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On-line version ISSN 2304-8557
Print version ISSN 0023-270X

Koers (Online) vol.77 n.1 Pretoria  2012




Competence development as normative practice - Educational reform in medicine as heuristic model to relate worldview and education


Bevoegdheidsontwikkeling as normatiewe praktyk - Onderwyshervorming in die geneeskunde as heuristiese model om werklikheidsbeskouing met onderwys in verband te bring



Gerrit Glas

Faculty of Philosophy, Vrije Universiteit, The Netherlands





In this article, a Normative Practice Model (NPM) for education was developed. Two hypotheses guided this article: (1) the presupposition that developments in medical education are relevant for education in general and (2) the idea that medical education, just as education in general, can be interpreted as a normative practice. The Normative Practice Model was initially designed for medicine. This original version attempted to clarify why norms and values are intrinsic to medical practice, what these norms and values are, and how they are related. This article introduced the recent reform of medical specialist training programmes in the Netherlands as a case study for application of the Normative Practice Model to education. This reform elucidates how and why norms and values are intrinsic to medical education. The Normative Practice Model offers a global framework that enables one to locate and evaluate the relative contribution of each of the norms and values. By doing so the model also gives an answer to the more general question of whether and how worldview and education are connected. It appears that in highly technical and specialised practices such as medicine, the concept of competence is used as bridge between valued-laden motivations and attitudes on the one hand and measurable performance on the other hand. In this article it was argued that thinking about competences in the context of normative practices helps to elucidate the relationship between worldview and education.


In hierdie artikel is 'n normatiewe praktyk-model (NPM) vir die onderwys ontwikkel. Twee hipoteses het hierdie artikel gelei: (1) dat die ontwikkelinge in die mediese onderwys relevant vir onderwys in die algemeen is en (2) dat mediese onderwys, net soos algemene onderwys, as 'n normatiewe praktyk geïnterpreteer kan word. Die normatiewe praktyk-model is aanvanklik vir geneeskunde ontwerp. Hierdie oorspronklike weergawe het probeer om te verduidelik hoekom waardes en norme intrinsiek aan die mediese praktyk is, wat hierdie norme en waardes is en hoe hulle met mekaar verband hou. Die artikel stel die onlangse hervorming van opleidingsprogramme vir mediese spesialiste in Nederland as 'n gevallestudie vir die toepassing van die normatiewe praktyk-model in die onderwys. Hierdie hervorming belig hoe en waarom norme en waardes intrinsiek aan mediese onderwys is. Die normatiewe praktyk-model bied 'n globale raamwerk wat 'n persoon in staat stel om die relatiewe bydrae van elk van die waardes en norme op te spoor en te evalueer. Deur dit te doen, bied die model ook 'n antwoord op die meer algemene vraag of en hoe wêreldbeskouing en die onderwys verwant is. Dit blyk dat in hoogs tegniese en gespesialiseerde praktyke soos geneeskunde die bevoegdheid-konsep as brug tussen waarde-belaaide motivering en houdings aan die een kant en meetbare prestasie aan die ander kant dien. In hierdie artikel is geargumenteer dat nadenke oor bevoegdheid in die konteks van normatiewe praktyke help om die verhouding tussen werklikheidsbeskouing en die onderwys toe te lig.



Full text available only in PDF format.



Competing interests

The author declares that he has no financial or personal relationship(s) which may have inappropriately influenced him in writing this article.



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Gerrit Glas
De Boelelaan 1105
1081 HV Amsterdam
The Netherlands

Received: 18 Mar. 2012
Accepted: 13 Sept. 2012
Published: [to be confirmed]

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