By Henri Colt M.D.
University of California, Irvine

Whether in science, technology, or social history, it is the courage, the faith and the passion of each single person that change the world. Hannah Arendt, in the Meaning of Revolution, insists on a notion of irresistibility when she suggests that a revolutionary spirit is not defined as the action of a people, but rather as the novel idea and well sustained thought that a concept is right [1]. Educating health care providers and patients about health-related issues today can be inspired by such revolutionary spirit because of two increasingly universal concepts; the first is that of the democratization of knowledge through free and nonelitist education, the second is that of a liberal dissemination of technology as computer and web-based learning, interactive informational systems, and virtual reality simulations become ever more available and affordable.

An educational system based on the concepts of democratization of knowledge and dissemination of technology is the exact opposite of the antiquated habit of coerced acceptance of conventional wisdoms. For generations, medical experience has maintained a balance between seeing and knowing [2]. The older method, still practiced today, includes a teacher who is the owner of knowledge and who has power over the learner; that other person who has the privilege of being accepted into the circle of those who know. The revolutionary spirit, on the otherhand, encompasses the instantaneous and open access to technological advances, information and exchange. Teacher and learner become codependent actors within an intertwined system where each actually learns from the other. Procedure-related skills are practiced using simulators and inanimate models, while knowledge theory is acquired through problem-based learning scenarios and interactive sessions with instructors [3-5].

Bridging the digital divide that separates the “haves” from the “have nots”, of course, requires more than access to information [6]. It also requires the development of interactive education curricula and personal example. Technology might allow our ideas and our images to transcend national boundaries, but healthcare education also requires one’s personal identification with a role model while learning to care for the sick, the injured, and the fatally ill. This blend of science and humanity is necessary in order to avoid an exaggerated technocratic model of health care delivery. In this way, the concepts of democratization of knowledge and dissemination of technology can fuel a revolutionary spirit that might change a world currently threatened by increasing inequality, exclusion of the masses, and an obscene concentration of financial and intellectual wealth in the hands of a powerful and often self-serving minority.

References

1. Arendt H. On Revolution. Penguin Books, edition (from original Viking Press, 1963). New York, pg 46-47. link
2. Foucault M. Birth of the clinic: an archeology of medical perception. Vintage Books Edition, 1994, New York, pg54-55. link
3. Morgan, P J, Cleave-Hogg, D. Simulation technology in training students, residents and faculty. Current Opinion in Anaesthesiology 2005; 18(2):199-203. link
4. Crawford SW, Colt HG. Virtual reality and written assessments are of potential value to determine knowledge and skill in flexible bronchoscopy. Respiration 2004;71:269-275. link
5. Groopman J. A model patient: how simulators are changing the way doctors are trained. The New Yorker, pgs 48-54, May 2, 2005. link
6. Virilio P. Open Sky. Verro Publishing, London, 1997.