Musing on Critical Pedagogy, “care” and Medical Education – Part 1

I am in now in a stage where it seems that all I have been reading so far is not enough in order to write a decent literature review, so I am spending all the available time in full immersions of reading, jumping between several books and articles, following  a rather personal logic that often takes me to more reading and more information to digest. I wonder if I should just stick to a book at the time, being more organised and linear, or this approach is actually the normal result of an iterative reading, non-linear, where the connections with other resources are just part of the process.

Anyway, during the past few weeks I’ve been shifting between 3 books (see references) which made me think about the concept of care and how this is a bridge between education in general, the more specific area of medical education and more broad themes like co-belonging and formation/growth of the human being.

“Medical Education for the Future: Identity, Power and Location”. A particular passage has caught my attention:

“The traditional academic view of medical education as a translation of learning theory into clinical practice is no longer sufficient to help us face the culture of change and uncertainty in which doctors of the future will practice. To rise to the challenge facing medical education and practice for the future, medical educators need to develop a systematic and programmatic approach to research in the field and also to have a clear idea of what it is that they are researching, why they are researching it and what they hope to achieve. Medical educators— researchers, teachers and clinicians—need to look again at what they are doing, why they are doing it and how they can do it better. We argue in this book that all the answers to these questions can and should be found within the care of patients.” (Boldtype is mine)

I can see two big thematics here: one related to the concept of care, which is placed at at the centre of the whole medical education paradigm; and one related to the necessity of grounding medical education research, teaching and clinical practice within the social fabric, in a way that makes them intrinsically connected to the “here and now”. Both these concepts are at the heart of Critical Pedagogy.

Critical pedagogy gives full importance to the historical and social nature of educative process. This means that the educative process should start and be grounded on a critical theory of society, of science and of the subject. The meaning of the term “critic” here is to “explain and interpret the society in order to actively change it” (see Max Horkheimer).

In this sense I think critical pedagogy foundations should be applied to medical education, using a critical approach to research and teaching. This means really embedding these processes into the social environment to get full benefits, which will eventually improve patients care. This is not an innovative thought, in fact while reflecting on this I remembered about Virchow‘s social medicine, which I read about at the university. This 19th century’s German doctor stated that:

“Medicine is a social science, and politics is nothing else but medicine on a large scale. Medicine, as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution: the politician, the practical anthropologist, must find the means for their actual solution… The physicians are the natural attorneys of the poor, and social problems fall to a large extent within their jurisdiction.”

In fact, when he was invited to write a report on a typhus epidemic, he stated that that “the outbreak could not be solved by treating individual patients with drugs or with minor changes in food, housing, or clothing laws, but only through radical action to promote the advancement of an entire population, which could only be achieved by full and unlimited democracy, education, freedom and prosperity”. 5

He is not the only one to connect democracy, education and economy – just to mention some: philosopher and psychologist John Dewey, Economist Amartya Sen and sociologist Antony Giddens – but surely he connects these more explicitly with health. I will explore these connections further for my literature review.

Part 1 ends here, I need to translate some rather confusing itanglish sentences… Part 2 will be more about the concept of care and a wrap-up of both posts… Hopefully I’ll manage to do it tomorrow while travelling, or under the Sardinian sun perhaps!


References (3 and 4 are for Part 2):

1. Bernhard, A. (2006). Pedagogia critica : tendenze di sviluppo e progetti per l ’ avvenire. Collana di Studi Internazionali di Scienze Filosofiche e Pedagogiche Studi pedagogici, (1), 1-24.

2. Bleakley A, Bligh J, Browne J. Medical Education for the Future: Identity, Power and Location. New York: Springer, 2011.

3. Carlgren, I. From Teaching to Learning: The End of Teaching or a Paradigmatic Shift in Teachers’ Work? in Hudson, H & Meyer, M. A. Beyond Fragmentation: Didactics, Learning and Teaching in Europe. BB, 2011.

4. Granese A. Istituzioni di Pedagogia Generale: Principia Educationis. Padova: CEDAM, 2003.

5. Wikipedia