Foucault's "fearless speech" and the transformation and mentoring of medical students

In his six 1983 lectures published under the title, Fearless Speech (2001), Michel Foucault developed the theme of free speech and its relation to frankness, truth-telling, criticism, and duty. Derived from the ancient Greek word parrhesia, Foucault's analysis of free speech is relevant to the mentoring of medical students. This is especially true given the educational and social need to transform future physicians into able citizens who practice a fearless freedom of expression on behalf of their patients, the public, the medical profession, and themselves in the public and political arena. In this paper, we argue that Foucault's understanding of free speech, or parrhesia, should be read as an ethical response to the American Medical Association's recent educational effort, Initiative to Transform Medical Education (ITME): Recommendations for change in the system of medical education (2007). In this document, the American Medical Association identifies gaps in medical education, emphasizing the need to enhance health system safety and quality, to improve education in training institutions, and to address the inadequacy of physician preparedness in new content areas. These gaps, and their relationship to the ITME goal of promoting excellence in patient care by implementing reform in the US system of medical education, call for a serious consideration and use of Foucault's parrhesia in the way that medical students are trained and mentored.

Foucault's "fearless speech" and the transformation and mentoring of medical students

In his six 1983 lectures published under the title, Fearless Speech (2001), Michel Foucault developed the theme of free speech and its relation to frankness, truth-telling, criticism, and duty. Derived from the ancient Greek word parrhesia, Foucault's analysis of free speech is relevant to the mentoring of medical students. This is especially true given the educational and social need to transform future physicians into able citizens who practice a fearless freedom of expression on behalf of their patients, the public, the medical profession, and themselves in the public and political arena. In this paper, we argue that Foucault's understanding of free speech, or parrhesia, should be read as an ethical response to the American Medical Association's recent educational effort, Initiative to Transform Medical Education (ITME): Recommendations for change in the system of medical education (2007). In this document, the American Medical Association identifies gaps in medical education, emphasizing the need to enhance health system safety and quality, to improve education in training institutions, and to address the inadequacy of physician preparedness in new content areas. These gaps, and their relationship to the ITME goal of promoting excellence in patient care by implementing reform in the US system of medical education, call for a serious consideration and use of Foucault's parrhesia in the way that medical students are trained and mentored.

A Test of the Revised Minkov-Hofstede Model of Culture: Mirror Images of Subjective and Objective Culture across Nations and the 50 US States

Various models of subjective culture (measures of self-reports) have been proposed since Hofstede’s original work but none of them have been validated by showing that they have analogs in objective culture (measures of societal practices). Inspired by Bardi and Schwartz’s discovery that Schwartz’s individual-level circumplex values model has an exact equivalent in a model of behaviors, we develop a test for the purpose of validating models of culture. We apply this test to Minkov’s revised two-dimensional variant of Hofstede’s subjective-culture model, consisting of individualism-collectivism (IDV-COLL) and flexibility-monumentalism (FLX-MON) (formerly “long-term orientation”), as Fog recently found that an analog to this model incorporates and summarizes all major validated models and dimensions of national culture. We analyze national measures of important social practices associated empirically and theoretically with IDV-COLL and FLX-MON: transparency-corruption, gender equality, political freedom, road death tolls, homicide rates, family structures, innovation rates, and educational effort and achievement. These yielded close analogs to IDV-COLL and FLX-MON, with similar factor structures across nations and across the 50 US states, explicable in terms of IDV-COLL, FLX-MON, and life-history strategy (LHS) theories. Thus, subjective culture structures have mirror images in objective culture structures. This provides validation for our test, for the Minkov-Hofstede two-dimensional model of culture, for the use of nations and some sub-national political entities as units of cultural analysis, as well as for IDV-COLL, FLX-MON, and LHS theories.

Qualitative Advancement in Inclusive Education in the Context of Societal Development: Dialectical Modelling

By applying a qualitative method of dialectical modelling, the following three models of inclusion are analysed: integration, inclusive special education, and universal design for learning. The prerequisites significant for the implementation of each model are tested by contradicting them against other models, in order to reveal education components and their connections that either strengthen or impede the qualitative evolution of inclusive believes and practice.The results of integrated education analysis underline the impulse of societal movement that encouraged the development of processes of inclusion and the restructuring of educational system; however, at the same time, they reveal the possibility of tension due to the desynchronization between various components of social and educational system. The reduction of tension and the sustainability of inclusive evolution requires the harmonisation of social believes and cultural experience.The analysis of the “Inclusive special education” model shows that any polarized attitude and educational effort towards different groups of pupils generates barriers for ensuring successful learning for all the pupils and shapes elements of educational segregation. In overcoming this barrier, the change in educators’ attitude and practice is significant, embracing the entirety of the learners and giving priority to professional co-operation.The connections between the components of universal design for learning model allow to cover the whole of the variety of learners and to aim at personal success for every pupil. A universal educational environment that corresponds with the variety of educational needs is the core precondition for a good quality inclusive education.

Teen Dating Violence Prevention Based on an Education for Intercultural and Critical Citizenship

Teen dating violence (TDV) is one of the problems that, both for its severity as for its prevalence, requires a greater educational effort aimed at its primary prevention on all the young people that make up our societies. However, both social studies and preventive strategies and public policies maintain a monocultural and homogenizing relational approach, which makes invisible the relationships that exist between non-European and non-heterosexual people. This chapter proposes an approach to dating violence based on a critical and intercultural citizenship education, which addresses existing biases. This approach aims, on the one hand, to understand relational diversity in democratic societies and, in turn, orient its action around three axes: socio-emotional education, education in values, and virtual education.

Eutanazja – zbrodnia czy cywilne prawo człowieka do wyboru śmierci?

Euthanasia – a crime or a human right to choose death? The contemporary phenomenon of euthanasia is very extensive and very complex. It is a manifestation of the „culture of death”, as evidenced by common practices in many countries and attempts to legalize it. In Poland, although euthanasia is forbidden and punished, a significant part of the society approves of its introduction. At the same time, the common awareness that it is a crime and a crime is fading away (EV 66). The most important motive of euthanasia, meaningless suffering, can only be understood, accepted and defeated in the light of faith. Moreover, the request to shorten the life is not always motivated by unbearable suffering. It often comes from feelings of loneliness, lack of interest and compassion, and proper care. So, asking for euthanasia is a desperate cry for help and love. Rather than cut corners, it would be better to increase the involvement of family, friends and physicians in palliative care, which could remove the causes of such a radical decision as asking to die. Public acceptance of euthanasia can seriously reduce the costs of palliative care, both financially and scientifically. The recipe for this phenomenon is rather the educational effort of society, which should accept the phenomenon of disease, aging and death, so that in families and society there should be a dignified place reserved for sick, disabled, old and dying people. Współczesne zjawisko eutanazji jest bardzo rozległe i złożone. Jest przejawem „kultury śmierci”, o czym świadczą powszechne praktyki w wielu krajach i próby jej legalizacji. W Polsce, choć eutanazja jest zakazana i karana, znaczna część społeczeństwa aprobuje jej wprowadzenie. Jednocześnie zanika powszechna świadomość, że jest to przestępstwo i zbrodnia (por. EV 66). Najważniejszy motyw eutanazji – bezsensowne cierpienie – można zrozumieć, zaakceptować i pokonać tylko w świetle wiary. Co więcej, prośba o skrócenie życia nie zawsze jest motywowana cierpieniem nie do zniesienia. Często wynika to z poczucia samotności, braku zainteresowania i współczucia oraz właściwej opieki. Proszenie o eutanazję jest więc rozpaczliwym wołaniem o pomoc i miłość. Zamiast iść na skróty, lepiej byłoby zwiększyć zaangażowanie rodziny, przyjaciół i lekarzy w opiekę paliatywną, co mogłoby usunąć przyczyny tak radykalnej decyzji, jak żądanie śmierci. Społeczna akceptacja eutanazji może poważnie obniżyć koszty opieki paliatywnej, zarówno finansowo, jak i naukowo. Receptą na to zjawisko jest raczej edukacyjny wysiłek społeczeństwa, które powinno zaakceptować zjawisko choroby, starzenia się i śmierci, aby w rodzinach i społeczeństwie było godne miejsce zarezerwowane dla osób chorych, niepełnosprawnych, starych i umierających.

Between Nordism and Nationalism: The Methods of the Norden Associations’ Educational Efforts, 1919–1965

The Norden Associations (föreningarna Norden) were established in 1919 with the intention of promoting understanding and cooperation between the Nordic countries. The definition of “Norden” was negotiated from the very beginning, and Icelandic and Finnish associations were not established until the 1920s. Promoting understanding and cooperation was very much considered an educational effort, and Norden was imagined within educational efforts sponsored by the associations. In this regard, the associations had predecessors in the Nordic schoolteacher meetings that dated back to the age of Scandinavism in the middle of the nineteenth century. The Norden Associations created special school boards in the 1920s in order to both promote a more Nordic approach in some subjects—mainly language, geography, and history—and to promote cooperation between the countries, with the youth as the catalyst for a more Nordistic future. This article looks into how the Norden Associations imagined a Nordic school, in which a Nordic sentiment was established, and how this imagination related to the reality of the nationalistic school and to ideas of broader international cooperation, between which the “Nordic idea” has always been sandwiched. The article shows how the methods used effectively hindered the imagination of Norden and the “Nordic idea” beyond the scope of cooperation between nations.

ROLES OF MONITORING AND EVALUATION, TEACHING PARTICIPATION, AND GOVERNMENT ON TEACHING PRODUCTIVITY RESULT AND INSTITUTIONAL DEVELOPMENT PLANNING

Lecturers as university educators have been main player and determinant of successful educational effort. Their roles are getting challenged when their role and productivity are highlighted. They face challenges which come from three sources, e.g., university standards; (2) education measurement; (3) issue of balancing government standards with institutional plan. However, there is a gap that lecturer’s efforts are rarely observed especially in college and universities. The purpose of this study is to determine whether programs that have been run by college have achieved the expected goals. This type of research is field research to observe college preparation and evaluation to measure their lecturers role in teaching and classroom interaction. Our study found that M E and lecturers active role can impact on the teaching productivity. We also found that lecturers understanding about government policy can improve college ability to develop their institutional plan. This study bring benefits for management auditors, institutional planner and educators to develop and improve their institutional plans.Keywords: monev, the active role of the lecturers, the lecturers 's interactive role in the class discussion, the productivity of the lecturers

SWK-08. DELAYED DIAGNOSIS OF CENTRAL NERVOUS SYSTEM (CNS) TUMORS IN CHILDREN: PERSPECTIVE FROM THE FRONTLINE

Delayed diagnosis of CNS tumors in children is well documented, partially due to challenges in recognizing rare diagnoses. Our objective was to describe Canadian family physicians’ attitudes and confidence in diagnosing and managing pediatric CNS tumors. A standardized questionnaire was administered at a Canadian national family physicians’ conference. Items were based on observations from our institutional study of prediagnostic symptomatic interval in pediatric CNS tumors. 449 surveys were completed. 302/443 (68%) physicians practice in cities. 153/447 (34%) report encountering parents that inquire about their children having brain tumors. 261/449 (58%) have not managed a pediatric brain tumor. 153/447 (34%) report they are not confident, 255/447 (57%) somewhat confident and 39/447 (9%) confident in managing a suspected brain tumor in a stable child. 259/447 (58%) would refer directly to a hospital/specialist. The reported median time for suspicion of a brain tumor was 8–14 days for children with vomiting and/or headache and 1 day for children with seizure and/or ataxia. 410/447 (97%) report not knowing any guidelines to help with management. 235/447 (53%) suggested barriers they experience to include 52/235 (22%) wait times for imaging/specialists, 37/235 (16%) geographical location of the child, 27/235 (12%) knowledge, 25/235 (11%) access to imaging/specialist, and 15/235 (6%) patient-related factors or system barriers, and 8/235 (3%) specialist attitudes. 68/235 (29%) identified no barriers in their practice. This study provides insight into family physicians’ perceived challenges and barriers in diagnosing and managing new suspected pediatric CNS tumors. Educational effort and overcoming systemic perceived barriers may increase physicians’ confidence.