Applied Philosophy for Health Professions Education: A Journey Towards Mutual Understanding

Foreword
Preface
Contents
Abbreviations
1 Philosophy as Praxis
References
2 Philosophy of Education: Towards a Practical Philosophy of Educational Practice
2.1 Introduction
2.2 Philosophy and Education
2.2.1 Plato and Aristotle on Education
2.2.2 Rousseau and Kant on Education
2.2.3 Dewey on Education
2.3 The Rise of Philosophy of Education
2.3.1 Pestalozzi, Herbart, and a Practice-Based School Pedagogy
2.3.2 The 20th Century and the Rise of Philosophy of Education
2.3.3 The Intellectual ‘Home’: Discipline or Educational Practice?
2.3.4 Pedagogy as Part of the Humanities
2.4 Philosophy of Education as a Theory of Practice: Meirieu’s View
2.4.1 Meirieu’s Pedagogy as a Map
2.4.2 A Situated Philosophy
2.5 Some Final Remarks on the Similarities Between the Healthcare and Educational Professions
References
3 Subjectification in Health Professions Education: Why We Should Look Beyond the Idea of Professional Identity Formation
3.1 Introduction
3.2 Consensus About PIF in Health Professions Education
3.3 Three Domains of Educational Purpose
3.4 Professional Identity Formation and Subjectification
3.4.1 PIF as a Psychological Concept Versus Subjectification as a Philosophical Concept
3.4.2 PIF as Socialisation Versus Subjectification as Different from Socialisation
3.4.3 PIF’s Third Person Perspective Versus Subjectification’s First-Person Perspective
3.5 Conclusion
3.6 Implications for Practice
3.6.1 Implications for Health Professions Education Research
3.6.2 Implications for Health Professions Education Practice
References
4 The Serious Healer: Developing an Ethic of Ambiguity Within Health Professions Education
4.1 Introduction
4.2 Tensions Between Ambiguity and Certainty
4.3 Ambiguity Within Health Professions Education
4.4 Simone de Beauvoir and Ambiguity
4.4.1 The Game of Being Serious: The Serious Healer
4.4.2 The Nihilistic Healer
4.4.3 The Adventurous Healer
4.4.4 The Passionate Healer
4.4.5 The Genuinely Free Healer
4.5 Towards a Pedagogy of Ambiguity Within Health Professions Education
4.5.1 Start with Yourself
4.5.2 Acknowledge Ambiguity
4.5.3 Start Early
4.5.4 Connect Embracing Ambiguity and Ethical Action
4.5.5 Focus Action on the Needs and Freedom of Patients
4.6 Conclusion
References
5 Acknowledgement: The Antidote to Skillification (of Empathy) in Health Professions Education
5.1 Introduction: Empathy and Education
5.2 Skillification
5.3 Acknowledgement
5.4 Conclusion
References
6 Tracing Philosophical Shifts in Health Professions Assessment
6.1 Introduction
6.2 Overview
6.3 Example 1: The Formative Versus Summative Admonition
6.4 Example 2: The Shifts to and in Programmatic Assessment
6.5 Example 3: The Shifted Role of Assessors in Assessment
6.6 Example 4: From Classical Test to Generalizability Theory
6.7 Example 5: Shifting Configurations in Validity
6.8 Discussion
6.9 Conclusion
References
7 The Significance of the Body in Health Professions Education
7.1 Introduction
7.2 What Is the Body?
7.3 How Do We Perceive Our Body as Self? The Symbolic Discourse of the Body
7.4 Ownership and Disownership of the Body
7.5 The Scientific Discourse of the Body
7.6 Blurred Boundaries—Buying Bodies
7.7 The Feminist Body
7.8 Sexual Bodies
7.8.1 Sex
7.8.2 Gender
7.8.3 Sexuality
7.8.4 Implications for Health
7.9 The Hidden Curriculum of the Body
7.10 Conclusion
References
8 The Philosophy of Education: Freire’s Critical Pedagogy
8.1 Introduction
8.2 Banking Models and Industrialised Education
8.3 Relevance to Medical Education
8.4 Rejecting Banking Models
8.5 Raising Critical Consciousness in Medicine
8.6 Case Study: Enacting a Critical Pedagogy Within Undergraduate GP Teaching
8.6.1 Integrating GP Work into Existing Knowledge of Clinical Practice
8.6.2 External Integration: Moving Past Positivist Bank Deposits
8.6.3 Education in Dialogue
8.6.4 Staying Authentic to Clinical Practice
8.6.5 Risk-Taking Educational Practice
8.6.6 Pedagogy as Activism
8.6.7 Knowledge and Power
8.6.8 Knowledge as Generative
8.6.9 Knowledge as Shared
8.6.10 Knowledge as Interactive
8.6.11 Knowledge as Co-constructed
8.6.12 Knowledge as Goal-Oriented
8.6.13 A Coherent Critical Pedagogy
8.7 Developing a Critical Pedagogy
8.7.1 Potential Problem-Posing Interventions
8.8 Limitations and Future Directions
8.9 Positionality
8.10 Conclusion
References
9 The Philosophy of Social Justice: Lessons for Achieving Progress in Health Professions Education Through Meaningful Inclusion
9.1 Introduction: What is Social Justice, and Why Does It Matter?
9.2 Structure and Reflexive Notes
9.3 Social Justice in Anti-racist Practice: Raimond Gaita’s Common Humanity as a Basis for Real World Equity and Compassionate Justice
9.3.1 The ‘Issue’/Injustice
9.3.2 The Philosophy: A Common Humanity (Gaita)
9.3.3 Case Study 1, Revisited
9.4 Beyond the Straight Male Norm: Social Justice for Women/Non-binary People and the LGBTQIA+ Community with Considerations About Androcentrism from Simone de Beauvoir’s Theories
9.4.1 The ‘Issue’/Injustice
9.4.2 The Philosophy, Androcentrism (de Beauvoir)
9.4.3 Case Study 2, Revisited
9.5 Social Justice in Widening Participation and Access: The Capability Approach to Rethink Outreach
9.5.1 The ‘Issue’/Injustice
9.5.2 The Philosophy, the Capability Approach (Sen)
9.5.3 Case Study 3, Revisited
9.6 Conclusion
References
10 The Future of Healthcare is Feminist: Philosophical Feminism in Health Professions Education
10.1 Introduction
10.2 Philosophical Feminism: Feminist Thought and Practice
10.3 Key Terms: Gender and Intersectionality
10.4 Gender Inequality and Bias in Healthcare and Professions
10.5 Reclaiming Health: Gender and Agency
10.6 Ethics of Care, Vulnerability, and Interdependence
10.7 Conclusion
References
11 The Philosophy of Agency: Agency as a Protective Mechanism Against Clinical Trainees’ Moral Injury
11.1 Introduction
11.2 Case Presentation
11.3 Agency Amidst Constraints: Normative Ethics and Postmodernism
11.3.1 Consequentialist Normative Ethics: The Problem of Resource-Bounded Agents
11.3.2 Postmodern Philosophy: The Prison-House-of-Language
11.4 A Sense of Agency: Phenomenology
11.4.1 Intentional Binding: Linking Intent and Outcome
11.4.2 Purposiveness: Characterizing Action
11.4.3 A Sense of Control: Global Planning, Local Planning, and Sensorimotor Representation
11.5 Conclusion
References
12 “What Does It Mean to Be?”: Ontology and Responsibility in Health Professions Education
12.1 Introduction
12.2 What Is Ontology?
12.2.1 Responsibility as Ontology
12.2.2 The Ontological Approaches of Heidegger, Latour, and Barad
12.3 Future Directions for Expanding Ontology in Medical Education
12.4 Conclusion
References
13 The Philosophy of Science: An Overview
13.1 Introduction to the Context of Health Professions Education
13.2 What Is the ‘Philosophy of Science’ and Why Is It Important?
13.3 Understanding Research Paradigms
13.3.1 A Closer Look at Ontology, Epistemology and Methodology
13.3.2 Overview of Philosophical Stances Within Research
13.3.3 Positivism
13.3.4 Post-positivism
13.3.5 Constructivism
13.3.6 Critical Theory
13.4 Where Are We Now and Where Do We Need to Be?
13.5 Complexity of Choosing and Explaining Our Philosophical Perspective: An Example
13.6 Conclusion
References
14 Tensions Between Individualism and Holism: A Philosophy of Social Science Perspective
14.1 Introduction: Health Professions Education as a Social Science
14.2 Workplace-Based Learning: Case Studies
14.3 Individualism and Holism in the Philosophy of Social Sciences
14.4 Differences Between Conceptualising Students Within HPE as Individuals and Students as Part of Interprofessional Teams
14.5 Social Phenomena, Intentions, and Collective Action
14.6 Conclusion
References
15 Ethics Education in the Health Professions
15.1 Introduction
15.2 The Structure of Human Action
15.3 Rules in Ethics
15.3.1 History Matters
15.3.2 Knowledge and Perspective Taking
15.3.3 Patient as Person
15.4 Outcomes in Ethics
15.5 A Virtue-Focused Ethic
15.5.1 The Five Keys to Virtue Education in the Health Professions
15.6 Conclusion
References
16 Climate Change and Health Care Education
16.1 Introduction: An Overview of Medical Ethics Education
16.1.1 History of Medical Ethics
16.1.2 Modern Day Medical Ethics—Theory
16.1.3 Modern Day Medical Ethics—Instruction
16.1.4 Modern Day Medical Ethics—Content
16.2 Models of Climate Change Ethics in Medical Education
16.2.1 Climate Change Ethics in UK Medical Education
16.2.2 Climate Change Ethics in US Health Professional Education
16.3 Practice Points: Implementing Climate Ethics in Health Professions Education
16.3.1 Opportunities
16.3.2 Challenges
16.4 Conclusion: A Call to Include Climate Change Ethics in All Health Professions Education
References
17 The Philosophy of Technology: On Medicine’s Technological Enframing
17.1 Introduction: Questioning Medical Technology
17.2 Art, Science, or Technology?
17.3 Lessons from the Philosophy of Technology
17.3.1 Heidegger’s Question Concerning Technology
17.3.2 Feenberg’s Critical Theory of Technology
17.3.3 Dewey’s Pragmatist Philosophy of Technology
17.4 Conclusion: Technology and the Practical Art of Medicine
17.4.1 Technology as a Way of Thinking
17.4.2 Technology as Value-Laden
17.4.3 Technology as a Continuum of Means and Ends
References
18 Philosophy as Therapy: Rebalancing Technology and Care in Health Professions Education
18.1 Introduction: Contradictions in 21st Century Health ‘Care’
18.2 Historical Precedents
18.3 What Is Hermeneutics?
18.4 Applying Hermeneutics
18.5 Language
18.6 Hermeneutic Reflections on the Language of Care on Health, Illness, Healing and Implications for Care
18.7 Philosophy as a Technology of Care
18.8 Implications for Health Professions Education
18.9 Caveats on a Hermeneutics of Care
18.10 Conclusion
References
19 Is Social Media Changing How We Become Healthcare Professionals? Reflections from SoMe Practitioners
19.1 Introduction
19.2 What Is SoMe?
19.3 What Is Professional Identity Formation?
19.4 Where SoMe and PIF Meet
19.5 #MedTwitter: A New, Virtual Community Of Practice?
19.5.1 What Are Communities of Practice?
19.5.2 #MedTwitter and Two Medics, One Mic: A Case Study
19.5.3 Is #MedTwitter a Community of Practice?: Discussion
19.5.4 #MedTwitter as a Community of Practice: Mapping a Learner’s Journey
19.6 Engaging in SoMe
19.6.1 Critical Engagement in SoMe: Our Exploration of Hierarchies as an Illustrative Example
19.7 Concluding Thoughts
References
20 Phronesis in Medical Practice: The Will and the Skill Needed to Do the Right Thing
20.1 Introduction
20.2 Why Doctors Need Practical Wisdom in Their Everyday Practice
20.3 The Crucial Virtues and Moral Skills Practical Wisdom Demands
20.3.1 Virtues
20.3.2 Moral Skills
20.4 What’s up with the Tattoo? An Illustrative Case
20.5 Designing for Wisdom
20.5.1 Wisdom-Generating Design Elements
20.6 Conclusion
References
21 In Pursuit of Time: An Inquiry into Kairos and Reflection in Medical Practice and Health Professions Education
21.1 Introduction
21.2 Experiencing Time
21.3 Chronos and Kairos
21.4 Walter Benjamin
21.5 A Boy in Berlin—A Man in Paris
21.6 Historicism
21.7 Opportunities in Medical Practice and Health Professions Education
21.8 Conclusion
References
22 The Application of Stoicism to Health Professions Education
22.1 Introduction
22.2 What is Stoicism?
22.2.1 History and Background
22.3 Core Tenants of the Philosophy
22.3.1 Dichotomy of Control
22.3.2 Therapy of Emotions
22.3.3 The Virtues
22.3.4 Moral Development and Cosmopolitanism
22.3.5 Theory of Happiness and Eudaimonia
22.3.6 Worldview
22.4 Stoicism Within Health Professions Education
22.4.1 How Has Stoicism Influenced Health Professions Education?
22.4.2 How Could Stoicism Influence Health Professions Education?
22.4.3 Stoic Research Tools
22.5 Practice Points
22.6 Conclusion
References
23 Teaching Dignity in the Health Professions
23.1 Introduction
23.2 Story-Telling Animals
23.3 The Concept of Dignity
23.4 Murky Concepts and Getting Things Right
23.5 Non-Standard Cases and Spaces
23.5.1 Lesson One: Retaining Dignity
23.5.2 Lesson Two: Undignified Treatments
23.5.3 Lesson Three: Recognition
23.6 The Unifying Ethics of Dignity
23.7 Conclusion
References
24 The Ambiguities of Humility: A Conceptual and Historical Exploration in the Context of Health Professions Education
24.1 Introduction
24.1.1 The Ambiguities of Humility
24.2 Current Perspectives on Humility: A Grounding
24.3 Historical Explorations of the Humility Concept
24.3.1 Classic Greek
24.3.2 Christian Philosophy
24.3.3 The Enlightenment
24.4 Contemporary Accounts of Humility
24.5 Humility and Health Professions Practice and Education
24.6 Moving Forward
24.7 Conclusion
References
25 Concluding Remarks
25.1 Our Practice Points