Bleakley Alan, Brice Julie, Bligh John
Institute of Clinical Education, Peninsula Medical School, Peninsula College of Medicine and Dentistry, Plymouth, Devon, UK.
Med Educ. 2008 Mar;42(3):266-70. doi: 10.1111/j.1365-2923.2007.02991.x.
Western medicine and medical techniques are being exported to all corners of the world at an increasing rate. In a parallel wave of globalisation, Western medical education is also making inroads into medical schools, hospitals and clinics across the world. Despite this rapidly expanding field of activity, there is no body of literature discussing the relationship between post-colonial theory and medical education.
Although the potential benefits of international partnerships and collaborations in education are incontrovertible, many medical educators are sometimes too unreflecting about what they are doing when they advocate the export of Western curricula, educational approaches and teaching technologies. The Western medical curriculum is steeped in a particular set of cultural attitudes that are rarely questioned. We argue that, from a critical theoretical perspective, the unconsidered enterprise of globalising the medical curriculum risks coming to represent a 'new wave' of imperialism. Using examples from Japan, India and Southeast Asia, we show how medical schools in non-Western countries struggle with the ingrained cultural assumptions of some curricular innovations such as the objective structured clinical examination, problem-based learning and the teaching of clinical skills.
We need to develop greater understanding of the relationship between post-colonial studies and medical education if we are to prevent a new wave of imperialism through the unreflecting dissemination of conceptual frameworks and practices which assume that 'metropolitan West is best'.
西医及医疗技术正以越来越快的速度向世界各个角落输出。在全球化的并行浪潮中,西方医学教育也正在进入世界各地的医学院、医院和诊所。尽管这一活动领域迅速扩大,但尚无文献探讨后殖民理论与医学教育之间的关系。
尽管国际教育伙伴关系与合作的潜在益处无可争议,但许多医学教育工作者在倡导输出西方课程、教育方法和教学技术时,有时对自己的所作所为缺乏反思。西方医学课程深深植根于一套特定的文化态度之中,而这些态度很少受到质疑。我们认为,从批判性理论的角度来看,在未经深思熟虑的情况下将医学课程全球化的做法,有可能成为帝国主义的“新浪潮”。我们以日本、印度和东南亚为例,展示了非西方国家的医学院如何应对某些课程创新(如客观结构化临床考试、基于问题的学习和临床技能教学)中根深蒂固的文化假设。
如果我们要防止通过不假思索地传播“西方大都市最好”的概念框架和做法而引发新一轮帝国主义浪潮,就需要加深对后殖民研究与医学教育之间关系的理解。