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Phronesis and the Medical Community

实践与医学界

基本信息

批准号：
AH/M006646/1
负责人：
Mervyn Conroy
金额：
$ 84.09万
依托单位：
University of Birmingham
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2015
资助国家：
英国
起止时间：
2015 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=AH%2FM006646%2F1
关键词：
Phronesis Medical Community

项目摘要

This study explores how doctors across their professional careers utilise moral resources to navigate the complex world of healthcare in an era of markets and user choice. The dual aims are first to understand the nature of phronesis (practical wisdom) transmission, interpretation and enactment by doctors through medical education and into practice and second to develop an arts based methodology to reliably frame phronesis in the institutions that participate in the study and that can be used in the study of phronesis in other professions (e.g. teachers and lawyers). To date little research has explored the ways in which phronesis is cultivated over a period of time within one professional community. There is an absence of research with medical professionals to explore how they have accumulated and enacted phronesis within their daily practice. Questions have rarely been asked as to how professionals are equipped morally (or otherwise) to navigate a chaotic world of practice rife with competing demands and relationships. To date, many researchers within medicine have made the case for a reorientation towards phronesis in medical education, but little has been undertaken to explore what that might look like.Existing studies have tended to capture practical wisdom within one snapshot, within one organisation or by following one practitioner. In this study three communities of doctors over three time periods will be studied: beginning of formal medical study; on placement at the end of formal study; and established medical professionals with 5 years plus qualified experience. This design will offer an opportunity to see how phronesis develops over time whilst enabling a varied discussion about how moral resources are accessed and what the role of formal education is in equipping practitioners for the messy realities of practice.By exploring how doctors at different points in their careers have access to or draw upon moral resources, we are interested to see how they make 'good' decisions for the patient at hand; balancing care, compassion, quality, resources, capacity, medical outcomes and the wider well-being of the community. The participants will be involved in creatively shaping an original 'soap opera' style series of video clips that will connect to an existing virtual community of health and social care practitioners, patients and the public. The purpose is to engage them in providing an artistic interpretation through which they see the issues of phronesis in their practice arena. The soap opera and the way it links to the community will be debated with a broad audience of academics, practitioners, patients and policy makers and others with an interest in the field. Through this process we expect to be informed and challenged e.g. about our approach, the teaching of ethics, public engagement and public trust. The video series will be available through the AHRC website and other mediums such as DVD and YouTube. A report, journal and conference papers will become a resource for Connected Communities researchers, medical education practitioners, wider academia and health and social care communities to utilise. The video series will offer an innovative, edgy complement to the many text based recommendations that have emanated from scandal enquiry reports and social science based studies to date. New understandings of the cultivation of phronesis in medical communities and its role in rebuilding public trust in the light of many scandals will be of interest to healthcare researchers, educators, practitioners and policymakers. Specific value to the AHRC Connected Community programme through the arts based methodology is expected. The project aims to deliver a return on the AHRC's investment by impacting on the medical and professional education of doctors as a community, building stronger links between the medical community and the public and rebuilding public confidence in the medical profession.

这项研究探讨了医生在其职业生涯中如何利用道德资源，在市场和用户选择的时代驾驭复杂的医疗保健世界。其双重目标是，首先了解医生通过医学教育传递、解释和实施实践智慧的本质，然后将其付诸实践；其次开发一种基于艺术的方法论，在参与研究的机构中可靠地构建实践智慧，并可用于其他职业（例如教师和律师）的实践智慧研究。迄今为止，很少有研究探讨在一个专业社区内一段时间内培养实践能力的方法。目前还没有针对医疗专业人员的研究来探索他们如何在日常实践中积累和实施实践。很少有人问专业人士如何在道德上（或其他方面）具备驾驭充满竞争需求和关系的混乱实践世界的能力。迄今为止，医学界的许多研究人员都提出了在医学教育中重新定位实践学的理由，但很少有人去探索它可能是什么样子。现有的研究倾向于在一个快照、一个组织内或通过跟随一位从业者来捕捉实践智慧。在这项研究中，将对三个时期的三个医生社区进行研究：正式医学研究的开始；正式学习结束时的安置；以及拥有5年以上合格经验的成熟医疗专业人员。这种设计将提供一个机会来了解实践如何随着时间的推移而发展，同时能够就如何获取道德资源以及正规教育在为从业者提供混乱的实践现实方面的作用进行各种讨论。通过探索处于职业生涯不同阶段的医生如何获取或利用道德资源，我们有兴趣了解他们如何为手头的患者做出“好的”决定；平衡护理、同情心、质量、资源、能力、医疗结果和更广泛的社区福祉。参与者将参与创造性地制作原创的“肥皂剧”风格的视频剪辑系列，这些视频剪辑将连接到现有的健康和社会护理从业者、患者和公众的虚拟社区。目的是让他们参与提供艺术解释，通过这种解释他们在实践舞台上看到实践问题。这部肥皂剧及其与社区的联系方式将与广大观众、学者、从业者、患者、政策制定者以及其他对该领域感兴趣的人进行辩论。通过这个过程，我们希望获得信息并受到挑战，例如关于我们的方法、道德教学、公众参与和公众信任。该视频系列将通过 AHRC 网站以及 DVD 和 YouTube 等其他媒体提供。报告、期刊和会议论文将成为互联社区研究人员、医学教育从业者、更广泛的学术界以及健康和社会护理社区使用的资源。该视频系列将为迄今为止丑闻调查报告和基于社会科学研究的许多基于文本的建议提供创新、前卫的补充。医疗保健研究人员、教育工作者、从业者和政策制定者将对医疗界培养实践能力及其在许多丑闻中重建公众信任方面的作用有新的认识。预计通过基于艺术的方法对 AHRC 互联社区计划具有特定价值。该项目旨在通过影响医生社区的医疗和专业教育、在医学界和公众之间建立更牢固的联系以及重建公众对医学专业的信心来实现 AHRC 的投资回报。