Medical Communication: From Theoretical Model To Practical Exploration. Tao Wang
2.2).3
Figure 2.1 Atlas of types of scientific communication activities.
Source of data: Science and the Public: Mapping Science Communication Activities. Prepared by Research International.2
Figure 2.2 Discipline and media use in science communication activities.
Source of data: Science and the public: Mapping science communication activities. Prepared by Research International.3
The complexity and diversity of science communication activities also exist in the practice of science communication in China. The results of the Chinese Citizens’ Scientific Literacy Survey conducted by the Chinese Association of Science and Technology over the years showed that the public’s access to scientific information is diversified, and the levels of the infrastructure and the science activities of science popularization were also improving steadily. From March to August in 2015, the Chinese Association of Science and Technology launched the ninth sampling survey on the scientific literacy of Chinese citizens, covering 31 provinces, autonomous regions and municipalities directly under the Central Government in the mainland of China. According to the survey published in September 2015 (Table 2.1), the proportion of citizens using the Internet and mobile Internet to obtain scientific and technological information reached 53.4%, which ranked more than twice of 26.6% in 2010, surpassing newspapers (38.5%) and second only to televisions (93.4%). Internet and mobile internet had become the first channel for citizens with scientific quality to obtain scientific and technological information, through which up to 91.2% of them obtained the information. As a traditional mass media, television is still the main channel for citizens to obtain scientific and technological information. The percentage of citizens using TV to obtain scientific and technological information was 93.4%, which was slightly higher than that in 2010 (87.5%), far less than the growth rate of the proportion of citizens accessing the information through the Internet. In terms of popular science facilities, the opportunities had increased in access to scientific knowledge and scientific and technological information through popular science facilities for citizens; also, the utilization rate of popular science facilities had been improved. In the past year, the proportions of citizens visiting all kinds of popular science venues are: science and technology museums (22.7%) and nature museums (22.1%). The proportions of visiting popular science places nearby are: book reading room (34.3%), popular science gallery, or propaganda board (20.7%). Comparing with the data of visiting rate of non-formal science education places in American Science and Engineering Index (2014), the utilization of popular science facilities in China is similar to that in the United States (25% of American citizens visited science and technology museums and other science and technology venues, 28% of them visited nature museums in 2012).
However, it was not clear whether the effectiveness of these scientific communication practices could be regarded as “success”. One of the important reasons was that there was no consensus on the goal of science communication. Therefore, Bruce Lewenstein, Professor of Science Communication at Cornell University, wrote the four common models of scientific communication.4
Table 2.1 The use of public science popularization channels in China in 2005, 2010, and 2015.
1.2.Four different models
1.2.1.Model 1: The deficit model
The deficit model was proposed by John Durant, a Professor of Public Understanding of Science at Imperial College of Science, Technology and Medicine. He was also the Editor-in-Chief of Public Understanding of Science and the first professor of public understanding of science appointed by Royal Society of England. Durant thought that the public was short of scientific literacy and interest in science, so it was necessary to popularize and educate scientific knowledge to the public. In short, the main characteristic of deficit models was the public education by scientists. For example, since the 1970s, the National Science Council of the United States had regularly measured the level of scientific knowledge of the public. The Committee was disappointed to find that only 10% of Americans could define a “molecule”, while more than half believed that humans and dinosaurs were present on Earth at the same time. Based on these findings, the Committee concluded that only 5% of American citizens were scientifically literate and only 20% were interested in science, while others were referred to as “the rest of the population”. The deficit model confirms that when the public’s scientific literacy improves, it will support the development and application of science and technology in the country. Therefore, the early deficit model had a strong government-oriented color.
However, critics of the deficit model believed that this model presupposes some ideas: scientific knowledge was absolutely reliable, playing a supreme role in modern life; scientific knowledge could only flow from top to bottom; the improvement of scientific knowledge level was the only way to solve the problem of public alienating, doubting or even rejecting science, and so on.5 More scholars pointed out that the deficit model did not take context into account. Learning theory shows that only when facts and theories were meaningful in life could people grasp them best. For example, residents in water-polluted areas could quickly grasp complex terminology related to water pollution. Some scholars pointed out that the fatal weakness of the deficit model was that it tried to impose the cognitive model of occupational science onto the public’s understanding of science. Durant himself also realized that the deficit model accused the public of not taking their place in the relationship between science and society, and it also did not realize that the inconsistency between experts and the public in understanding might be due to the redefinition or reestablishment of science in specific contexts. It produced a one-way propagation process between science and the public, which is of no value or even of destruction, so, the public is skeptical about science in the process.
We assumed that the deficit model was applied to medical communication, then it was top-down propaganda of medical knowledge. Just as the deficit model in scientific communication characterized by scientists educating the public, the deficit model in medical communication was characterized by professional medical personnel educating the public. However, if only through education, it was very questionable whether the public was interested and how much they can be accepted. Figuratively speaking, the deficit model was similar to spoon-feeding education in primary and secondary school. I forced the transfer or education of medical knowledge to you in a variety of ways, regardless of whether this method was effective or whether the content was appropriate. Not to mention how effective it was for the public to acquire medical knowledge in this mode. Under the cramming education, even if the public acquired some medical knowledge, he might not understand the knowledge he had acquired very well. Such education is deficient congenitally. Let us take iodine supplementation for example. Iodine is one of the essential trace elements in human body. If iodine deficiency occurs, it may cause abortion, stillbirth, congenital malformation, neuromotor dysfunction in the fetus, hypothyroidism and goiter in the newborn, goiter in the childhood, hypothyroidism, subclinical cretinism, mental retardation and physical development disorder in adolescence, and goiter and its complications, hypothyroidism, and mental retardation in adulthood. If iodine is excessive, it may cause hyperthyroidism and other problems. In China, there are many iodine deficiency areas where iodine needs to be supplemented. Many authoritative media often propagated that the residents of our country should use iodized salt. In the Reform Plan of Salt Industry System, it was also stipulated that the coverage rate of qualified iodized salt should be over 90%. That is the deficit model in medical communication if we do not consider the regional issues of whether all regions are iodine deficiency areas, and the reason why iodine supplement should be used