title: Meaning and value in medical school curricula.
abstract: OBJECTIVE
  Bioethics and professionalism are standard subjects in medical training programmes, and these curricula reflect particular representations of meaning and practice. It is important that these curricula cohere with the actual concerns of practicing clinicians so that students are prepared for real-world practice. We aimed to identify ethical and professional concerns that do not appear to be adequately addressed in standard curricula by comparing ethics curricula with themes that emerged from a qualitative study of medical practitioners.
  
  
  METHODS
  Curriculum analysis: Thirty-two prominent ethics and professionalism curricula were identified through a database search and were analysed thematically. Qualitative study: In-depth, semi-structured interviews were conducted with 20 medical practitioners. Participants were invited to reflect upon their perceptions of the ways in which values matter in their practices and their educational experiences. The themes emerging from the two studies were compared and contrasted.
  
  
  RESULTS
  While representations of meaning and value in ethics and professionalism curricula overlap with the preoccupations of practicing clinicians, there are significant aspects of 'real-world' clinical practice that are largely ignored. These fell into two broad domains: (1) 'sociological' concerns about enculturation, bureaucracy, intra-professional relationships, and public perceptions of medicine; and (2) epistemic concerns about making good decisions, balancing different kinds of knowledge, and practising within the bounds of professional protocols.
  
  
  CONCLUSIONS
  Our findings support the view that philosophy and sociology should be included in medical school and specialty training curricula. Curricula should be reframed to introduce students to habits of thought that recognize the need for critical reflection on the social processes in which they are embedded, and on the philosophical assumptions that underpin their practice.
authors.affiliation: University of Sydney, New South Wales, Australia. wendylipworth@gmail.com
authors.forename: Wendy
authors.initials: W
authors.lastname: Lipworth
authors.forename: Ian
authors.initials: I
authors.lastname: Kerridge
authors.forename: Miles
authors.initials: M
authors.lastname: Little
authors.forename: Jill
authors.initials: J
authors.lastname: Gordon
authors.forename: Pippa
authors.initials: P
authors.lastname: Markham
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003479:Curriculum; D016208:Databases, Factual; D004992:Ethics, Medical / Q000193:education; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010686:Philosophy, Medical; D010820:Physicians / Q000523:psychology; D036301:Qualitative Research; D012577:Schools, Medical; D012945:Social Values