The healthy curriculum (Part 3)
In some ways, it seems like such an obvious idea. But dogmatic beliefs about the nature of professional training; the inherent risk aversion of higher education establishments, which derive so much income from health professional education; and the profession’s own desire to enculturate detachment and objectivity in its students, can create formidable barriers to new ideas, no matter how obvious they may seem.
So is an alternative possible? And if so, what would it look like?
The first thing to say is that I don’t believe you can achieve a healthy curriculum by adapting the current approach to education. You would have to start from scratch, with an entirely different ethos of learning, a different pedagogy, and a different outcome in mind.
But it wouldn’t have to be entirely new, either. There are lots of examples of curricula in other disciplines that are based around students becoming more mindful and deliberate.**
A friend of mine studied fine art at a prestigious art college.
There were three components to the students’ curriculum:
Occasional and infrequent lectures on art theory, art history, and practice, given by lecturers and occasional visiting artists;
Access to technical rooms where students can learn anything from oil painting to 3-D printing and ceramics. These are staffed by practicing artists who act as technicians and advisors;
And weekly meetings with the other people in their study group (usually no more than five), a lecturer, and a practicing artist.
At the start of each semester, all of the students in the year are given the same topic as the theme for their work. This is usually quite a big and expansive contemporary social question, asking them to respond, for instance, to the #metoo movement, urban pollution, or migration.
The student’s task is to find and craft their response.
To do this, they have to choose a medium, booking time with the technician who can help them become more skilled in their chosen medium.
The students have to find a way into the subject and a personal connection.
They have to research extensively to see what other people had done and, in doing so, become part of a community of practice.
And they have to build their ideas over a semester into a portfolio that can be examined at the end.
Each week, their developing ideas are presented for critical review by the other students, their supervising lecturer, and the practicing artist.
And each semester the process repeats, becoming gradually more and more exacting, demanding more and more complexity, and an ever-increasing sense that the student is finding themselves as an artist.
Now, it’s not hard to imagine how this could work in healthcare.
Students would bring their life experiences, and use these to begin exploring the galaxy of options available to them: mental, physical, social, cultural, economic, political, and spiritual approaches, would all be there. The student simply has to choose the direction their passion is leading them in.
One semester it could be physical therapies, the next it could be mindfulness and behavioural therapies.
They would be given a topic: movement, poverty, the end of work, back pain…, and a semester to find their response.
It would be up to them to decide how much theory and technical skill they needed. Resources would be there for them — including technicians, lecturers, and other practicing clinicians — but they would have to decide what they wanted to do.
As the course goes by, the topics, and expectations, would become more complex, such that by the end of their course they might be able to apply for professional registration if they wanted to.
Some students would learn that they love relational caring practices and talk therapies, others might want to do something more hands-on. Some would learn to assess a person’s gait pattern and go on from here to become experts in robotics and motion sensing, others would choose to learn Gestalt psychology.
The key, though, would be that they find themselves. They discover what kind of health professional they wanted to be.
And, as a side-effect of their process of learning, healthcare would get people who were passionate about their practice, trained to be innovative and responsive to the conditions they find themselves in, and hugely self-aware.
This is only one example, and there are many others that could be used, but it is a reminder that educational reform in healthcare is not impossible.
And we should remember that the way we do things today is neither the oldest nor the most ideal way to educate people into health.
There are always other ways.
*In a sad coincidence from last week’s post, the Journal of Philosophy of Education posted a special issue last week on the mental health crisis in education. A reminder, if ever it was needed, of how professional training is losing touch with the health of our students.
**If you haven’t seen it, I can heartily recommend Franziska Trede and Celina McEwen’s excellent Educating the Deliberate Professional: Preparing for future practices. Many of you will know of Franziska through her links with the CPN and her work in physiotherapy education.