What constitutes a medical miseducation? Ten mishaps, readily remedied.

In adopting reductive instrumentalism as a dominant discourse medical education can be seen to have cultivated a values monoculture resistant to innovation. This culture characteristically retreats to the safety of conservatism rather than diversifying and innovating to embrace values beyond the functional - such as the ethical, aesthetic, and political. Here - where teaching displaces facilitation of learning - training is privileged over education, competence over capability, linearity over complexity, and information over knowledge.

A therapeutic intervention for an ailing medical education: The values prism model as proof of concept.

Purpose: To articulate proof of concept in relation to a complex pedagogical values intervention for a range of medical education's historically accumulated symptoms.

Methods: Using a discursive approach, symptoms that hinder development of medical education are set out. Such symptoms rest with the instrumentality of current pedagogical approaches, supressing potential.

As 'synapses' become 'protoplasmic kisses': Symmetry across clinical reasoning and poetry.

Context: We argue that biomedicine at root is not primarily instrumental, but shares aesthetic, ethical and political values with poetry. Yet an instrumentalist bias in medical pedagogy can lead to frustration of biomedicine's potential. Such unfulfilled potential is exposed when making a comparison with poetry, a knowledge system that expressly engages a range of value systems.

Empathy across cultures - one size does not fit all: from the ego-logical to the eco-logical of relational empathy.

Empathy is extolled in Western healthcare and medical education as an exemplary quality to cultivate in trainees and providers. Yet it remains an elusive and inadequately understood attribute. It posits a "one size fits all" unidimensional attribute applicable across contexts with scant attention given to its multifaceted dimensions in intercultural contexts.

Re-visioning clinical reasoning, or stepping out from the skull.

The Problem: Progress in teaching and learning clinical reasoning depends upon more sophisticated modelling of the reasoning process itself. Current accounts of clinical reasoning, grounded in experimental psychology, show a bias towards situating reasoning inside the skull, further reduced to neural processes signified by imaging. Such a model is necessary but not sufficient to explain the clinical reasoning process where it fails to embrace cognition extended to the environment and social contexts.

Embracing the collective through medical education.

The journal Advances in Health Sciences Education: Theory and Practice has, under Geoff Norman's leadership, promoted a collaborative approach to investigating educationally-savvy and innovative health care practices, where academic medical educators can work closely with healthcare practitioners to improve patient care and safety. But in medical practice in particular this networked approach is often compromised by a lingering, historically conditioned pattern of heroic individualism (under the banner 'self help'). In an era promising patient-centredness and inter-professional practices, we must ask: 'when will medicine, and its informing agent medical education, embrace democratic habits and collectivism?' The symptom of lingering heroic individualism is particularly prominent in North American medical education.

Embracing ambiguity: Curriculum design and activity theory.

A curriculum innovation for a new UK medical school - Peninsula, launched in 2002 - was grounded in a period of radical pedagogical innovation in medical education in the UK during the 1990s. Part of this thinking was to include the medical humanities as a medium for re-thinking medical practice, especially how medical students might better learn to communicate with patients and colleagues, and how they might become agents of change in progressing medicine through innovations. In designing the curriculum, Cultural-historical Activity Theory (CHAT) was used as a model to 'think', or reconceptualise, the purposes of a curriculum.

Where medical education meets artificial intelligence: 'Does technology care?'.

'COLD' TECHNOLOGIES AND 'WARM' HANDS-ON MEDICINE NEED TO WALK HAND-IN-HAND: Technologies, such as deep learning artificial intelligence (AI), promise benign solutions to thorny, complex problems; but this view is misguided. Though AI has revolutionised aspects of technical medicine, it has brought in its wake practical, conceptual, pedagogical and ethical conundrums. For example, widespread adoption of technologies threatens to shift emphasis from 'hands-on' embodied clinical work to disembodied 'technology enhanced' fuzzy scenarios muddying ethical responsibilities.

Invoking the Medical Humanities to Develop a #MedicineWeCanTrust.

Trust is a complex phenomenon that resists easy definition, but it is easily recognizable, or rather its absence is impossible to miss. The author draws inspiration from the #MedsWeCanTrust movement to advocate for #MedicineWeCanTrust. Trust can be seen as a "soft," "tender-minded," optimistic condition fighting for survival in a "hard," "tough-minded," or jaundiced medicine.

Force and Presence in the World of Medicine.

Medicine can not only be read with a poetic imagination, but also configured as a poetic practice, moving beyond the instrumental. The poet Wallace Stevens made a distinction between 'Force' and 'Presence'-the former can be read as combative, the latter as pacific. Modern medicine has been shaped historically by the combative metaphor of a 'war against disease', turning medicine into a quasi-militaristic culture fond of hierarchy.

The Perils and Rewards of Critical Consciousness Raising in Medical Education.

Inequalities in society are reflected in patterns of disease and access to health care, where the disadvantaged suffer most. Traditionally, doctors have kept politics out of their work, even though politics often shape medicine. What political responsibilities, then, should doctors have as they facilitate the learning of medical students? The article in this issue by Kumagai, Jackson, and Razack goes straight to the heart of this question.

What would you ideally do if there were no targets? An ethnographic study of the unintended consequences of top-down governance in two clinical settings.

Top-down policy directives, such as targets and their associated protocols, may be driven politically rather than clinically and can be described as macro-political texts. While targets supposedly provide incentives for healthcare services, they may unintentionally shape practices of accommodation rather than implementation, deflecting practitioners from providing optimal care. Live work activities were observed for two six months periods in a UK NHS Emergency Department and a Mental Health Ward using video and field notes ethnography, with post hoc unstructured interviews for clarification and verification.

Whistleblowing in medicine and in Homer's Iliad.

'Thinking with Homer', or drawing creatively on themes and scenes from Homer's Iliad and Odyssey, can help us to better understand medical culture and practice. One current, pressing, issue is the role of the whistleblower, who recognises and exposes perceived poor practice or ethical transgressions that compromise patient care and safety. Once, whistleblowers were ostracised where medical culture closed ranks.

Seven Types of Ambiguity in Evaluating the Impact of Humanities Provision in Undergraduate Medicine Curricula.

Inclusion of the humanities in undergraduate medicine curricula remains controversial. Skeptics have placed the burden of proof of effectiveness upon the shoulders of advocates, but this may lead to pursuing measurement of the immeasurable, deflecting attention away from the more pressing task of defining what we mean by the humanities in medicine. While humanities input can offer a fundamental critical counterweight to a potentially reductive biomedical science education, a new wave of thinking suggests that the kinds of arts and humanities currently used in medical education are neither radical nor critical enough to have a deep effect on students' learning and may need to be reformulated.

The dislocation of medical dominance: making space for interprofessional care.

The historical transition of modern medicine from an autonomous profession to a team-based interprofessional practice can be described in terms of space rather than time, with "place" as the unit of analysis. Imagining modern medicine spatially was instigated by Foucault, who described medical dominance as a territorializing of both individual body spaces and public spaces--the former through the diagnostic medical gaze, the latter in a gaze of health surveillance. However, much has happened since Foucault's (1963) analysis.

Lost in translation. Homer in English; the patient's story in medicine.

In a series of previous articles, we have considered how we might reconceptualise central themes in medicine and medical education through 'thinking with Homer'. This has involved using textual approaches, scenes and characters from the Iliad and Odyssey for rethinking what is a 'communication skill', and what do we mean by 'empathy' in medical practice; in what sense is medical practice formulaic, like a Homeric 'song'; and what is lyrical about medical practice. Our approach is not to historicise medicine and medical education, but to use thinking with Homer as a medium and metaphor for questioning the habitual and the taken-for-granted in contemporary practice.

Can the science of communication inform the art of the medical humanities?

Context: There is increasing interest in establishing the medical humanities as core integrated provision in undergraduate medicine curricula, but sceptics point to the lack of evidence for their impact upon patient care. Further, the medical humanities culture has often failed to provide a convincing theoretical rationale for the inclusion of the arts and humanities in medical education.

Discussion: Poor communication with colleagues and patients is the main factor in creating the conditions for medical error; this is grounded in a historically determined refusal of democracy within medical work.