Myths and social structure: The unbearable necessity of mythology in medical education

Abstract

Context: Myth busting engages scholars in the critical examination of commonly accepted but poorly evidenced claims with the goal of instilling quality and trust in knowledge making. The debunking of such knowledge “myths” and associated misguided practices purportedly serves to avert resources and attention from wasteful and dangerous scholarship. We address the myth that “all myths in medical education deserve to be busted”. Methods: Using a critical narrative approach, we searched the medical education literature for orientations to myths and myth busting, and reviewed this literature analytically drawing from the sociology of science and Merton's concepts of manifest and latent functions. The results of this analysis are presented in the form of a narrative that deploys the articles reviewed to explore the utility of myth busting for medical education reform and begins with a brief exploration of the etymology of “myth” and how meaning making is related to symbols, practices and storytelling. Results: Our analysis revealed the important function of myths in the social practice of medical education and practice. A deconstruction of five salient examples of the contemporary myth in medical education (the myth of the “ideal candidate”, the myth of “cut-throats”, the myth of “cadaver stories”, the myth of “learning styles”, and the myth of “patient information leaflets”) demonstrates that myths continue to have material effects even after they have been busted. Conclusions: Our analysis makes evident that myth busting disrupts, renegotiates and reconstitutes socio-epistemic relationships rather than simply correcting falsehoods. We also argue that myths play important and inescapable roles in the social practice of medical education and the negotiation of values, and in constructing the conditions for group change and transformation. Imperatives related to humanism, compassion and patient engagement offer a healthy humanising counter-mythologising that we suggest must survive any contemporary myth-busting endeavour aimed at improving medical education practice.