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It is increasingly claimed that modern medicine has entered into crisis —a crisis of knowledge (uncertainty over what counts as "evidence" for decision-making and what does not), care (a deficit in sympathy, empathy, compassion, dignity, autonomy), patient safety (neglect, iatrogenic injury, malpractice, excess deaths), economic costs (which threaten to bankrupt health systems worldwide) and clinical and institutional governance (a failure of basic and advanced management, inspirational and transformational leadership). We believe such a contention to be essentially correct. In the current article, we ask how the delineated components of the crisis can be individually understood in order to allow them to be collectively addressed. We ask how a transition can be effected away from impersonal, decontextualized and fragmented services in the direction of newer models of service provision that are personalized, contextualized and integrated. How, we ask, can we improve healthcare outcomes while simultaneously containing or lowering their costs? In initial answer to such questions —which are of considerable political as well as clinical significance— we assert that a new approach has become necessary, particularly in the context of the current epidemic of multi-morbid and socially complex long term illness. This new approach, we argue, is represented by the development and application of the concepts and methods of person-centered healthcare (PCH), a philosophy and technique in the care of the sick that enables clinicians and health systems to re-introduce humanistic ideals into clinical practice alongside continuing scientific advance, thereby restoring to medicine the humanism it has lost in over a century of empiricism. But the delivery of a person-centered healthcare within health systems requires a person-centered education and training. In this article we consider, then, why person-centered teaching innovations in the undergraduate medical curriculum are necessary, as a first step, to achieving real progress in the integrity of modern undergraduate medical education. Without such innovations, we do not believe that suitable foundations for subsequent innovations in postgraduate training can be laid and, with them, a continuing professional education in PCH that spans entire medical careers. We first review the historical perspectives of relevance to our arguments and then advocate a radical re-think of what we believe to be the urgent imperatives for a modern medical undergraduate and postgraduate training. ; post-print ; 300 KB

It is increasingly claimed that modern medicine has entered into crisis —a crisis of knowledge (uncertainty over what counts as "evidence" for decision-making and what does not), care (a deficit in sympathy, empathy, compassion, dignity, autonomy), patient safety (neglect, iatrogenic injury, malpractice, excess deaths), economic costs (which threaten to bankrupt health systems worldwide) and clinical and institutional governance (a failure of basic and advanced management, inspirational and transformational leadership). We believe such a contention to be essentially correct. In the current article, we ask how the delineated components of the crisis can be individually understood in order to allow them to be collectively addressed. We ask how a transition can be effected away from impersonal, decontextualized and fragmented services in the direction of newer models of service provision that are personalized, contextualized and integrated. How, we ask, can we improve healthcare outcomes while simultaneously containing or lowering their costs? In initial answer to such questions —which are of considerable political as well as clinical significance— we assert that a new approach has become necessary, particularly in the context of the current epidemic of multi-morbid and socially complex long term illness. This new approach, we argue, is represented by the development and application of the concepts and methods of person-centered healthcare (PCH), a philosophy and technique in the care of the sick that enables clinicians and health systems to re-introduce humanistic ideals into clinical practice alongside continuing scientific advance, thereby restoring to medicine the humanism it has lost in over a century of empiricism. But the delivery of a person-centered healthcare within health systems requires a person-centered education and training. In this article we consider, then, why person-centered teaching innovations in the undergraduate medical curriculum are necessary, as a first step, to achieving real progress in the integrity of modern undergraduate medical education. Without such innovations, we do not believe that suitable foundations for subsequent innovations in postgraduate training can be laid and, with them, a continuing professional education in PCH that spans entire medical careers. We first review the historical perspectives of relevance to our arguments and then advocate a radical re-think of what we believe to be the urgent imperatives for a modern medical undergraduate and postgraduate training. ; post-print ; 300 KB

This article investigates the work of Henry Morris (1889–1961), in particular his ideas on the Cambridgeshire village colleges. It is now 90 years since the first of these was founded in Sawston in 1930, and the article aims to address the issue of whether Morris's views on education and democ- racy encapsulated in the village colleges still have relevancy in the early twenty-first century. An overview of Morris's career and the creation of the village colleges is investigated, using the work of Paul Hirst and associative democracy as a theoretical lens. It is argued that the Cambridgeshire village colleges do have some attributes of associative democracy, particularly their original emphasis as sites of local democracy and participation from voluntary bodies and private individuals. How- ever, Morris's role as Cambridgeshire's Chief Education Officer (1922–1954) meant that the local state (in the guise of the County Council) played a more significant role in the village colleges than Hirst advocates for his version of associative democracy. As English primary and secondary schools turn from local authority control to academy status, Morris's vision for local schools of and for local people is becoming increasingly compromised. The article ends with the work of Allen and Gann, both influenced by Morris, who argue for a revitalised form of comprehensive schooling and lifelong learning that again sees educational institutions as sites of grassroots democracy. ; publisher will not permit final published pdf to be used - do you have a previous version, eg after review but before publisher formatting applied? RVO 29/4/20 File supplied 29/4/20

1. Introduction -- 2. Introducing the 'field' : the ethnographic setting of the research -- 3, The formation of the Kadazan : ethnic identities in precolonial, colonial and early postcolonial Sabah -- 4. The Dusunic peoples and Malaysian nation-building (1967-present) -- 5. Self and other : collective identities between citizenship rights and illegal immigration -- 6. Media and belonging to the nation -- 7. The constitution of village belonging through leisure sociality -- 8. A tale of two celebrations : the Pesta Kaamatan as a site of struggle between the Dusunic peoples and the state -- 9. Conclusion.