TPST: Assignment 2:
September 21, 2012
Question: Why and how is it important for medical experts to
be intellectually curious, intentional and mindful professionals?
Assumptions:
1.
Curiosity, intentionality, mindfulness and
professionalism are important or essential to practice medicine.
2.
All of these traits can be taught and learned at
a medical school.
3.
All of these traits are compatible with each
other
Before I move on to discover some deep thoughts on this
question I would like to consider what the definitions of these terms are and
how they are related to one other.
Intellectual curiosity:
is there any other form of curiosity?
1Thane
Stenne, journalist for Global mail, articulated a common thread that runs in
successful investors as follows “However, what is a common trait in virtually all of them is that they
are “intellectually curious.” They love to learn. They look for insights,
always a better way of doing things… an “edge.”
In medical education, it is getting more and more evident that to set the students up for success in their individual medical careers, it is for paramount importance to be intellectually curious. The entire process of diagnosis and prognosis is based on asking the right questions and getting all the information possible from the patient. If a physician neglects to ask about a particular detail, that very detail maybe the cause a misdiagnosis2. Where and how do we instill this sense of curiosity in the student or do they come into medical school because this is one of their strengths. The reason I say this is because increasingly medical school are looking for not just the grades and tests scores during the admission process but also for a few key characteristics in the individual. This shift from mere intellectual abilities to a blend of characteristic needed to function effectively as a physician impregnated the field of medical education as early as 20053.
Can we take for granted that intellectual curiosity can recognise the boundaries when intellectual curiosity clashes with ethical issues4?
Intentional learners are not only inquiry based but also self-motivated and responsible for their own learning5. Medical students are flooded with information at a very rapid rate daily in a regular school day. What learning and the depth of learning the individual students get out of it each day is entirely up to them.
Mindfulness seems to me like an art form of medicine or any profession. We need to get the message across in a respectful and sensitive manner. Doctors very often have to have the heart to empathise with the patient and the head to make the right decisions for their patients’ wellbeing6. Are we able to elicit these similar situations during their education? Do we train them to be mindful?
Professionalism: Direct quote: The Canadian Stakeholders Coalition on Medical Professionalism states: "Medical professionalism describes the skills, attitudes and behaviours common to those undertaking the practice of medicine. It includes concepts such as the maintenance of competence for a unique body of knowledge and skill set, personal integrity, altruism, adherence to ethical codes of conduct, accountability, a dedication to self-regulation, and the exercise of discretionary judgment. Professionalism is also the moral understanding among medical practitioners that gives reality to the social contract between medicine and society. This contract in return grants the medical profession a monopoly over the use of its knowledge base, the right to considerable autonomy in practice and the privilege of self-regulation."
Assumption 1 and 3: Curiosity, intentionality, mindfulness and professionalism are important or essential to practice medicine. Are these compatible?
All of these traits are
indeed compatible as one feeds into the other. Intellectual curiosity in
students makes the experience of learning more student-centered. The students
who are motivated to research and take responsibility of their learning are
very often intentional learning. Mindfulness
is the art of medicine while Professionalism is the act of medicine. The two
are part of developing both the intellectual quotient and the emotional quotient
within the individual.
Assumption 2: All of these features can be taught and learned at a medical school.
Medical school in North America are explicitly and
inexplicitly incorporating these aspects of training as part of medical
education. These are often competencies that are common themes running through
the years of medical education.
As a medical educator, I can connect with all of these
traits. The anatomy laboratory sessions are great teaching opportunities to
foster these traits. As students come in to deal with cadaveric tissue, the emphasis
on respect and professionalism are explicitly cited and practiced. The students
learn to work as a team together with mindfulness and intentional learning.
2.
Dyche L, Epstein RM;
Curiosity and medical education Med Educ. 2011
Jul;45(7):663-8. doi: 10.1111/j.1365-2923.2011.03944. http://www.ncbi.nlm.nih.gov/pubmed/21649698
3.
REPORT OF THE COUNCIL ON MEDICAL EDUCATION;
2010. http://www.ama-assn.org/resources/doc/council-on-med-ed/cmereport3a11.pdf
4.
http://goodgeneration.org/2012/02/04/in-search-of-meaning-why-intellectual-curiosity-is-not-enough/
8.
Linda Blank; Medical
Professionalism in the New Millennium: A Physician Charter; Ann Intern Med. 5 February 2002;136(3):243-246.
http://annals.org/article.aspx?volume=136&issue=3&page=243
Wow, Anna, You've really explored this in depth as your beginning blog! Hard worker!
ReplyDeleteI have to agree with your statement that intellectual curiosity is a necessity for physicians. If there is no curiosity, then what motivates the student to discover the cause of any given ailment? 10 or 20 years down the road, a graduate physician without curiosity is substandard at best and likely dangerous. He or she is not likely to keep up with medical or reasearch advances and fall behind on awareness of technology, reasearch, or use of best practice guidelines.
A second point that caught my attention was your comment re: the student centred approach to learning and taking ownership. To quote "Intellectual curiosity in students makes the experience of learning more student-centered." I agree with the idea at a base level, yet wish to expand on it. This is a desireable individual focus but not at the expense of the teachers' learning focus, as students still need to learn that which they might not find as stimulating. The teacher must therefore remain focused on the need for the students to learn content, the process of learning and critical thinking.
I believe that the student should be encouraged at their base level of intellectual curiosity, which is likely student focused (as we are all self focused at our core level of existence). It is then contingent upon the teacher to increase stimulation of interest in the student to expand that curiosity within a learning focused approach. The assumption here is that the students do have some level of curiosity beyond self gratification. That higher level stimulation is key to the choices for our triangulated learning outcomes, assessment assignments and marking rubrics.
Exciting question, Anna! Looking forward to further blogs!
Very interesting post, Anna. I'm left curious about a few things:
ReplyDeletea) How are you defining intellectual curiosity? The section of your post that purports to answer this poses a question -- "is there any other kind?" -- that isn't answered, which makes me believe it's meant to be rhetorical. Are you saying, then, that intellectual curiosity is just curiosity? The quote you provide from Stenne isn't discussed, so that seems to reinforce the conclusion that you define intellectual curiosity as just curiosity (as Stenne seems to be doing). Although you don't define curiosity, the Stenne quote mentions several characteristics of curiosity that, I take it, you agree with.
2) Is learning really ENTIRELY the responsibility of students? If so, it seems that we teachers are irrelevant. If not, what are our responsibilities, and how do we balance our responsibilities with theirs?
3) The long quotation about professionalism made me believe you accepted that conception of professionalism without question. Why do you accept it?
4) I think you've managed to indicate why you think the traits of curiosity, mindfulness, professionalism and intentional practice are compatible, and why they're important. However, it doesn't follow from what you've said here that they are ESSENTIAL, for if they were essential we'd have to accept that one could not practice medicine without them -- that all people who have ever practiced medicine exhibit those traits. If there exists even one person who manages to practice medicine while lacking even one of those traits, that will show that the traits aren't actually essential. And I can think of at least a few physicians in my life who didn't display all of these traits!
5) As you say, medical schools are (and have been) trying to incorporate these traits into their curricula and pedagogy -- but that doesn't necessarily mean they can be taught well. If we accept that teaching is connected to learning, and thus that something "can be taught" only if such teaching can result in learning, the situation changes. We can TRY to teach things that can't actually be taught, so we can't assume just from the fact that people are trying to teach something that it can be taught. That means the second assumption is still open for you, I think. We need to turn it around: Can these traits be learned as part of a university curriculum?
The approach you've taken to mindfulness is interesting, as it's focused on the affective dimension of the professional relationship. It's a mindfulness of others' inner lives, their emotions, how they are affected by things. Now: are you interested in whether this is taught? Whether it should be taught? How it could be learned? There are several avenues you could explore here.
You explain why you believe curiosity is important -- because it's connected to competence. Your claim is that curious students will ask better questions, thus get better information, thus provide better care. I'm not sure that follows, for two reasons:
1)It seems evident that curious students would ask MORE questions, but why assume that the questions they ask would be better? It seems to me that something more than curiosity is required here.
2) Let's say curious students asked more (or better) questions and received more information. That, in itself, wouldn't lead to better care for their patients unless that information was put to use effectively. But what reason do we have to believe that students who have more information are likely to use it, or to use it well? We can draw from our everyday experiences for examples of people who have lots of information that they don't use.
I'm curious about this question that you ask, and wonder what you mean by it: "Can we take for granted that intellectual curiosity can recognise the boundaries when intellectual curiosity clashes with ethical issues?" Perhaps this is something you could explore in a later post!
Hi Anna,
ReplyDeleteI was also struck by your explanation of mindfulness because of the duel focus on self-awareness and other-awareness. I'm interested to know more about the ways in which mindfulness is incorporated into medical education.
I've heard you mention your work with cadavers before and I appreciate how this teaches students respect. But how does this teach mindfulness based on the way you've presented this concept?
Moreover, in what other ways, particularly explicit ways, are medical students taught mindfulness? Are components of mindfulness, such as empathy and compassion, inherent traits?
Thanks for an interesting Monday morning read. I'll look forward to reading more!
Thank you again for the sparks of stimulating thoughts. Before I make an attempt to address the comments; I have to mention two points. First, I have not yet added how I fit into the question as a teacher and how it connects with my teaching approach....still researching it. Second, I did not try to imply that ONLY the students are responsible for the learning experience. I will draw of the connections as I create my web of teaching philosophies.
ReplyDeleteThank you Brenda for pointing out that as medical practitioners keeping up with medical research, policies and technologies is vital. I agree, the teacher as a sheepdog if I may continue the metaphor is directing and tracking the learning.
Micheal, curiosity can be defined as inquisitiveness, curiosity could be as simple as wondering why the neighbors law looks better that mine. Intellectual curiosity is asking, researching and finding out how to keep the lawn well nourished and that in turn would be demonstrated in a healthy lawn.
Run out of time...will address the rest in next blog.
All right, for the second time I lose my comment on your post!!!
ReplyDeleteI was basically saying that I liked how you formulated your question and the different assumptions. Can appreciate why you picked up these qualities, given your profession. I agree that they go hand-in-hand.
One point though, these traits are basically those of a scholar in general, right. I can see why you would need a physician to be inquisitive and questioning, thorough and mindful, a self-learner and professional. That would typically be the ideal practitioner; however, would everyone be? Is it practical? Or, if we are to aim in principle that high to promote the standards of profession.
Some thoughts- hoping it would help with your research and further refinement for coming week! Good luck,
ahmed