Cultural Learning in Medicine

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Doering, Michele
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Mount Saint Vincent University
Many papers have indicated that the medical school experience has a negative impact on the attitudes of medical students (Becker, 1958; Knight, 1981; Muller, 1984; Retzel, 1974; Rosenburg & Silver, 1984; Weinstein, 1983; Wolf, 1989). The social structure of medicine and the culture of medicine each make a significant contribution to the development of students as they develop their identities as physicians. This thesis attempts to enrich current formulations of the forces that influence the development of the medical student by utilizing literature and research from education, anthropology and psychology. Individuals grow and develop by participating in a culture and simultaneously the culture evolves because of the participation of individuals. The medical culture exerts a powerful influence on the student to develop along acceptable trajectories within the medical culture. A major task for medical students is to develop their identities as physicians. As they follow their trajectory through medicine, they must reconcile past experiences with present ones as they create identities for themselves. The medical school class forms a community of practice where significant learning occurs. Taken together, the different communities of practice of medicine form a constellation of communities, which constitute the culture of medicine. Medical students occupy a unique position not only within their medical class community of practice, but also within the communities they visit and within the overall culture of medicine. Understanding these social relationships may help us understand better the forces that direct the development of students. Changes to the medical culture can occur and this may be facilitated by changes in medical education. Hopefully this thesis can stimulate further discussions about the struggles that students face when exposed to the culture of medicine and the potential curriculum changes that could better support student development.
medical students , medical school , communities of practice , Culture