Perspective: To What End Communication? Developing a Conceptual Framework for Communication in Medical Education
Bibliographic record
Abstract
A growing discourse about broadening the educational experience of physicians in medical education focuses on professional formation and the wider social context within which health care is delivered. This shift suggests a complex reconfiguration of medical education. Where does one begin this task? First, medical education reform must be grounded in a clarification of the conceptual terrain where proposed changes in pedagogy and practice are occurring. More specifically, some clarity is needed regarding the basic or key competencies that students are expected to acquire through educational processes. Accordingly, the author argues that having a clear and comprehensive conceptual understanding of the educational aims defining this reform is a necessary starting point. Although descriptions of competencies (such as those required by CanMeds and the Accreditation Council for Graduate Medical Education) focus on lists of skills, greater detail is needed regarding our understanding of the values and rationale underlying such skills if they are to be applied in educationally effective ways. The author shows the extent to which and ways in which our understanding of these basic concepts will influence the direction of reforms. He examines various conceptions of the role of communication in medicine and indicates various educational benefits and shortcomings in these approaches. He concludes by identifying one concept of communication, termed "communication as a medical-epistemic competency, " that can include and incorporate many facets of communication in the medical context while also responding to broader societal changes being addressed through post-Flexner developments in educational reform.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.009 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.007 | 0.010 |
| Science and technology studies | 0.003 | 0.028 |
| Scholarly communication | 0.010 | 0.020 |
| Open science | 0.004 | 0.006 |
| Research integrity | 0.010 | 0.013 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".