Westin S
Institutt for samfunnsmedisinske fag, Norges teknisk-naturvitenskapelige universitet, Medisinsk teknisk forskningssenter, 7489 Trondheim.
Tidsskr Nor Laegeforen. 2000 Dec 10;120(30):3765-9.
Inspired by the concept of "two cultures", coined by C.P. Snow, this paper discusses the role of the humanities in relation to the natural sciences in a recently (since 1993) revised medical curriculum at the Faculty of Medicine in Trondheim, Norway. A concept of a "third culture" is identified as well: community medicine in a broad sense, disciplines dealing with health, illness and disease in the context of society and the environment. The implementation of the new curriculum was affected by intended and unintended social forces. The result was a hybrid model rather than the planned "pure" problem-based model. The humanities and "third culture" disciplines tended to yield to the pressure from the basic sciences when numbers of formal lectures were strictly limited, while the basic sciences themselves felt cut short by clinical disciplines. Problem-based learning in groups did seem efficient in basic sciences and clinical subjects, but not for the humanities or third culture disciplines. This apparent limitation in the problem-based approach was probably due to contextual factors, rather than inherent in the method itself.
受C.P. 斯诺提出的“两种文化”概念启发，本文探讨了在挪威特隆赫姆医学院最近（自1993年起）修订的医学课程中，人文学科相对于自然科学所起的作用。同时还确定了一种“第三种文化”的概念：广义的社区医学，即在社会和环境背景下处理健康、疾病和病患的学科。新课程的实施受到了有意和无意的社会力量的影响。结果是形成了一种混合模式，而非计划中的“纯粹”基于问题的模式。当正式讲座数量受到严格限制时，人文学科和“第三种文化”学科往往屈从于基础科学的压力，而基础科学自身也感到受到临床学科的限制。小组式的基于问题的学习在基础科学和临床学科中似乎很有效，但对人文学科或“第三种文化”学科却并非如此。基于问题的方法中这种明显的局限性可能是由背景因素造成的，而非该方法本身所固有。
