Health care education: towards a corporate paradigm

Abstract

In 1962, Thomas Kuhn published his seminal work on the structure of scientific revolutions. In it, he argued that philosophers of science had been misled in their analysis of the nature of the endeavour. In contrast to the then conventional view of science as objective reality assembled through disinterested experiment, Kuhn, through historical analysis, saw only communities of scientists acting like human beings. They were often reluctant to change their ways, precious about their theories and inclined to dogma. Most of their time was spent trying to solve puzzles set in a dominant conceptual framework of received beliefs which the community acknowledged as supplying the foundation for its practice. These received beliefs he called the ‘paradigm’. It enshrined values, methods of work and fundamental concepts which provided the basis of explanation. The dogma of the paradigm, he claimed, is maintained through social pressure and education. If someone discovers or does something inconsistent with the paradigm, it is normally considered the problem of the individual, not the paradigm. Perhaps the experiment was flawed or the technique inaccurate or maybe the scientist wasn’t quite up to it. Inevitably the quality of the work is questioned. In any event, no scientific group could practise its trade without its received beliefs and, in this context, education and training must initiate the new recruit into the paradigm. Textbooks serve their purpose by focusing on achievements which support the paradigm.

In this chapter the concept of paradigm de stabilization is applied as a metaphor for the educational revolution consequent upon the introduction of market forces into health care education. The status of UKCC Project 2000 as a radical educational reform is discussed, and the basic thesis of the book is defined.