging students to reflect on their experiences can help them make sense of troubling events and give voice to the inconsistencies and value conflicts within medical practice that are so often ignored. The authors describe the development of their new Reflective Scribe program and offer suggestions for future directions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Teaching Ethics in the Health Care Setting Part I:Survey of the LiteratureMary Carrington Coutts (bio)The last twenty years have brought important changes to health care and health care education. Educators and students alike face an enormous number of new fields of study and new medical technologies. Health care professionals and institutions are also facing new challenges in the form of shrinking economic resources, and the AIDS epidemic. They (...) must also respond to increased patient participation in health care decisions, and public concern about abortion and euthanasia. These challenges to the health care professional have compelled educators to accommodate ethics within their already overcrowded curriculum. Those same dilemmas have influenced health care institutions to become active in health care ethics education.Medical ethics education gained a foothold in the United States during the late 1960s, when the medical schools of Pennsylvania State University, the University of Florida, and the State University of New York at Stonybrook established programs in the humanities (Pellegrino 1982). In 1978 Robert Veatch noted that formal teaching in medical ethics was rare; most institutions that taught medical ethics used "informal instruction in the apprenticeship mode" (Veatch 1978). However, by 1982 a survey by the American Medical Association (AMA) revealed that all but one of the 127 medical schools had courses that included medical ethics. Thirty eight of these had medical ethics as a required course (Pellegrino 1985). And by 1989, 43 of the 127 medical schools had separate courses in medical ethics, while 100 covered medical ethics within required courses. Medical ethics is now an accepted part of medical curriculum, though it is not fully mature, and its future remains somewhat unclear (Miles 1989).The evolution of ethics in the nursing curriculum has essentially mirrored that of the medical curriculum. A 1977 survey of baccalaureate nursing programs revealed that only 7 percent of nursing programs required courses in ethics [End Page 171] (Aroskar 1977). A decade later a second survey of undergraduate programs identified 85 percent of responding nursing schools as teaching nursing ethics either in separate ethics courses or within other required courses (Cassells and Redman 1989).Though the precise future of health care ethics may be unpredictable, there is little thought that the role of ethics will diminish in importance as the 21st century approaches. Ethics is seen as part of a larger plan to develop and enhance the health professional's human values, social conscience, and interpersonal skills. "This broader effort derives from concerns about the personal attributes and humanistic sensitivity of physicians, the recent overly 'scientized' trend in premedical education, the selection of medical students, and the socialization and cynicism engendered by medical education" (Miles 1989, p. 705).While nearly every medical and nursing school in the United States now teaches ethics in one form or another, the degree to which ethics is integrated into the curriculum varies from school to school. Some ethics courses are required elements of the students' education; some institutions require attendance at seminars and ethics grand rounds. Other schools offer an array of elective courses in topics that relate to ethics in medicine and nursing (including medical humanities, medicine and the law, literature and medicine, history of medicine, patient advocacy, and human values in nursing.) "Brown bag" seminars and journal clubs are also common.There is much debate over how health care ethics should be taught. Some argue that medical professionals should be conversant with theories of ethics and principles of biomedical ethics. Others think that a theoretical approach will alienate already over-worked medical or nursing students, and that instruction in ethical theory should be kept to a minimum. Case studies are frequently cited as a way to involve students in medical decision making, forcing them to analyze problems that they can relate to their own experiences.Additional concerns center around who should teach health care ethics. Frequently, physicians and nurses interested in ethics teach courses. Some commentators see this as the most desirable arrangement, asserting that practicing health care professionals best understand the conflicts faced by physicians and nurses-in-training. However, there is a growing pool of professionals who are undergoing training as medical ethicists. These individuals study ethical theory and bioethical... (shrink)

This book moves away from the frameworks that have traditionally guided ethical decision-making in the Western clinical setting, towards an inclusive, non-coercive and, reflective dialogic approach to moral decision-making. Inspired in part by Jürgen Habermas's discourse theory of morality and principles of communicative action, the book offers a proportionist approach as a way of balancing out the wisdom in traditional frameworks, set in the actual reality of the clinical situation at hand. Putting this approach into practice requires having a conversation, (...) a dialogue or a discourse, with collaboration amongst all the stakeholders. The aim of the dialogue is to reach consensus in the decision, via mutual understanding of the values held by the patient and others whom they see as significant. This book aims to underscore the moral philosophical foundations for having a meaningful conversation. Life and Death Decision in the Clinical Setting is especially relevant in our contemporary era, characterised medically by an ever-increasing armamentarium of life-sustaining technology, but also by increasing multiculturalism, a multiplicity of faiths, and increasing value pluralism. (shrink)

There are reasons to believe that decision‐making capacity (mental competence) of women in labor may be compromised in relation to giving informed consent to epidural analgesia. Not only severe labor pain, but also stress, anxiety, and premedication of analgesics such as opioids, may influence women’s decisional capacity. Decision‐making capacity is a complex construct involving cognitive and emotional components which cannot be reduced to ‘understanding’ alone. A systematic literature search identified a total of 20 empirical studies focused on women’s decision‐making about (...) epidural analgesia for labor pain. Our review of these studies suggests that empirical evidence to date is insufficient to determine whether women undergoing labor are capable of consenting to epidural analgesia. Given such uncertainties, sufficient information about pain management should be provided as part of prenatal education and the consent process must be carefully conducted to enhance women’s autonomy. To fill in the significant gap in clinical knowledge about laboring women’s decision‐making capacity, well‐designed prospective and retrospective studies may be required. (shrink)

The inclusion of structural competency training in pre-health undergraduate programs may offer significant benefits to future healthcare professionals. This paper presents the results of a comparative study of an interdisciplinary pre-health curriculum based in structural competency with a traditional premedical curriculum. The authors describe a new evaluation tool, the Structural Foundations of Health Survey ©, developed to evaluate structural skills and sensibilities. The authors use the survey to evaluate two groups of graduating seniors at Vanderbilt University—majors in an interdisciplinary (...) pre-health curriculum titled Medicine, Health, and Society, and premed science majors—with particular attention to understanding how political, cultural, economic, and social factors shape health. Results suggest that MHS majors identified and analyzed relationships between structural factors and health outcomes at higher rates and in deeper ways than did premed science majors. MHS students also demonstrated higher understanding of structural and cultural competency in their approaches to race, intersectionality, and racial health disparities. The skills that MHS students exhibited represent proficiencies increasingly emphasized by the MCAT, the AAMC, and other educational bodies that, in an era of epigenetics and social determinants, emphasize how contextual factors shape expressions of health and illness. (shrink)

One of the important determinants of development during the transition to adulthood is the undertaking of social roles characteristic of adults, also in the area of finishing formal education, which usually coincides with beginning fulltime employment. In the study discussed in this paper, it has been hypothesized that continuing full-time education above the age of 26, a phenomenon rarely observed in Poland, can be considered as an unpunctual event that may be connected with difficulties in the process of (...) identity formation. Relationships between identity dimensions and identity statuses, and age and educational context were analyzed. 693 individuals aged 19-35 took part in the study. The participants attended three types of educational institutions: full-time university studies, part-time university studies, and full-time post-secondary school. Among the students of full-time university studies predictable dependencies, also in respect of highlevels of indicators of identity crisis and a high frequency of diffused identity occurrence, were observed. Such dependencies were not found in the group of full-time post-secondary school students. (shrink)

Part of the educational system in England has been geared towards the preparation of particular professions, while the identity and status of members of some professions have depended significantly on the general education they have received. Originally published in 1973, this volume explores the interaction between education and the professions. It also looks at the education of the main professions in sixteenth century England and at how twentieth century university teaching is a key profession for the training (...) of new recruits to other professions. (shrink)

Originally published in 1971, this volume examines the relationship between the history and sociology of education. History does not stand in isolation, but has much to draw from and contribute to, other disciplines. The methods and concepts of sociology, in particular, are exerting increasing influence on historical studies, especially the history of education. Since education is considered to be part of the social system, historians and sociologists have come to survey similar fields; yet each discipline appears to (...) have its own aims and methodology. (shrink)

Higher education has been changing radically in recent years, with increasing numbers of students, and complaints about declining standards. This volume brings together leading intellectuals from the US and UK to examine the issues involved.

Place-based education is founded on the idea that the student’s local community is one of their primary learning resources. Place-based education’s underlying educational principle is that students need to first have an experiential understanding of the history, culture, and ecology of the environment in which they are situated before tackling broader national and global issues. Such attempts are a step in the right direction in dealing with controversial issues in a democracy by providing resources for synthesising curriculum though (...) theory (curriculum content, including traditional subjects) and practice (practical learning as experiential education). Nevertheless, many place-based accounts discount Indigenous conceptions of place, which are integral to Indigenous ways of knowing, being and doing, especially in relation to the ontological relationship to Land and Country. Indigenous philosophy has the potential to inform what place-based education means by students developing a ‘sense of place’ when engaging with local communities as their ‘own’ place. In this article we re-imagine the community of inquiry as a place-responsive pedagogy by learning from Indigenous philosophy, and recentring Indigenous notions of place in experiential learning. In addition to exploring the pedagogical potential of a place-responsive account of the community of inquiry, we look to the implications for teacher preparation. (shrink)

In this article Cristoph Wulf examines the basic concepts of pedagogy and educational science in the German-speaking world, looking at education and socialization from the perspective of educational anthropology. He makes evident that the complex German concept of Bildung, in particular, can only be fully understood by means of a historical and philosophical analysis.

There is a common tradition in European education going back to the Middle Ages which long played a part in providing the curriculum of schools which catered both for the wealthy and for able sons of less well-to-do families. Originally published in 1974, this volume examines the relationship between education and society in the different countries of Europe from which differences in tradition and practice emerge. The countries discussed include: France, Germany, the former Soviet Union, Poland and Sweden.

This article utilises Gadamerian hermeneutics method and Freirean theory of the purpose of Religious Education to explore how Religious Education can contribute to achieving United Nations Sustainable Development Goal (SDG) 4, emphasising education for sustainable development. The study contends that Religious Education in Lesotho occupies a distinctive position in the education system, surpassing other countries in its extensive integration. Due to historical factors, Religious Education is taught in nearly all religiously affiliated schools, comprising about (...) 90% of all educational institutions in Lesotho, and even in certain public schools. The curriculum of Religious Education in Lesotho aligns directly with the educational objectives of SDG 4. Additionally, Lesotho’s Religious Education corresponds to three levels of school education for sustainable development: whole school approach, classroom approach, and community approach. Nevertheless, the study asserts that for Religious Education in Lesotho to better align with education for sustainable development, various enhancements are required. Firstly, inclusivity across all religious traditions is essential, moving beyond a sole focus on Christianity. Secondly, there is a need for wider dissemination and implementation of Religious Education in all schools, irrespective of their affiliation. Lastly, a shift from traditional pedagogies to transformative approaches is recommended to boost the effectiveness of Religious Education in advancing sustainable development.Contribution: This article contributes by analysing Lesotho’s case and its implications for enhancing Religious Education teaching to effectively address SDGs. It broadens existing knowledge on Religious Education’s potential as a platform for sustainable development and provides recommendations for its improved implementation in a specific context. (shrink)

Neoliberalism is an approach to social policy, now globally influential, that applies market approaches to all aspects of social life, including education. Charter schools, privately operated but publicly funded, are its most prominent manifestation in the U.S. The neoliberal principles of competition, consumerism, and choice cannot serve as foundations of a sound and equitable public education system. Neoliberalism embraces socio-economic inequality overall and in doing so constricts any justice mission its adherents espouse in virtue of serving a relatively (...) disadvantaged student population, as charter schools often (by no means always) do. It constricts educational justice by (1) embracing a “human capital” approach as the primary good of education, (2) creating educational inequality through (unofficially) selecting a relatively advantaged segment of the disadvantaged demographic it serves, (3) denying the effect of poverty on educational performance, and (4) devaluing its students’ familial ethnic cultures. (shrink)

According to virtue epistemology, the main aim of education is the development of the cognitive character of students (Pritchard, 2014, 2016). Given the proliferation of technological tools such as ChatGPT and other LLMs for solving cognitive tasks, how should educational practices incorporate the use of such tools without undermining the cognitive character of students? Pritchard (2014, 2016) argues that it is possible to properly solve this ‘technology-education tension’ (TET) by combining the virtue epistemology framework with the theory of (...) extended cognition (EXT) (Clark and Chalmers, 1998). He argues that EXT enables us to consider tools as constitutive parts of the students’ cognitive system, thus preserving their cognitive character from technologically induced cognitive diminishment. The first aim of this paper is to show that this solution is not sufficient to solve the TET. Second, I aim to offer a complementary and more encompassing framework of tool-use to address the TET. Then, I apply it to the educational uses of ChatGPT as the most notable example of LLM, although my arguments can be extended to other generative AI systems. To do so, in Sect. 1.1, I present Pritchard’s framework of cognitive character and virtue epistemology applied in education, to which I am committed in this treatment. In Sects. 2 and 3, I respectively illustrate Pritchard’s (2014) solution to the TET, and I highlight the general limitations of his proposal. Thus, in Sect. 4.1 I characterize ChatGPT as a computational cognitive artifact using Fasoli’s (2017, 2018) taxonomy of cognitive artifacts. In Sect. 4.2, I introduce my proposal, which combines Pritchard’s account of virtue epistemology with Fasoli’s (2017, 2018) taxonomy of cognitive artifacts to address the TET. Finally, in Sect. 5.1, I present some epistemically virtuous uses of ChatGPT in educational contexts. To conclude, I argue in favor of a multidisciplinary approach for analyzing educational activities involving AI technologies such as ChatGPT. (shrink)

Originally published in 1972, this book is concerned with education as part of a larger social history. Chapters include: The roots of Anglican supremacy in English education The Board schools of London The use of ecclesiastical records for the history of education Topographical resources: private and secondary education from the sixteenth to the twentieth century.

Recently in this journal, Jessica Morley and colleagues (AI & SOC 2023 38:411–423) review AI ethics and education, suggesting that a cultural shift is necessary in order to prepare students for their responsibilities in developing technology infrastructure that should shape ways of life for many generations. Current AI ethics guidelines are abstract and difficult to implement as practical moral concerns proliferate. They call for improvements in ethics course design, focusing on real-world cases and perspective-taking tools to immerse students in (...) challenging situations with relatable personal, social and environmental implications. The present paper considers the ACTWith model of moral cognition for use in such training contexts. Morley and colleagues' paper and contemporary literature are reviewed. Whistleblowing as a source for relatable case studies is discussed, and the purpose of ethics education considered. The ACTWith model is introduced, and correlations with contemporaries noted. The ACTWith model has been successfully employed in a broad range of technology ethics courses in the Netherlands and South Korea. Illustrations are offered. Correlations with contemporary efforts are drawn in the context of software engineering. Summary discussion considers strengths and limitations of the ACTWith program. Overall, the paper emphasizes training high-level moral reasoning through guided inquiry education informing lifetime professional practice, and indicates an outstanding need for teachers able to do the job. (shrink)

Children must be taught morality. They must be taught to recognise the authority of moral standards and to understand what makes them authoritative. But there’s a problem: the content and justification of morality are matters of reasonable disagreement among reasonable people. This makes it hard to see how educators can secure children’s commitment to moral standards without indoctrinating them. -/- In A Theory of Moral Education, Michael Hand tackles this problem head on. He sets out to show that moral (...) education can and should be fully rational. It is true that many moral standards and justificatory theories are controversial, and educators have an obligation to teach these nondirectively, with the aim of enabling children to form their own considered views. But reasonable moral disagreement does not go all the way down: some basic moral standards are robustly justified, and these should be taught directively, with the aim of bringing children to recognise and understand their authority. -/- This is an original and important contribution to the philosophy of moral education, which lays a new theoretical foundation for the urgent practical task of teaching right from wrong. (shrink)