Thursday 3 December 2015

Educational Technology and the Intersubjectivity of the Anatomical Theatre

I started a new job working in a faculty of health (*but now I can't say where*). I think health is a fascinating and important domain for educational technology. It was the domain which largely drove initial developments in e-portfolio, competency management and simulation, as well as being an important test-ground for pedagogies like PBL (although this has interestingly fallen out-of-favour). In my interview I commented that one of the things that really fascinates me in health is that it has become apparent over the years that "competencies are not enough"; or rather that the bureaucratisation of box-ticking and form-signing has tended to instrumentalise the educational process, leaving much of the important learning beyond assessment schemes (although no doubt it influences outcomes). Maybe that's as it should be, but it does seem that instrumental education is not great either for teachers or learners.

All this made think about how medical education has happened over the centuries. One of the most fascinating educational technologies' in health education is the 'anatomical theatre'. This designed room where students would gather round on steeply banked platforms usually in a circle, where at the centre would be a surgeon demonstrator and a cadaver.

What was going on in this space? What happened in the minds of the students? First and foremost, it was theatre, so perhaps the question is one that relates to questions about what happens to us when we watch a play or television. Except that the groups of students would have been more involved in the action. It would have been hot, intense, probably smelly - there would have been a complex relationship between the demonstrator surgeon and the students and between the students and each other. Each student could look across at each others' reaction. The demonstrator would occasionally look up at the students staring down.

What was going on here is what Alfred Schutz calls 'tuning in' to the inner life of each other. Schutz emphasises the shared experience of time in these kind of intense situations.  Within these 'tuning in' engagements, knowledge would have emerged about the nature of causes and effects within human anatomy: "if I do this, this happens". But it was more than the information about cause and effect; it was the sharing of the experience of activating a cause and experiencing its effect - not just on the body, but on everybody watching.

Coming back to the instrumentalisation of education, the business of theatre and the construction of knowledge about causes and effects has largely been replaced by the simple didacticism of cause and effect. Cause and effect has been stripped of its intersubjective context. And the logical development of this is competency divorced from its social practice and context.

My point in saying this is that there's an opportunity to address this. If we could think back in history and understand the intersubjective relations of the anatomical theatre then we would design our educational technology, and our assessment frameworks differently.  Our current learning technologies make assumptions about knowledge which sit on shaky foundations and which our ancestors possibly had a better grasp of than we do. A bit of history might go a long way in rethinking our current educational practices!


Frances Bell said...

Congratulations on your new post Mark. I hope you have a rewarding time working in this new area. I always valued working with my colleagues in health at Salford and became a friend of Moira McLoughlin. When I was reading what you said about moving away from instrumental approaches in health education, I thought about the approach to social media education taken by ex-colleagues at Salford, Moira and Wendy Sinclair, also influenced by excellent medical educators such as Anne Marie Cunningham.
I came across a re-posting of a blog post by Wendy that captures their non-instrumental approach to Social Media in Health Education so I thought I would share it with you

Mark Johnson said...

Thanks Frances!

Really grateful for the blog post - very interesting!

Best wishes,