Appleby Alistair, Swinton John, Wilson Philip
General Practitioner, Aviemore Medical Practice , Aviemore , Scotland.
School of Divinity, History and Philosophy, King's College, University of Aberdeen , Aberdeen , Scotland.
Educ Prim Care. 2019 Jul;30(4):194-197. doi: 10.1080/14739879.2019.1600383. Epub 2019 Jul 17.
This article examines the place of spirituality in medical education, with special reference to primary care. It highlights evidence of current discrepancies and problems with spiritual care in general practice, demonstrating that GPs do not have a common approach or set of competencies. The authors illuminate the fact that medical education teaches spirituality sporadically and largely through optional and non-embedded learning. This and the general paradigm and culture of medical education may actually impair doctors' ability to understand spirituality and integrate this in practice. The authors critique philosophical limitations in the Royal College of GPs' curriculum statements on spirituality and foreground more general problems with the current philosophy of science on which primary care is based. Consideration is given to retracting or reducing claims to address spirituality in primary care before solutions to these issues are put forward. Potential solutions proposed include a shift to a broader philosophical framework, such as "critical realism", and the use of alternative learning approaches such as transformational learning.
本文探讨了灵性在医学教育中的地位，特别提及了初级保健领域。它突出了当前全科医疗中灵性关怀存在差异和问题的证据，表明全科医生没有共同的方法或一套能力。作者阐明了医学教育对灵性的教学是零星的，且主要通过选修和非嵌入式学习进行这一事实。这以及医学教育的总体范式和文化实际上可能损害医生理解灵性并将其融入实践的能力。作者批评了皇家全科医师学院关于灵性的课程声明中的哲学局限性，并突出了初级保健所基于的当前科学哲学的更普遍问题。在提出这些问题的解决方案之前，考虑收回或减少在初级保健中解决灵性问题的主张。提出的潜在解决方案包括转向更广泛的哲学框架，如“批判实在论”，以及使用替代性学习方法，如变革性学习。
