Gilles Deleuze and the search for “sense” in the stories of illness: a methodological proposal

Introduction: this article briefly summarises some of the concepts in the Logic of Sense, by Gilles Deleuze and proposes a method of structural analysis of a text of illness narrative. Methods: the main concepts are the distinction of Things from the Events, the importance of the surface separating them, the concepts of problem and of paradoxical instance. A eight step process of textual analysis is proposed. Results: A worked example clarifies the steps of the method and some suggestions for the educational use of this kind of textual analysis is provided. Discussion: this is a useful approach when the focus is on analysing the social discourse and social structures that can be a source of oppression for some social groups, but also to increase the awareness about the way in which sense is produced in verbal production.Introduzione: questo articolo riassume brevemente alcuni concetti contenuti nella Logica del senso, di Gilles Deleuze e propone un metodo di analisi strutturale di un testo narrativo di malattia. Metodi: i concetti principali sono la distinzione delle Cose dagli Eventi, l'importanza della superficie che li separa, i concetti di problema e di istanza paradossale. Viene proposto un processo di analisi testuale in otto fasi. Risultati: un esempio sviluppato chiarisce le fasi del metodo e fornisce alcuni suggerimenti per l'uso didattico di questo tipo di analisi testuale. Discussione: l’ approccio proposto è utile quando l'attenzione è rivolta all'analisi del discorso sociale e delle strutture sociali che possono essere fonte di oppressione per alcuni gruppi sociali. Tuttavia può essere usato anche per aumentare la consapevolezza sul modo in cui il senso viene prodotto nella produzione verbale

Come trasformare un corso d’aula tradizionale in un corso flipped e perché. Esperienza in un corso di metodologia clinica

Esiste una crescente pressione sul mondo accademico italiano per una formazione centrata sullo studente, professionalizzante e orientata alla competenza. Tra i metodi attivi, la flipped classroom sta ricevendo sempre più attenzione. Questo articolo riporta i risultati della prima sperimentazione dle metodo in una calsse di 3° anno del corsodi laurea in medicina, nel corso integrato diMetodologia ClinicaThere is a growing pressure on the Italian academic world for a student-centered, professional competency-based education. Among the active methods, the flipped classroom is receiving more and more attention. This article reports about the results of the first application of this method in a medical curriculum , in a class of Introduction to Cllinical Medicin

Frequency and severity of globus pharyngeus symptoms in patients undergoing thyroidectomy. A pre-post short term cross-sectional study

Globus pharyngeus is a sensation of a lump or foreign body in the throat, sometimes associated with thyroid diseases and surgery. Previous studies investigated this condition with contradictory results, mainly because not standardized instruments of measure were used. The aim of this study was to evaluate the prevalence and severity of globus pattern symptoms in a population of patients three months after a thyroidectomy, and the reduction or increase of pre-existing symptoms or the onset of new symptoms

Evaluation of the acceptability of Peer Physical Examination (PPE) in medical and osteopathic students: a cross sectional survey

BACKGROUND: Peer physical examination (PPE) is a method of training in medical and osteopathic curricula. The aim of this study was to compare the acceptability of PPE in two classes of medical and osteopathic students after their first experience, to obtain comparative information useful for an understanding of the different professional approaches. The leading hypothesis was that osteopathic students enter the curriculum with a more positive attitude to bodily contact. As a secondary aim, this study validated the new version of a questionnaire to assess the acceptability of PPE. METHODS: A new version of a previously validated questionnaire and an instrument from the literature (the Examining Fellow Student [EFS] questionnaire) were used for a cross-sectional survey in a class of 129 3rd year medical students and in two parallel classes of 1st year osteopathic students (total of 112 students). RESULTS: The mean score of the new questionnaire was significantly higher for the osteopathic students than for the medical students (53.4 ± 6.3 vs. 43.4 ± 8.9; p < 0.01). The only independent variables that were significantly predictive of the score in a linear regression analysis were gender and the condition of medical or osteopathic student. The EFS mean score also showed a significant difference between the osteopathic and medical students (30.76 ± 2.9 vs. 27.85 ± 4.3; p < 0.01). Factor analysis of the new questionnaire identified three factors (appropriateness and usefulness, sexual implications and passive role) accounting for 62.8% of the variance. Criterion validity was assessed by correlation with the EFS (Pearson’s r coefficient = 0.61). Reliability was expressed in terms of Cronbach’s alpha coefficient, which equals 0.86. CONCLUSIONS: These quantitative results are consistent with previous qualitative research on the process of embodiment both in medicine and osteopathy. The new questionnaire proved to be valid and reliable. The objective assessment of the acceptability of PPE is a way to determine differences in students’ attitudes towards contact with the body and can be used for counselling students regarding career choice. This study can also highlight differences between students from different professions and serve as a basis for reflection for improved mutual interprofessional understanding and future interprofessional education

L'esperienza vissuta di didattica a distanze di studenti di medicina durante la pandemia CoViD-19 in Italia: una ricerca di fenomenologia descrittiva

Introduction - The pandemic forced the quick adoption of distance education in Italian schools of Medicine. Qualitative research about the sudden adoption of distance education is missing. This study explores from a phenomenological perspective the lived experience of medical students of distance education during the CoViD-19 pandemic. Methods – A descriptive phenomenological research of written narrative essays about one distance lesson was conducted. Texts were collected through the e-learning platform and analysed according to Giorgi’s method Results – Eighteen narratives were analysed. Three themes emerged, which described the lived experience of the participants: distance learning was not an educational choice but a mandatory answer to the pandemic that disrupted the usual course of our lives; distance learning can make the classroom cozy; distance learning puts you in a “bubble”. Discussion – These findings confirm what is already known in general about distance learning and add a new insight on the importance of the social processes and physical presence of students in the development of their identity as a student. Our findings underline the importance of faculty development on the issues of distance learning.Introduzione - La pandemia ha costretto le scuole di medicina italiane ad adottare molto rapidamente la formazione a distanza. A questo riguardo, manca ricerca qualitativa sugli effetti dell’adozione improvvisa di questa forma di didattica. Questo studio esplora da una prospettiva fenomenologica l'esperienza vissuta degli studenti di medicina circa la didattica a distanza durante la pandemia CoViD-19. Metodi – E’ stata condotto una ricerca fenomenologica descrittiva di saggi narrativi scritti a proposito di una lezione a distanza. I testi sono stati raccolti attraverso la piattaforma di e-learning e analizzati secondo il metodo di Giorgi. Risultati - Sono state analizzate diciotto narrazioni. Sono emersi tre temi che descrivono l'esperienza vissuta dei partecipanti: l'apprendimento a distanza non è stata una scelta educativa ma una risposta obbligatoria alla pandemia, che ha sconvolto il normale corso della nostra vita; l'apprendimento a distanza può rendere accogliente la classe; l'apprendimento a distanza ti mette in una "bolla". Discussione - Questi risultati confermano quanto già noto in generale sull'apprendimento a distanza e aggiungono una nuova visione dell'importanza dei processi sociali e della presenza fisica degli studenti nello sviluppo della loro identità di studente. I nostri risultati sottolineano l'importanza dello sviluppo della facoltà sulle questioni dell'apprendimento a distanza

A phenomenological study of italian students’ responses to professional dilemmas. A cross-cultural comparison

Phenomenon: Medical professionalism is a complex construct, based in social and cultural influences, yet little research has been done to show how culture influences the behaviors and attitudes of medical students. We presented Italian students with the same professional dilemmas used in a previous Canadian and Taiwanese cross-cultural study to look for similarities and differences and detect elements of Italian culture that influenced how students responded to dilemmas. The aim was to provide medical educators with some insights into students’ behavioral strategies and feelings when faced with a professional dilemma. Approach: Using Giorgi’s method, we performed a phenomenological analysis of 15 interviews of Italian medical students who responded to standardized video scenarios representing professional dilemmas. These videos were used in Canada and Taiwan and were translated into Italian. All students were from the same degree course, at Year 6, and were recruited on a voluntary basis at the beginning of the Internal Medicine course. Interview transcripts were anonymized before analysis. Findings: Scenarios were perceived as realistic and easy to envision in Italy. Four themes emerged: establishing priority among principles, using tactics to escape the dilemma, defending the self, and defending the relationships. When compared with previous studies, we noted that Italian students did not mention the principles of reporting inappropriate behavior, seeking excellence, or following senior trainees’ advice. Insights: This is the first cross-cultural study of professionalism that involves a Mediterranean country and the observed differences could be interpreted as expressions of Italian cultural traits: distrust toward authority and a cooperative rather than competitive attitude. These findings have practical implications for educators to design and run curricula of professionalism with culturally appropriate topics. They highlight the need for more cross-cultural research

Le sfide della pedagogia medica oggi. Un’analisi SWOT della SIPeM

In modern times, the Italian Society of Medical Pedagogy (SIPeM) faces greater complexity. Over the last decades, great changes of the SIPeM goals and instruments there has been. Therefore it is necessary today a reflection on the goals reached, on the difficulties encountered and on future challenges. Procedure: a SWOT analysis of SIPeM was conducted with the members of the Direct Board and the Heads of the Local Sections. Results: 23 conceptual units were identified and divided into strength elements (5), weakness (7), opportunity (6) and risk (5). Conclusions: the analysis confirms some strategic choices made by SIPeM, such as the Green Line Project and underlines the need to define their own future goals in order to plan the resources distribution

Understanding petri nets in health sciences education. The health issue network perspective

Scarce literature exists as to the use of Petri Nets (PN) to model the dynamic evolution of health issues in a deterministic way. Starting from the HIN (Health Issue Network) approach, the paper aims at describing the suitability of PN in supporting the Case–Based Learning method for improving an educational simulation environment in which students can manage realistic clinical data related to the evolution of a patient's health state over time

Medical Education in Italy: challenges and opportunities

Italy is a country of 60 million citizens with a high life expectancy, an increasing prevalence of chronic multi-morbidity and a public healthcare system. There are 61 medical schools and more than one thousand postgraduate programs for 50 different specialisations. In this article, we describe the Italian medical educational system and its most recent evolution towards a process of internationalization, alongside pedagogical and cultural changes. The main challenges are in the process of students’ selection, which is still only based on the assessment of basic knowledge, and in the reform of the post-graduate education, which lacks an official, formal definition of the learning outcomes and the aligned methods of assessment. The opportunities come from the increasing awareness of the importance of faculty development programs. The pandemic itself acted as a catalyst of innovation, pushing toward more student-centered teaching-learning activities. Finally, an increase in international collaborations in medical education research could be effective to foster the development of medical education in the country