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Wednesday, 27 July 2011

Turning a jungle path into an urban street

I've been labelling each paragraph of my thesis with a claim, hoping that it might help to organise the narrative. My thanks go to Thomas Basboll for sharing his insights on this. At the moment, the first few chapters reads like a journey along a roughly cleared jungle path rather than a well-mapped trip along well-lit streets, which is more the aim. So, the challenge is to get from this

 
and this 
to this
  
and this
  

While staking the claims for each paragraph seems simple enough, it is rather painstaking and leads rapidly to boredom in a thesis of some 80,000 words. However, I am starting to see how the path has been constructed so far and how I can improve on it.

Monday, 25 July 2011

Applying Dasein to workplace learning

Dasein is based on the idea that we understand our world through the way we interact with it, as a world of purposes and underlying mood, in which we are usually absorbed in coping. Care is an overarching theme of human existence. This means that we cannot help but care, and even when we profess not to care it implies caring. Our engagement with living and the meaning of such engagement is predicated on care.

Work is a special kind of activity, because it involves engagement with predefined practices - 'the way we do things here'. This sets up and limits the space of possibilities that an understanding Dasein faces. For example, when a qualified nurse encounters a change in a patient's condition she/he can autonomously amend the care plan and give instructions to the team accordingly. A health care assistant encountering the same situation would have a different space of possibilities, which is likely to include reporting the change to the responsible nurse and then taking instructions from the nurse as to the required changes in care. In a workplace, then, individuals interpret situations depending on their work role or identity and their capacity to act.

The reason why Dasein is a useful frame for understanding workplace learning is at least fourfold:
  1. If we are to accept that 'doing nursing' and 'being a nurse' are part and parcel of the same thing, knowledge is nothing without the familiarity with practice. It calls for a practice epistemology that questions any preoccupation with transfer of knowledge from mentor to student.
  2. Skill teaching and skill learning are fundamental aspects of workplace learning. However, most skill is tacitly employed, in what Heidegger called 'ready-to-hand' absorption in practice.Reading a patient's body language and noticing that their dosage of pain medication is overly conservative might happen in an instant, but unpicking the knowledge involved might be impossible. However, there in the moment, the nurse inteprets subtle changes in the patients' appearance and being familiar with the normal doses of analgesia and perhaps having been involved in previous conversations about the patient and knowing the prescribing doctor was quite junior, makes the connection. How can we understand this better to help mentors support learning?
  3. When we talk about practice, we are representing it in some way. Talk, as an existential feature of Dasein, could be the 'idle talk' of the inauthentic Dasein using language as a signification of what is happening. For example, the nurse might say the patient is in pain and needs more medication, but that is idle talk,which glosses over the lived experience of knowing and interpreting the situation.However, we are also dependent on language as a sense-making device. Can awareness of the use and role of language in practice help mentors to sharpen their educational practices?
  4. Practice and equipment are joined in meaning making. The syringe driver delivering analgesia to an epidural catheter is full of meaning in terms of the patient's pain control, the risks of the procedure, knowing what to do if the machine alarm sounds, and so on. The same equipment on the shelf of the storage cupboard is devoid of such situational meanings and is seen as a very poor substitute in terms of teaching potential. Moreover, the patient's body as part of the practice situation, brings further parameters that impinge on the space of possibility for the nurse. Understanding practice situations as having certain existential possibilities could be a fruitful line of thought.
What I said earlier about the differences between a nurse and a health care assistant is also important when debating the merits or otherwise of student nurses learning practice by working alongside health care assistants.