Model for the formation of the environmental culture in the medical career
SUMMARY
The studies on Science- Technology- Society (STS) constitute a scientific field of academic research on areas of scientific and educational policy. They play emphasis on the social aspects of the sciences and the technology phenomenon and its social and environmental consequences. Its conceptions are of great relevance for the analysis of the sciences and technology of health, thus transforming them into a significant instrument for the Higher Medical Education. This work approaches, from the STS perspectives, the fissures observed in the medical science professional"s process of formation due to the inadequacies related to the environmental culture and detected in this career, a fact that limits these professionals" performance. An analysis on how STS can be applied to educative processes is done. The objective is centered on the reflections about the socio-cultural implications of the Pedagogical model for the formation of the environmental culture in the medical career, which is of great relevance to the medical community and the society. The formation of health professionals with a high level is a key question in the Cuban society involved in the revolution of knowledge which transforms it constantly.
KEY WORDS: implications, formation, medicine, culture, model, socio-cultural, pedagogical
Introduction
The social studies of science and technology constitute a scientific field consolidated in the areas of academic research in the scientific policy and in education. They have been institutionalized in universities, centers of studies and of public administration in several countries, including Latin America. Establishing the relation between science and technology we can observe that both require an experimental method to be confirmed and it could be demonstrated thanks to the repetition. From another point of view, science is rather interested in the development of laws which are applied by the technology. According to on his article "Science and technology as social processes" [1] the STS constitute nowadays an important work area in scientific research, public policy and education. It is tried in this field to understand the social aspects of the scientific and social phenomena, as much as regarding its social determinants, as what pertains to its social and environmental consequences. Its general approach has a critical character (according to the classical visions of science and technology where their social dimensions are hidden) and interdisciplinary characters where other disciplines like Philosophy, History, Sociology of Science and Technology, among others, coincide. STS define nowadays a field well consolidated institutionally in universities, public administration and educative centers in several industrialized countries and in some others in Latin America (Brazil, Argentina, Mexico, Venezuela, Colombia and Uruguay). In our country there is not only awareness of the enormous scientific and technological challenge that the underdeveloped world faces, but there are being promoted strategies in the fields of economy, education and the scientific and technological policies that try to offer effective answers to that challenge. All that, of course, needs conceptual renovated frames within which the STS approaches could be very useful.
The interest nowadays goes to the interrelation between the science and the technology and how they interrelate with the society, thus acquiring the technology much more importance in the social development, so the integration of both, the techno-science, comprises the center of the studies of this subject. The relation between the science and the technology is that both need an experimental method to be confirmed. They could be demonstrated by way of repetition. On the other hand, science is more interested on the development of laws that are applied by the technology for its development. There is a technology for each science, i.e., each branch has a system of different technology that permits a better development for each of them. We have to remember that the technology is perceived with the senses, i. e, we can observe it and see it.
The Science, Technology and Society constitute an approach that has grown up in importance in the last decades, and according to our opinion, it should keep doing it in a very special way in the health professionals" formation. The reasons to pay attention to it in the Cuban context should be found in the different dimension going from the character of the scientific technological development in general to the peculiarities of a country coming out of its III World pertinence, and in a singular way for its socialist positions
In the scientific revolution of the XXIst century to approach the social problems of the science and technology is vital. The medical sciences, among which is Medicine, have the challenge of approaching its complex scientific problems from a point of view contextualized in the middle of a society transformed in the present , with revolutionary and transcendental changes in its formative processes, much more qualitative, cognitive and humanistic.
If we take into account that the educative context constitutes the scene where there are shaped different ways of observing, interpreting and intervening in the professional reality and its relation with the rest of the contexts, in which the formation of the environmental culture is incorporated, it could be considered the importance of this approach that emphasizes the social aspects of the scientific technological phenomenon, and this is guided toward an attitude of bigger responsibility around that activity and encourages the criticism toward the images of classis visions of the science and technology that are predominant yet.
Cuba faces this situation from different positions as a nation where the political ideal of transformation of the society has as a very special goal the overcoming of the underdevelopment and the scientific technological dependence. Nevertheless, there is a group of questions that reflects the worry about the capability of the professional"s preparation to answer the social interests. The conscious formation is not always in correspondence with the requirements of the social practice and its epistemological, ethical-axiological imperatives, that in our opinion are in very close relation with the images of the sciences and the technology transmitted in the formative process.
From the socio-cultural perspective there are evident inadequacies in the health professional"s formation that later will constitute limitations in the socio-health job.
There are limitations in the incorporation of the transdisciplinarian dimensions ( intradisciplinarian, interdisciplinarian ), taking into account the subject, the discipline and the year horizontally and vertically, from the 1st to the 6th year through the systematization of that environmental culture.
The future health professional"s knowledge of the elements that participate in the process of appropriation of the environmental culture is not enough.
Limitations faced by these future professionals to establish an adequate relation between the knowledge of elements and the process health- sickness.
Inadequacies in the dynamics of the process of formation of the environmental culture that would lead to the adequate instruction and education in environmental values.
We have formed in Cuba a system of science and technological innovation that influences powerfully in health care, in the incorporation of the scientific and technological progress throughout the country in all the levels of attention, and that comprises as well all the medical specialties. That is why we have to remember the need to incorporate educative aspects that would allow the development of the environmental culture as socio-cultural process interacting with the studies of the STS.
Development
The Medical University, as an institution, constitutes an integrating factor of the investigation and service and it has the capacity of embracing all the components of the health care and it is in position of integrating also the different levels of the health system. It represents at the same time the institutional frame where our health professionals" main cognitive , ideological and methodological commitments are channeled, starting from their first pre-grade steps or in the chapters of continued education and medical improvement, so it is extraordinarily important to think about the development of an environmental culture in the professional"s process of formation in this area.
There are socio-economical factors that have, accordingly, led to think that the natural resources in plenty amounts in our planet could be run out if there are not taken urgent steps to protect and to strengthen much more the values leading to an adequate environmental attitude, so it is important to know the harmful processes to the nature, to the environment and to the man as one of the main components, such as: phenomena brought up by the climate change, natural disasters, desertification, decrease of species, degradation of the soil; water, soil and air contamination, among others like hunger, premature mortality due to sicknesses highly possible to prevent, such as the AIDS, the increase of morbidity due environmental causes and other causes of big impact, like exploitation of men by men, the frenzied development of the arm race, the external debt of a big number of underdeveloped nations, the illiteracy, the interethnic fights, the pillage wars, the brain drains, the unemployment, among others, are leading to a change in the social, political and economic life of the society and of the planet being a result of all this a shortness of a correct and accurate environmental culture. All this brings up, at the same time, a significant group of acute needs, that should be solved for the development of all the nations and also to understand that in this century the health professional should not and cannot get away from the principle of doing science and of participating in the processes of social implication, using the technological tools at his service and which final result would be to favor the society and not to destroy it. We believe that the definitions made by of the modern man"s would be the things that would characterize him from the rest of the professionals, and I quote "The man should be participant of the transformation of the world by means of a new education that would help him to perform criticism of his reality and that would lead him to value his experience as something full of real value¨. [2] While there is a contradiction that has its essence between the process of the medical formation of the future professionals at Appropriating of the Medic-Clinic Epidemiological Culture, and the Deepening of the Professionalizing Socio- Psycho-bio-medic Environmental Culture. We are talking about an environmental culture that this future professional must have to do an educative preventive work and to promote health, on time and correctly, knowing that 70% of the morbidity and mortality problems suffered today by the community are due to environmental causes. [3]
The perspective to science, technology and society in the context of the medical sciences is a fascinating and promising field due to the multiple fissures in the health professionals" process of formation and it is irrevocable the importance of seeing and solving them, mostly the ones interacting with the Pedagogy. In this work the author approaches the inadequacies of the process of formation of the environmental culture in the medical career that limit the health professionals" work, defining this distinctive characteristic in the process of investigation as the problem to be solved with a social, scientific and technological approach.
Its improvement in our country is nurtured on the base of a continuous, dynamic and strengthening process as an integrated part of the challenges of the pedagogical revolution of the new times and showing transcendental changes since the 90s decade about the transformation of the pedagogy of knowledge to the pedagogy of the being.
This important step in the formalized – educative process, mostly in the teaching learning process, has been carried out at the same time to promote efficiently in the students new ways of awareness, behavior, social acting, norms, world comprehension,, among others, that would allow them to enrich their life perspectives while facing the nowadays complex situation of today"s man buried in the objective process of the globalization.
That is why it is compulsory to think much more about the search of a significant paradigm that would interpret throughout the what, the how, the why and the what for to take care directly, of the circumstances of man"s life, so it is unavoidable to work on the base of the socio-cultural implications of the social model for the formation of the environmental culture in the medical career.
The social problems are and will be mitigating factors of the transformation of the technological and human activities, buried in a variety of tasks with different approaches, having the man as a social being according to his time and space and responsible for the global development and well being.
The health professionals" formation as a social process that belongs to the medical education for the sake of its health human resources, prepares the man for his insertion in a social context as it brings up the culture and social experience, the way to acquire the knowledge, skills, acting ways according to his profession and for his adequate development in his working life, which is in the center of the social relations from which others come out. It also prepares him for his political life as a citizen that will contribute to the sustainable development of the society and that will make him capable of leading the social class that he represents in every aspect of the social life. There are established tight relations between the society and the process of formation that must be taken into account in every formative process as part of the medical education and the need to guide from the human resources .It is pointed out as components of the process of the health"s professional formation the academic, the working and the investigative components, stating that they do not always get developed at the same time in the different curriculums. [4]
The objective centers the attention on analyzing, and taking care at the same time of the socio-cultural implications of the pedagogical model of the formation of the environmental culture in the medical career. Its validation in a community context is proved with an approach of science, technology and society, based in the social processes that happen in everyday life with the presence of transmissible and non-transmissible sicknesses.
In the context of High Education and in that of the Medical Education, there are reflections that asses the medical professional"s process of formation .These are the researchers" cases that assume the curricular design as an easy way to reach the goal of the proposed objectives, as it is approached by different authors. [5, 6, 7,8] assuming a change of paradigms in the health care used by the loss of validity of the Medicine as much as in the care as in the medical education, moving both to the community so a new one comes out – the socio-doctor needed by the community. Consequently, Cuba has been able to carry a health-prevention policy according to the needs of the Cuban society, a revolution in the health services and that of the medical education.
The new scientific developments in this new concept of the doctor"s formation where health, promotion and prevention have a central and outstanding place in this doctor"s formation being this of vital importance in the XXI century, nevertheless, there are still inadequacies that make this health professional face work limitations that do not allow him to strengthen the prevention of sicknesses derived from the environment in his community.
The health professionals" formation has been ruled out in these conditions by the changes in the way to practice Medicine that have taken it away from the needs of the society. It has been downgraded, many times, to an economical and instrumental fact while putting the viewpoint of innovation on a dominance place. The accelerated scientific- technological development has strengthened the rationality based on the logics of the bio- natural disciplines as if this would mean the only valid and efficient model.
The culture, for example, is one of the links in tune with the STS, which can be defined as the group of material and spiritual values created by the humanity in the process of the socio- historical practice and that characterizes the stage historically reached in the development of the society. It is a patrimonial asset. It is a component of the environment and it is expressed in the way of organization and of social coexistence, in the way of transforming and of using the natural resources for the satisfaction of the human needs and interests. It is present in all the working tools in the created and developed technology, in the knowledge and skills transmitted from generation to generation in the process of the development of the workforce, in the traditions and ways of life. [9, 10]
The environmental culture is a dimension of the general all- embracing culture. The latter is characterized by the kind of relations that the man and the society establish with the nature. When the system of material and spiritual values is built by the human kind starting from a natural development of the productive forces based in the real needs of the society it is guided toward a sustainable development. The development of an environmental culture becomes an important contribution to prepare the person, the social groups and the society to face the problems of their time, which come out as environmental problems. Its integration in the educative process is based in the consideration that the education as a process as well as a result is produced in three independent processes that are actually integrated as one through an indissoluble inter-relation that constitutes a dialectic unit, being each of them carrier of the other two, although each of them keeps its identity. [11]
The High Education, in the present conditions, presupposes information, knowledge and competence. The world tendencies in the present sciences are given by the polarization of the scientific international system and by the increasing global character of the innovative process.
This approach is the result of re-planning a group of educative materials and experience that allow to understand the environment in its holistic confirmation and as a whole when carrying more appropriated actions capable of developing a balanced coexistence with the surrounding. Assuming a conception of the whole Is to consider the phenomenon as a whole seeing the essence and the peculiarities of each component elements, as well as the dialectic relation among them. It implies, therefore, an interdisciplinary approach, essential characteristic of the environmental education. This approach tries to globalize the problems to avoid preconceptions. It does not consist of juxtaposition of the different subjects, but of covering a process as a whole, so, to explain a phenomenon it is needed to establish a global reference frame that would integrate the particular contributions of different subjects establishing their interdependence. It is, therefore, a new orientation where different educative subjects and experience merge and allow to understand the environment fully and to act rationally and accordingly. Taking this into consideration, we have that from the dialectic point of view as a conception of the development as a method of analysis and reproduction of the reality the environmental education can carry out the integral study demanded by the environmental problems. The dialectic method allows the reproduction of the reality in a concrete integrality, as a system in which interact all its components revealing the essential relations and the contradictions present in the environmental totality derived from the man- surrounding relation.
"The environmental culture is fundamental to acquire conscience, values, attitudes, that would favor the effective public participation in the process of adopting decisions. The man"s relation with the environment and their mutual relation shape a scale of values of spiritual order and the environmental question stands up as a question of the current values which at the same time are the reflection of the economical conditions of the moment. [12] It is being conditioned nowadays a process of conformation of a new form of the social conscience, which is understood as the group of conceptions, reproduction, ideas, feelings, inclinations of the society or of the individual about the environmental reality. Of course, not the whole conception of the world is systematized, or consciously elaborated. The environmental culture is called to contribute to elaborate and systematize the correct view of the world. It must help men to consciously shape their world conception about the environmental reality, the particular view of the man"s relations with the environment and that he has to improve and to adequate them constantly."
It is not, therefore, only a theoretical question, but one that influences practically on the everyday man"s acting and behavior. It is related, therefore, of acquiring an environmental culture that would allow assuming a conception of the world adequately and consciously; to act in correspondence with it and to improve our activity directed to solve the environmental problems translated as quality of life.
Herein, the formation from an environmental perspective should be formed in such a way that it would contribute to solve the practical problems of the reality. Starting from the practical social activity is, precisely, how the man interacts with the environment. This practical activity constitutes the intermediate link between conscience and objective reality.
The man"s social practical activity constitutes the most important base of the process that leads to discover the essence of the objects of the material world, as the only criterion of veracity of all our knowledge and its final objective. For this analysis we come from the criterion that the practice, from the environmental point of view, is every varied and multiple man"s activity conditioned by the degree of social development and guided to auto transformation and this way to develop his human transforming capacity in order to preserve life and protect the environment.
It is presumed that this environmental culture would contribute to shape in the citizen an awareness of the problems opposed to the individual"s ones and of collective well-being, to make their causes clear and to determine the adequate means to solve them. This would allow people to participate in the elaboration and execution of strategies that would tend to solve the problems affecting the quality of the environment and of life. This kind of education presupposes a community practice as men will be affected by the quality of the environment every day, and as a need they will fight the negative effects provoked by the environmental problems in their community.
The medical career professionals" process of formation of the environmental culture reaches its maximum expression in the community context in reference to socio- cultural implications when incorporating the environmental dimension translated into environmental culture according to prophylaxis as one of its work directions; the community is a source for learning not only for the different angles present to carry out activities, but also because in it you meet people with a huge experience and popular wisdom that can contribute, in a decisive way, to acquire the environmental culture through the educative–environmental message which at the same time can strengthen the socio-environmental conscience when interacting with the environment.
This topic, the author"s center of attention, is based on a mutual conception that would favor the aspiration of reaching the objectives stated more than 25 years ago in Tbilisi and more than 15 years ago in Rio, that up to this moment are aspirations.
We have to work to revitalize and strengthen the complementary character between the popular wisdom of our rich culture and our specialists" scientific knowledge to contribute to enrich one"s own environmental knowledge, to educate based in the rescue of the richest and most autochthonous of our Pedagogy to contribute to a Latin-American and Caribbean environmental culture based on our natural, changing, shocking and complex conditions of the rest of the world to which we belong and of which we cannot and should not detach.
There is a nowadays re-shape of the spaces of the practice and the formation in the medical career under the principles of a strong relation of the career, the disciplines and the subjects with the community.
Re-shape of the spaces of the practice and the formation.
-It is stated from the pedagogical point of view that the quality of the education is based on the process and not only on the product / graduates.
-Reshape and redefinition of concepts of health / sickness in a transdisciplinarian frame and of articulation of socio- biological knowledge.
-The link between the techno-medicine / excellence / professional"s technique and the relevance / integral satisfaction of the society.
– To emphasize in the institutional accreditation more than in the professional"s certification.
The professionals´ process of formation in the medical career is re-shaped considering the new demands to the curriculum, without taking into account that there are still contradictions in the process of formation where we find inadequacies that bring up limitations for their professionalizing development.
Nowaday in the Medical Sciences Universities and health centers in the country it s done a job to re conceptualize the epidemiological-clinic method to establish the doctor-patient relation, the doctor-community, strengthening values and a human mind, essential features that have stayed behind with
the technological revolution. With this new focus it´ll be established an approach to the graduate´s profile as a General Doctor demanded by our society. There is yet a lack of balance between the components of this formation process, related with the dynamics of socio-cultural intervention from the point of view of the knowledge of the environmental culture that must have this future health professional to diagnose and achieve the Transforming Orientation toward the Medical-Environmental Practice in the function of the Prevention and Health Promotion with the right application of the Epidemiological-clinic method, and from an interdisciplinary approach, to get the Pedagogical Social Medic-Environmental Interaction in the Professionalizing Context. [13,14]
Conclusions
To contribute to increase the conscience about the importance and the need to introduce the formation of the culture, from the environmental point of view, in the educative, socioeconomic and cultural processes.
To work for the formation of our own human resources capable of facing, and giving solutions to, the environmental problems with a social approach centered in the community as part of his acting in the context.
To guide and to direct the formation process in the medical career to acquire an environmental formation as a participant culture in the dynamics contextualized in the community.
To direct the educative process to defend our cultural element as a decisive element of our social economic and technological development as condition for the insertion in an international context of economic and technological globalization.
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Disponible en: www.apc.rimed.cu
Autor:
Adalis Labrada Espinosa;
Vicente Luis Ribas-Rocafull Oliva
Especialista en Defectologia, Especialista en Posgrado y Docencia Universitaria.
Lic. En Inglés y Ruso. Instructor. Filial de Ciencias Médicas