Comment: Why South Africa will find it hard to break free from its vicious teaching cycle

There are standards that professionalise teaching and standards that simply manage teachers. While standards which professionalise create cultures of collegiality, expertise and pride among teachers, standards that manage can leave them feeling brow-beaten, untrusted, and demotivated.

Robinson, N. (2019). Why South Africa will find it hard to break free from its vicious teaching cycle. The Conversation.

While the article refers specifically to the primary and secondary teaching context in South Africa, the principles are relevant for a wide range of international higher education and professional contexts as well. The article differentiates between two types of standardisation; professionalisation and management.

Standards that aim to professionalise an activity invariably lead to virtuous cycles. From the article “…teaching [in Finland] is a prestigious and attractive profession which recruits the brightest and most motivated school graduates, who don’t require continual monitoring and oversight. Teachers instead enjoy professional autonomy; they are trusted in key decisions about their teaching and professional development.” You can easily see how this applies to any other profession as well when professionalisation standards are being applied i.e. the standards open up spaces and encourage autonomy as part of trusting relationships.

In contrast, management standards (especially when presented under the pretext of developing professionalism), can lead to vicious cycles. In these situations “…governments take it upon themselves to hold teachers accountable. Standards are used to manage teachers, and to protect students from the worst educators through supervisory surveillance and control. Invariably, the relationship between teacher unions and governments becomes antagonistic and generates feelings of fear and mistrust.” You can see how this could play out in the context of professional organisations tasked with developing cultures of professionalism. Instead of opening up spaces by trusting and supporting people who can make their own choices, organisations may use management standards that aim to close down space and control the people within them.

We need to ask if the standards we’re being asked to meet are aimed at developing cultures of professionalism, or whether they’re simply being used to manage us. One way of determining which standards are being used in your context is to ask how much autonomy you have to make decisions about the work you do.

Introducing the Humanities into physiotherapy education

This post has been modified and published on The Conversation: Africa as Physiotherapy students have much to learn from the humanities.

Selection_018I’m increasingly drawn to the idea of integrating some aspect of the Humanities into undergraduate physiotherapy education. We focus (almost) all of the curriculum on the basic sciences and then the clinical sciences, which has a certain pragmatic appeal but ignores the fact that a person is more than an assemblage of body parts. We spend a lot of time time teaching anatomy and biomechanics (i.e. bodies as machines), and then exploring what we can do to bodies in order to “fix” them. While we pay lip service to the holistic management of the patient, there is little in our curriculum that signals to the student that this is something that we really care about.

“Science is the foundation of an excellent medical education, but a well-rounded humanist is best suited to make the most of that education.”

Empathy is critical to the development of professionalism in medical students, and the humanities – particularly literature – have been touted as an effective tool for increasing student empathy. In addition, there is some evidence that training in the Humanities and liberal arts results in health professionals with improved professionalism and self-care. In other words, health professionals who are exposed to the arts as part of their undergraduate education may demonstrate an increased ability to manage themselves and their patients with more care.

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The relationship between emotion and learning has also been explored, with findings from multiple disciplines supporting the idea that emotion is intimately and inseparably intertwined with cognition in guiding learning, behaviour and decision making. The introduction of the Humanities in health professions education therefore has another potential impact; by using the arts to develop an awareness of emotional response, educators and students may find that exposure to the Humanities might lead to improvements in learning.

As I started looking into these ideas in a bit more detail, I realised that there are several examples of how art and literature are being explored formally by some very prominent medical schools.

dancingwheelsI was disappointed – although not surprised – not to find any good examples of physiotherapy departments who have formally integrated the Humanities into their curricula. However, I did find several papers (all by the same author with various colleagues) that describe a process of integrating these concepts into an undergraduate physiotherapy programme over a period of time, and these are listed in the references below.

avery_hosp_ward_low_resOver the past year or so, I’ve tried to bring some of these ideas into my Professional Ethics module, using the assignments for students to explore the Humanities (art, literature, theatre, music, dance, etc.) as a process of developing a sense of awareness of empathy in the context of clinical education. They can interpret the assignment in any way they want, for example, by writing a poem, drawing a picture, taking a photo, or re-interpreting a song. However, the important part is the reflection that they attach to the piece. Here are some examples of previous student work in this module, without the more personal reflections that accompany them.

  • Eleven hundred hours – poem by a student
  • The mind of the innocent – poem by a student
  • I’ve had two students provide videos of interpretive dance sessions used as methods to try and present an embodied experience of what it might be like to live with a disability.
  • Photovoice assignments (see below for examples): in these assignments students took photos of people and places and then reflected on how those experiences had informed their personal and professional development as ethical practitioners.

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I’m hoping to get some experience with this process as part of these little experiments I’m running in the classroom, and that over time we can start building something more formal into the curriculum. Watch this space.

Additional readings