Steven Scrivener said:
>As someone who may come under the knife one day, I would like most
>surgeons to be worrying about the advancement of surgical procedure, which I
>would assume is largely stimulated by problematic situations in surgery and
>advanced through surgery.
I thought I would share an observation made by a colleague who is not a medic
but has a senior role in a Medical School. He felt that thinking about research
in medicine had become constrained by the presence of the "gold standard" of
the clinical trial to the extent that research and the clinical trial were
synonymous in many people's minds.
He contrasted this with the position of surgeons (often brilliant and
practically minded craftspeople) confronted with patients who would die if
radical action were not taken. He observed that unlike other doctors, who must
rely on drug regimes designed through the clinical trial process (for very
sensible reasons), surgeons are relatively free to innovate and this will
sometimes develop into new techniques which may become widely used. This may be
advanced practice but it is not thought of as research. Of course there is
always a need for rigorous evaluation and that is difficult if nobody is doing
the surgical procedures to start with.
So that poses the question for me of whether the research is primarily in the
clinical trial (is the surgeon an artesan who has stumbled on a research
question that others must pursue?) or is the surgeon playing a significant role
in the research by proposing the hypothesis (the new procedure) and embodying
it in their practice so that the trial can proceed.
Thanks Steven, that's been simmering in my mind for some time and your comment
encapsulated it nicely for me.
Best wishes from Sheffield
Chris Rust
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Chris Rust
Reader in Design
Art and Design Research Centre
Sheffield Hallam University UK
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