I was invited to speak at the 2a Conferencia Internacional de Inovacao em Saude Natal, Brasil Oct 30-Nov 1, 2018. Here’s portions of the paper I wrote (and sorry – not sure how to get the imported end notes to line up):
1.2 Constructivism and Digital 21st Century Learning
If any set of factors has fuelled the shift in traditional teaching and learning, it was the tandem rise of digital technologies and the emergence of constructivist learning models.[i] These did not arise in parallel. Constructivism was a central topic in adult learning as early as the late 1980s.[ii] However, it appears that digital teaching and learning, especially as it evolved in the remix culture of the mid-2000s, needed a theoretical basis to rest on.[iii] Constructivism fit the bill.
Constructivist learning is defined as learners making their own meaning individually and socially about what they are learning.[iv] It is also a philosophical stance about the nature of knowing, denying the absolute nature of knowledge, and placing it into relative perspective vis a vis other positions of knowing. At its extreme, this requires an educator to abandon any notion of an objective reality.[v] The product of a learner’s work is less about some objective finding, and more about their meaning-making about their finding. Knowledge is (socially) constructed and can be evaluated on a continuum of relativity, rather than perceived as objective facts. This is problematic for the hard sciences but less so for the social sciences and humanities. The science and culture wars that continue to rage are beyond my scope here, however, the unwary educator (or doctoral candidate preparing for defence) is well-advised to become conversant with the challenges posed by accepting or rejecting constructivism wholesale, especially at this point in history.[vi] [vii]
220.127.116.11 Health Education and Constructivism
Health education tends to bridge the worlds of science and social science. We are necessarily grounded in the Real[viii] and often prefer pragmatics over epistemological debate. The nurse in a psychiatry ward may be more interested in the practicality of administering an anti-psychotic to a violent patient than contemplating the consensual social construction of reality that the patient was not, at that time, participating in.
Heffernan[ix] discusses the notion of symbolic representation in the Web 2.0 environment. This environment, as noted below, is one of a constant shifting of symbolic representation, and a constant remixing of content. Grounded in a process of constant meaning re-making, today’s news image is tomorrow’s meme. Today’s innovative learning process is tomorrow’s faux pas or educational fad.[x] Grounding a learning theory in this context is inherently problematic for health education. Nearly every health discipline runs into an immovable problem that constructivist thought cannot manage – the body.
Different from fields where social contexts and meaning are in the foreground, health education needs always to return to the source of its ontology, the physical body. Certainly, it is possible to layer the constructivist agenda on top of the physical. For example, in this way of thinking, a broken arm is not a broken arm. It is, perhaps, representative of risk, or violence. It holds meaning (the broken arm of a child who fell off a bike is different in meaning than the broken arm of a woman experiencing domestic violence.) The health professional trained in the constructivist milieu will see these differences and seek to understand their meanings with and through their patients. However, at one level, a broken arm is a broken arm, regardless of its provenance and regardless of the meaning placed on it by its owner. It is a real, physical condition that requires a certain, prescribed treatment response from the health professional.
Rarely would we argue the pragmatics of the body. Those who espouse the constructivist perspective in teaching health care would agree that the philosophical position of constructivism is less important than meeting their students’ multiplicity of lived experiences and perspectives as they engage with learning how to set a broken arm.[xi]
My points for this section are two – first, that there is a reality that exists independent of our mentalization about reality (this is the so-called ‘scientific realism’ stance and is not without its detractors[xii]) and it demands our attention no less than does the meaning surrounding it; and second, the layers of meaning and experience that seem to be valued by the constructivist position are eventually meaningless representations of representations of representations.[xiii] The arm still needs to be set, and some ways of doing this are, frankly, better than others.
4.1 Reject an Exclusive Reliance on Constructivism
The first is a rejection of constructivism when approaching basic research, and a curtailing of the more radical forms of constructivist pedagogy. Philosophically, we need to be comfortable with having an object of research. For example, when researching any digital technology in learning (for example, AI), we need to focus more on the content and the development of that technology, and less on the experience or meaning of it. These other considerations are important as well, but it is frankly impossible to curate and make meaning from non-existent research because we eschewed content. Another way of saying this is we cannot do constructivist learning until something has been constructed to learn about. Health education needs to return to the production and dissemination of practical knowledge, and place as secondary the notions of meaning and relativity.[i] Otherwise we may find ourselves with a generation of health graduates who will know why they do, but not how to do or what to do.
4.1.1 Practical Implications
Any successful future trend in learning will continue to focus as much on the positivist quest for knowledge, and the development of content, as it will on the generation of meaning and the remixing of content. In spite of calls for integration[ii] future learners may still experience the science-social science divide and the qualitative-quantitative divide in approaches to research. The growth of interdisciplinary studies has been fertile ground on two fronts. The first is the evolution of ‘humanity’ (in the broadest sense) in the sciences. The second has been more heavily loaded on the social sciences, for example, the examination of ethics in health research.[iii] However, successful future learning trends will avoid the nihilism of post-modern constructivism, in favour of (at worst) post-positivist perspectives. The alternative is a descent into parody and spectacle, which does not help us in a post-truth era.[iv]
[i] Kurtz, S., Silverman, J., Benson, J., & Draper, J. (2003). Marrying content and process in clinical method teaching: Enhancing the Calgary-Cambridge guides. Academic Medicine, 78(8), 802-809
[ii] Kukhta, M., Homushku, O., Kornieko, M., & Kutsenko, L. (2015). Experience of integrating humanities and natural sciences into the educational environment. Procedia – Social and Behavioral Sciences, 206 October, 369-373. doi.org/10.1016/j.sbspro.2015.10.067
[iii] Fried, C., Madar, S., & Donley, C. (2003). The biomedical humanities program: Merging humanities and science in a premedical curriculum at Hiram College. Academic Medicine, 78(10), 993-996.
[iv] Hoaxers Slip Breastaurants and Dog-Park Sex Into Journals. New York Times, October 4, 2018, Page A1 under different title. Available: https://www.nytimes.com/2018/10/04/arts/academic-journals-hoax.html
[i] Tedman, R.A., & Tedman, D.K. Introduction to the evolution of teaching and learning paradigms, Ch 1, In Tedman, R.A., & Tedman, D.K. (Eds.) (2007). Evolution of teaching and learning paradigms in intelligent environment, Springer.
[ii] Glaserfield, E.V. (1989). Cognition, construction of knowledge, and teaching. Synthese, 80(1), 121-140.
[iii] For example, see Lessig, L. (2008). Remix: Making art and commerce thrive in the hybrid economy. London: Bloomsbury Academic.
[iv] Glaserfield, E.V. (1989). Cognition, construction of knowledge, and teaching. Synthese, 80(1), 121-140.
[v] Glaserfield, E.V. (1995). Radical constructivism: A way of knowing and learning. London: Falmer Press.
[vi] On the pro-constructivist side, see Golinski, J. (2005). Constructivism and the history of science. Chicago: University of Chicago Press.
[vii] On the anti-constructivist side, see Meyer, D.L. (2009). The poverty of constructivism. Educational Philosophy and Theory, 41(3), 332-341, doi: 10.1111/j.1469-5812.2008.00457.x
[ix] Heffernan, V. (2018). Weimar 2.0: Maybe hyperinflation isn’t just a pox on currency. Wired Magazine, 26(11), 17-18.
[x] See for example Salomon, G. (1998). Novel constructivist learning environments and novel technologies: Some issues to be concerned with. Learning and Instruction, 8(1), 3-12. https://doi.org/10.1016/S0959-4752(98)00007-3 and also Bowers, C.A. (2005) The false promises of constructivist theories of learning: A global and ecological critique. New York: Peter Lang Publishers. For a more detailed critique.
[xi] Colburn, A. (2015). Constructivism: Science education’s “Grand Unifying Theory”. The Clearing House: A Journal of Educational Strategies, Issues and Ideas, 74:1, 9-12, doi: 10.1080/00098655.2000.11478630
[xiii] Or, to revive an old phrase, “it’s turtles all the way down.” https://en.wikipedia.org/wiki/Turtles_all_the_way_down