{"title":"Practical wisdom and the integration of science and humanism in medicine","authors":"Lauris C. Kaldjian","doi":"10.1111/medu.70010","DOIUrl":"10.1111/medu.70010","url":null,"abstract":"<p>Early in my training as a physician, I noticed that some physicians are much more capable than others in caring for patients. In time, I realised why. While most physicians are really smart (they have a large fund of knowledge) and many also demonstrate good clinical judgement (they can apply knowledge to achieve desired outcomes), only some physicians integrated knowledge and good judgement with an ethical perspective. This moral vision allowed them to see patients not as problems to be solved or cases managed but as persons requiring care within the particularity of their physical, psychological, social and spiritual needs. In short, I learned to recognise the difference between knowledge, problem solving and a virtue-based understanding of practical wisdom in medicine. In doing so, I came to appreciate the truth of Edmund Pellegrino's pronouncement that ‘Medicine is the most humane of sciences, the most empiric of arts, and the most scientific of humanities’.<span><sup>1</sup></span> Science, practicality and humanism: these three dimensions combined explain excellence in patient-centred care.</p><p>This multidimensionality is reflected in the virtue of practical wisdom, a <i>telos</i>-guided capacity to know and pursue the best means to achieve good ends.<span><sup>2</sup></span> In the virtue traditions associated with Aristotle and Aquinas, practical wisdom is understood as goal-oriented, context-sensitive, ethically integrated, deliberative, motivated and guided by reason-informed emotion.<span><sup>3-5</sup></span> Practical wisdom in medicine reflects a capacity for patient-centred deliberation directed toward the goals of health and flourishing; it accurately perceives context and circumstances, integrates moral virtues and principles, harmonises reason and emotion and is motivated to act to promote the patient's good.<span><sup>6</sup></span> Practical wisdom can be described as a master virtue, or meta-virtue, because it orchestrates other virtues that need to be integrated, prioritised and balanced.<span><sup>5</sup></span> Anchored in virtue ethics,<span><sup>7</sup></span> practical wisdom in medicine is part of the character of a physician who treats patients as persons, holistically, recognising the biological nature of disease and the human experience of illness. It responds to the needs, preferences and goals relevant to the health, flourishing and dignity of a particular patient in a particular context at a particular time.</p><p>In this issue, the study by Millhollin et al.<span><sup>8</sup></span> is an interesting effort to explore and model medical wisdom through a blend of qualitative research and conceptual theorising. It also endeavours to relate medical wisdom to the ACGME core competencies<span><sup>9</sup></span> in medical education. The qualitative portion of their study comprised thematic analyses of interviews with 19 internal medicine physicians to elicit their definitions of medical wisdom and situations tha","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 9","pages":"905-907"},"PeriodicalIF":5.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://asmepublications.onlinelibrary.wiley.com/doi/epdf/10.1111/medu.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The doctor as an educator-A call to action.","authors":"Stephanie Penswick, Victoria Sobolewska","doi":"10.1111/medu.70011","DOIUrl":"https://doi.org/10.1111/medu.70011","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Narrative candour: Learning from diverse stories of imperfect medical practice.","authors":"Margaret Bearman, Elizabeth Molloy, Lara Varpio","doi":"10.1111/medu.70005","DOIUrl":"https://doi.org/10.1111/medu.70005","url":null,"abstract":"<p><strong>Introduction: </strong>Medical training often induces stress and burnout, exacerbated by competition and imposter syndrome, which can collectively contribute to trainee distress. Drawing from narrative theories, this conceptual paper examines how myths of the heroic doctor and discourses of exceptionalism contribute to this distress, suggesting that little stories may be harnessed to counterbalance these myths and promote more collaborative and inclusive practices.</p><p><strong>Theoretical framing: </strong>The doctor as hero myth promotes selflessness and excellence, but it simultaneously overshadows the contributions of day-to-day acts and of the collective healthcare team. A greater diversity of narratives may be needed for valuing doctors in all their various roles. Alternative narratives-including counternarratives-can challenge dominant stories in everyday clinical education and offer new perspectives by highlighting voices that are often less heard, which can provide valuable insights and disrupt conventions.</p><p><strong>Conceptualisation: </strong>Narrative candour is presented as an educational approach where revealing less-than-ideal stories of practice can promote learning, within informal practice interactions, formal curricula and even ceremonial occasions. Stories of everyday imperfections-e.g., of moments when the doctor is not the protagonist, of inspiration without greatness, of denied resolutions-are offered as means of bringing narrative candour to life. They can be powerfully conveyed: told at formal events of recognition (e.g., commencement) by senior community members or shared with peer or embedded into the informal stories of daily healthcare delivery.</p><p><strong>Conclusion: </strong>Narrative candour might have substantial impact on individuals, relationships and broader communities-all in the name of understanding doctors as complex and diverse humans rather than simply the trope of exceptional heroes.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"When I say 'edutainment'.","authors":"Sze-Yuen Yau, Ching-Yi Lee","doi":"10.1111/medu.70009","DOIUrl":"https://doi.org/10.1111/medu.70009","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"When I say … informed consent.","authors":"Cormac McGrath, Per J Palmgren, Matilda Liljedahl","doi":"10.1111/medu.70008","DOIUrl":"https://doi.org/10.1111/medu.70008","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yasith Mathangasinghe, Jason S Massey, Vandana Nathan, David G Gonsalvez
{"title":"Simulated anatomy ward rounds: Bridging preclinical and clinical assessment.","authors":"Yasith Mathangasinghe, Jason S Massey, Vandana Nathan, David G Gonsalvez","doi":"10.1111/medu.70007","DOIUrl":"https://doi.org/10.1111/medu.70007","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unmasking the professional doctor archetype","authors":"Harikeerthan Raghuram, Satendra Singh","doi":"10.1111/medu.70003","DOIUrl":"10.1111/medu.70003","url":null,"abstract":"<p>Neurodivergent doctors challenge a harmful archetype of \"professionalism\" - the authors outline how their doing so benefits all, not just neurodivergent clinicians and patients</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 10","pages":"1032-1034"},"PeriodicalIF":5.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jameleddine Benhamida, Maggie Eckerstorfer, Aakanksha Angra, Jonathan D Kirsch, Jessica Hane
{"title":"Enhancing early medical education through mobile health care.","authors":"Jameleddine Benhamida, Maggie Eckerstorfer, Aakanksha Angra, Jonathan D Kirsch, Jessica Hane","doi":"10.1111/medu.70000","DOIUrl":"https://doi.org/10.1111/medu.70000","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"August in this issue","authors":"","doi":"10.1111/medu.15758","DOIUrl":"10.1111/medu.15758","url":null,"abstract":"<p>Renewing a health education curriculum is a significant undertaking, requiring substantial effort and resourcing. However, no comprehensive list of curriculum renewal drivers exists to guide educators that are considering commencing a renewal. This scoping review identified and catalogued published drivers of curriculum renewal of health professional degrees across a 10-year period. Qualitative content analysis was then used to generate 10 categories that clustered drivers into groups. The proposed framework may be used to scaffold future curricular review processes and for informing future scholarly inquiry into the renewal process.</p><p>\u0000 <span>Kok, D</span>, <span>Xu, M</span>, <span>Trumble, S</span>, <span>Matthews, K</span>, <span>Wright, C</span>. Categorising drivers of curriculum renewal in entry-to-practice health professional education: a scoping review. Med Educ. 2025;59(8):812-822. DOI: 10 1111/medu15614.</p><p>A meta-study review was conducted to explore the current state of historical scholarship in medical education, to understand the state of the art and to improve methodological, analytical and reporting rigour. Although there were some exemplary articles identified, the majority reflected many deficits in scholarly practice including a lack of methodology, no engagement with theory, inattention to replicability and lack of reflective critique and positionality. There is a discursive space for historical scholarship in medical education that needs further exploration and development to bring together the best of scholarship from the traditions of medical education and history.</p><p>\u0000 <span>Ellaway, R</span>, <span>MacLeod, A</span>, <span>Schalkwyk, S</span>, <span>Cleland, J</span>. Study the past if you would define the future: historical methods in medical education scholarship. Med Educ. 2025;59(8):823-832. DOI: 10 1111/medu15621.</p><p>This qualitative study enhances our understanding of how social structures affect the training of intraprofessional collaboration between family physicians and specialist physicians. Conducted in an academic outpatient setting in Canada, the study examines how macrosocial imperatives shape physician supervisors' engagement and teaching of intraprofessional collaboration. The findings reveal that intraprofessional collaboration is influenced by discourses that ironically reinforce professional boundaries, thereby maintaining asymmetric power dynamics. The article proposes how the sociological concepts of discourse and boundaries could guide the development of intraprofessional learning initiatives in ways that mitigate the impact of structural power.</p><p>\u0000 <span>Wong, R</span>, <span>Whitehead, C</span>. Exploring how structural forms of power shape the training of intraprofessional collaboration between family physicians and specialty physicians in outpatient workplace settings. Med Educ. 2025;59(8):842-852. DOI: 10 1111/medu15607.</p><p>The ","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 8","pages":"777-778"},"PeriodicalIF":5.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15758","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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