Academic medicine : journal of the Association of American Medical Colleges
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The ethics of caring, though the subject of much recent discussion by philosophers, has hardly been applied to medical ethics and medical education. Based on receptivity (that is, empathy and compassion) toward and taking responsibility for other persons, the ethics of caring has particular relevance to medicine. Caring guides the physician always to remain the patient's advocate and to maintain the therapeutic relationship when dealing with and resolving ethical dilemmas. This article discusses the philosophy behind the ethics of caring and then explores three issues that arise within its context: receptivity, taking responsibility, and creating an educational environment that fosters caring.
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Though few question the importance of incorporating professionalism and humanism in the training of physicians, traditional residency programs have given little direct attention to the processes by which professional and humanistic values, attitudes, and behaviors are cultivated. The authors discuss the underlying philosophy of their primary care internal medicine residency program, in which the development of professionalism and humanism is an explicit educational goal. They also describe the specific components of the program designed to create a learner-centered environment that supports the acquisition of professional values; these components include a communication-skills training program, challenging-case conferences, home visits with patients, a resident support group, and a mentoring program. The successful ten-year history of the program shows how a residency program can enable its trainees to develop not only the requisite excellent diagnostic and technical tools and skills but also the humane and professional attributes of the fully competent physician.
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Literature and medicine is a flourishing subdiscipline of literary studies that examines the many relations between literary acts and texts and medical acts and texts. The author examines the historical connections between these two fields and suggests that the growth and decline in medicine's attentiveness to the power of words can be used as a marker for medicine's degree of attentiveness to the individual patient's predicament. The recent explosive growth in medicine's interest in literature and narrative is taken as evidence that medicine's swing toward the reductionist and away from the narrative has ended. Patients and doctors have reason to await the return swing of the pendulum-if not the turn of the spiral-toward a medicine that is both technologically and narratively competent.
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Medical schools are increasingly cognizant of their inability to critically evaluate faculty who support the core mission of education. To address this need, the Project on Scholarship was initiated by the Group on Educational Affairs (GEA) of the Association of American Medical Colleges. ⋯ Two major conclusions/recommendations emerged from these discussions: (1) the use of commonly accepted scholarship criteria (clear goals, appropriate methods, significant results, effective communication) provides a framework for identifying the types of evidence needed to document teaching scholarship, and (2) medical schools must create an infrastructure for promoting educational scholarship. This infrastructure must support the reliable and valid collection of evidence of educational scholarship and the continuous development of faculty as teaching scholars.