Sociomateriality in medical practice and learning: attuning to what matters
Sociomateriality in medical practice and learning: attuning to what matters
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DOI：
10.1111/medu.12295
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发表时间：
2014-01-01
影响因子：
6
通讯作者：
Fenwick, Tara
中科院分区：
文献类型：
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作者：
Fenwick, Tara
背景在当前关于专业实践和教育的争论中，越来越强调将学习理解为持续参与的过程，而不是获取知识和技能的过程。然而，尽管这种社会文化观点重要且有用，但在基于实践的学习研究中出现了一些问题，这些问题指向某些疏忽。方法这里描述了三个问题：（i）在学习问题中对物质性（物体、技术、自然等）的重要性的关注有限； （ii）以人为中心的实践观没有注意到社会和物质力量之间的关系，以及（iii）基于证据的标准化模型的理想与临床实践的社会物质偶然性之间的冲突。讨论这里认为，实践和学习的社会物质方法为医学教育提供了重要的见解。这种观点与日常生活物质性的不断发展的研究领域是一致的，该领域涵盖了广泛的理论家族，这些理论只能在这篇简短的论文中简要提及。他们共同的主要前提是社会和物质力量、文化、自然和技术都融入到日常实践中。物体和人类以相互改变其特征和活动的方式相互作用。医学实践研究的例子表明，材料如何积极影响临床实践，学习本身如何成为一个物质问题，协议实际上如何是暂时的社会物质成就，以及实践如何形成独特且有时相互冲突的社会物质世界，对同一事物有不同的诊断和治疗方法。结论本次讨论的结论是对实践中学习的影响。我们需要从强调获取知识转向更明智地参与特定情况。这个重点是学习如何适应微小的物质波动和意外，如何跟踪自己和他人对行动内的影响和新出现的影响，以及如何即兴解决方案。讨论讨论中文章中提出的想法
ContextIn current debates about professional practice and education, increasing emphasis is placed on understanding learning as a process of ongoing participation rather than one of acquiring knowledge and skills. However, although this socio-cultural view is important and useful, issues have emerged in studies of practice-based learning that point to certain oversights.MethodsThree issues are described here: (i) the limited attention paid to the importance of materiality - objects, technologies, nature, etc. - in questions of learning; (ii) the human-centric view of practice that fails to note the relations among social and material forces, and (iii) the conflicts between ideals of evidence-based standardised models and the sociomaterial contingencies of clinical practice.DiscussionIt is argued here that a socio-material approach to practice and learning offers important insights for medical education. This view is in line with a growing field of research in the materiality of everyday life, which embraces wide-ranging families of theory that can be only briefly mentioned in this short paper. The main premise they share is that social and material forces, culture, nature and technology, are enmeshed in everyday practice. Objects and humans act upon one another in ways that mutually transform their characteristics and activity. Examples from research in medical practice show how materials actively influence clinical practice, how learning itself is a material matter, how protocols are in fact temporary sociomaterial achievements, and how practices form unique and sometimes conflicting sociomaterial worlds, with diverse diagnostic and treatment approaches for the same thing.ConclusionsThis discussion concludes with implications for learning in practice. What is required is a shift from an emphasis on acquiring knowledge to participating more wisely in particular situations. This focus is on learning how to attune to minor material fluctuations and surprises, how to track one's own and others' effects on intra-actions' and emerging effects, and how to improvise solutions.Discuss ideas arising from the article at discuss'