Brosnan Caragh
School of Humanities & Social Science, Faculty of Education and Arts, University of Newcastle, Callaghan, NSW, Australia; Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
Health Sociol Rev. 2016 May 3;25(2):171-186. doi: 10.1080/14461242.2016.1171161. Epub 2016 Apr 18.
There is increasing pressure on complementary and alternative medicine (CAM) to follow the evidence-based approach promoted in allied health and medicine, in which the randomised control trial represents the evidence gold standard. However, many CAM advocates see these methods as undermining the holism of CAM practice. This paper explores how such tensions are managed in CAM university departments - settings in which particular forms of knowledge and evidence are given 'official' imprimatur by CAM educators and researchers. By comparing two types of CAM, the paper also unpacks differences within this broad category, asking whether CAM academic disciplines comprise different 'epistemic cultures' (Knorr-Cetina, K. (1999). . Cambridge, MA: Harvard University Press). Interviews were conducted with 20 lecturers in Chinese medicine and osteopathy, across five Australian universities, and augmented with observation in two degree programs. Findings reveal contrasting ontological and epistemological perspectives between the two academic fields. Chinese medicine lecturers had largely adopted bioscientific models of research, typically conducting laboratory work and trials, although teaching included traditional theories. Osteopathy academics were more critical of dominant approaches and were focused on reframing notions of evidence to account for experiences, with some advocating qualitative research. The study illustrates CAM's 'epistemic disunity' while also highlighting the particular challenges facing academic CAM.
补充与替代医学(CAM)面临着越来越大的压力,要遵循在联合健康与医学领域所倡导的循证方法,在该方法中,随机对照试验是证据的黄金标准。然而,许多CAM的倡导者认为这些方法破坏了CAM实践的整体性。本文探讨了在CAM大学院系中如何处理这种紧张关系,在这些院系中,特定形式的知识和证据得到了CAM教育工作者和研究人员的“官方”认可。通过比较两种类型的CAM,本文还剖析了这一广泛类别中的差异,询问CAM学术学科是否包含不同的“认知文化”(克诺尔-塞蒂纳,K.(1999年)。。马萨诸塞州剑桥:哈佛大学出版社)。对澳大利亚五所大学的20位中医和整骨疗法讲师进行了访谈,并对两个学位课程进行了观察以作补充。研究结果揭示了这两个学术领域在本体论和认识论上的不同观点。中医讲师大多采用生物科学研究模式,通常进行实验室工作和试验,尽管教学内容包括传统理论。整骨疗法学者对主流方法更为批判,专注于重新构建证据概念以纳入经验,一些人倡导定性研究。该研究说明了CAM的“认知不统一”,同时也凸显了CAM学术领域面临的特殊挑战。