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THE POTENTIAL CONTRIBUTIONS OF CLINICAL MEDICINE TO THE STUDYOF CREATIVITY HUGH M. SCOTT, M.D* "Creativity is a Chameleon" This bit ofpotential graffito paraphrases the difficulty in defining this most sought after but most elusive ofhuman characteristics. The questions as to what to include under this heading are legion. For example: "Do the concert pianist and the atomic scientist share a personality trait?" "Was the developer ofthe hula hoop creative?" "Are graphic artists as a group more creative by definition than schoolteachers?" "Finally [and most crucial for this paper], is a physician who encounters a patient for the first time and carries out a plan ofmanagement performing a creative act?" A recent study [i, 2] suggeststhat aconsensus is notlikelytobe achieved in response to these questions and that the responses would probably vary, depending upon the group asked. It therefore behooves anyone writing in this area to clarify his frame ofreference. Three closely related characteristics or concepts need to be considered. These are creativity, innovation, and problem solving. Agreement is certainly not unanimous on how to distinguish between these three. Indeed, the potential for overlap is acknowledged in such phrases as "a creative innovation" or "a unique [innovative] solution to the problem." However , if one reads Gagné's [3, pp. 305-308] discussion of the problemsolving literature one finds a potentially useful distinction. He suggests that in most problem-solving studies the experimenter explicitly or implicitly does the following for the subject: (a) identifies the required terminal performance, that is, states what the problem is; (b) identifies as- * American Heart Association Fellow in Medical Education, Office of Medical Education, Research and Development, Michigan State University, East Lansing. Present address: Department of Medicine, Royal Victoria Hospital, Montreal 1I2, Quebec, Canada. 319 pects ofthe stimulus situation; (c) recalls relevant capabilities (this may be more or less evident in different designs); and (d) channels thinking. In other words, in this situation the problem is known to both subjects and experimenter. The solution is known to the experimenter and the technology to be used is assumed to be known by the subject. Creativity ifstudied in a pure form may be viewed as the inverse ofthis situation. Here the "problem" is known in advance to neither experimenter nor subject. The solution to the problem (desired terminal behavior ) is not known either. The technology appropriate for solution may not even exist at the time the creative act begins. PROBLEM SOLVING CREATVE INNOVATION REQUIRED TECHNOLOGY AVALABLE INNOVATIVE PROBLEM SOLVING CREATIVITY 0-0 l¿_____ IO DEGREE OF EXPLICiTMESS OF PROBLEM Fig. i.—Schematic problem solving-creativity relationship In between these two is innovation. This is a much broader category and includes elements ofboth problem solving and creativity. For example the problem may not be known, but the technology is. This is the sort of activity frequently seen in industry. A new product (e.g., Teflon) is developed and a search begins to find problems to which this product may provide a better solution than those currently in use. Conversely, the problem is known, but the technology for its solution may not be. Thus, with the Apollo Project, it was estimated that 10,000 problems were identified in 1961 that had to be solved before a moon landing could be attempted. This situation is represented graphically in figure 1. By this formulation, true or pure creativity is an extremely rare event in human history. In factjust as a point has no dimension, so pure human creativity does not exist, nor does pure problem solving. In the one case, some piece ofprior experience (technology) is being used even in such a creative act as inventing the wheel. In problem solving, for any given individual, any problem has sufficient uniqueness that he has to discover 320 Hugh M. Scott · Clinical Medicine and Creativity Perspectives in Biology and Medicine · Winter 1971 for himselfat least to some minimal degree rather than recall prior knowledge . How does this formulation agree with some put forward by respected workers in the field? Using Torrence's definition [4, p. 6]: "A process of becoming sensitive to problems, deficiencies, gaps in knowledge, missing elements, disharmonies and so on: identifying the difficulties; searching for solutions, making guesses, or formulating...


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