Biomedical subjects
R J Macnaughton
Publications and source records attributed to R J Macnaughton.
Evidence and clinical judgement.
Widespread acceptance of the neologism 'evidence-based medicine' (EBM) has had the consequences of obscuring what evidence really is, and of eroding the importance of judgement in clinical situations. In this essay I seek to correct this lack of balance in the view of clinical encounters as portrayed by EBM. A better understanding of what evidence is can be obtained by looking beyond medicine to the way in which scientists and detectives view evidence. In both spheres, the importance of judgement is emphasized, even if it is a technical type of judgement. Clinicians also employ a technical kind of judgement, similar to that in science and detective work, when assessing the evidence relating to the truth of a diagnosis for an individual patient; but judgements relating to the ongoing care and treatment of that patient are based on what Aristotle calls phronesis or 'practical wisdom'.
Special study modules: an opportunity not to be missed.
The General Medical Council's (GMC's) Tomorrow's Doctors has proposed a radical rethink of undergraduate medical education. The two main planks of the proposals are the core curriculum and special study modules (SSMs) or options. Medical schools around the country have been much exercised in creating their core curricula but there has been less time given to a consideration of the SSMs. This paper looks at the GMC's proposals for SSMs and emphasizes their importance in introducing innovation and originality. Three different categories of SSM are described and a justification made for including each in the curriculum. The focus is on what non-medical subjects might contribute to medical education.
Humanizing medicine: a special study module.
As medical schools begin to implement their new curricula under the guidance of Tomorrow's Doctors, the authors wish to raise some discussion on the form and content of the special study module (SSM) component. In order to do this they put forward in this paper proposals for an SSM in Medicine and Literature. This course has been designed jointly and will be run concurrently in three Scottish medical schools: Glasgow, Aberdeen and Dundee. Arguments for the course's acceptability to faculties of medicine and to students are discussed and its inclusion in the curriculum in terms of its educational impact, skills training, effect on personal development and broadening of the student's perspective are justified. The course structure, content and assessment procedures are described and a reading list proposed. The General Medical Council points out that SSMs should be seen as opportunities for innovation and this course demands a different educational approach from the standard objectives-led approach of most medical education. A process-led model is more appropriate as it stresses the way that students develop while taking the course rather than the end point reached at its finish.
Numbers, scales, and qualitative research.
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