The craft of generalism clinical skills and attitudes for whole person care

Lynch, Johanna M.; van Driel, Mieke; Meredith, Pamela; Stange, Kurt C.; Getz, Linn; Reeve, Joanne; Miller, William L.; Dowrick, Christopher

Abstract

Rationale, aims and objectives: Generalists manage a broad range of biomedical and biographical knowledge as part of each clinical encounter, often in multiple encounters over time. The sophistication of this broad integrative work is often misunderstood by those schooled in reductionist or constructivist approaches to evidence. There is a need to describe the practical and philosophically robust ways that understanding about the whole person is formed. In this paper we describe first principles of generalist approaches to knowledge formation in clinical practice. We name the Craft of Generalism. Methods: The newly described methodology of Transdisciplinary Generalism is examined by skilled generalist clinicians and translated into skills and attitudes useful for everyday generalist person-centred practice and research. Results: The Craft of Generalism defines the required scope, process, priorities, and knowledge management skills of all generalists seeking to care for the whole person. These principles are Whole Person Scope, Relational Process, Healing Orientation, and Integrative Wisdom. These skills and attitudes are required for whole person care. If any element of these first principles is left out, the resultant knowledge is incomplete and philosophically incoherent. Conclusions: Naming the Craft of Generalism defines the generalist gaze and protects generalism from the colonization of a narrowed medical gaze that excludes all but reductionist evidence or constructivist experience. Defining the Craft of Generalism enables clear teaching of the sophisticated skills and attitudes of the generalist clinician. These philosophically robust principles encourage and defend the use of generalist approaches to knowledge in settings across the community – including health policy, education, and research.

Citation

Lynch, J. M., van Driel, M., Meredith, P., Stange, K. C., Getz, L., Reeve, J., …Dowrick, C. (in press). The craft of generalism clinical skills and attitudes for whole person care. Journal of evaluation in clinical practice, https://doi.org/10.1111/jep.13624

• Journal Article Type: Article
• Acceptance Date: Sep 12, 2021
• Online Publication Date: Oct 15, 2021
• Deposit Date: Apr 2, 2022
• Publicly Available Date: Oct 16, 2022
• Journal: Journal of Evaluation in Clinical Practice
• Print ISSN: 1356-1294
• Electronic ISSN: 1365-2753
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/jep.13624
• Keywords: Complexity; Epistemology; Generalism; Primary care; Whole person
• Public URL: https://hull-repository.worktribe.com/output/3856800