Kinsella Phronesis As Professional Knowledge
Kinsella Phronesis As Professional Knowledge
PROFESSIONAL PRACTICE AND EDUCATION: A Diversity of Voices Volume 1 Series Editor Allan Pitman University of Western Ontario Professional Practice and Education aims to provide a forum for perspectives of our understanding of the nature of professional practice and the consequences flowing for education in the professions. It is the intention of the Editor that a platform will be provided for contributors from diverse cultural backgrounds, so that, on a global level, the nature of professions and their cultural/historical positioning might be problematised and re-examined.
Edited by
A C.I.P. record for this book is available from the Library of Congress.
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All Rights Reserved 2012 Sense Publishers No part of this work may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording or otherwise, without written permission from the publisher, with the exception of any material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work.
TABLE OF CONTENTS
Acknowledgements 1. Engaging phronesis in professional practice and education Elizabeth Anne Kinsella and Allan Pitman 2. Practical rationality and a recovery of Aristotles phronesis for the professions Frederick S. Ellett, Jr. 3. Practitioner reflection and judgement as phronesis: A continuum of reflection and considerations for phronetic judgement Elizabeth Anne Kinsella 4. Reflective healthcare practice: Claims, phronesis and dialogue Arthur W. Frank 5. Cultivating capacity: Phronesis, learning, and diversity in professional education Kathryn Hibbert 6. Realising practical wisdom from the pursuit of wise practice Joy Higgs 7. Phronesis, aporia, and qualitative research Rob Macklin and Gail Whiteford 8. Phronesis and the practice of science Farrukh Chishtie 9. Reclaiming competence for professional phronesis Derek Sellman 10. Professionalism and professionalisation: Hostile ground for growing phronesis? Allan Pitman 11. Phron sis, experience, and the primacy of praxis Stephen Kemmis 12. Phronesis as professional knowledge: Implications for education and practice Elizabeth Anne Kinsella and Allan Pitman Notes on the contributors Index
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vii 1
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35 53
61 73 87 101 115
131 147
ACKNOWLEDGEMENTS
The editors acknowledge with gratitude the support of the Interdisciplinary Network for Scholarship in Professions Research in Education (INSPiRE), The School of Occupational Therapy, The Faculty of Health Sciences and The Faculty of Education at the University of Western Ontario, Canada, and The Research Institute for Professional Practice, Learning and Education (RIPPLE), Charles Sturt University, Australia. To our contributors for their generosity of spirit in developing the arguments presented in the book and for their responsiveness to our editorial requests we extend our appreciation. Also, we are indebted to Mariko Obokato for untiring and superb editing and for shepherding the manuscript to its final form; this has been a significant contribution to the book. Finally, special thanks to Susan Bidinosti for her assistance, flexibility and attention to detail in integrating the final edits.
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INTRODUCTION
This book originated from a continuing conversation in which we voiced concern (bordering on distress) regarding the instrumentalist values that permeate (often without question) our professional schools, professional practices, and policy decisions. Like others, we were grappling with a sense that something of fundamental importanceof moral significancewas missing in the vision of what it means to be a professional, and in the ensuing educational aims in professional schools and continuing professional education. We are not alone in this concern; numerous social theorists have pointed out that, for more than two centuries, value-rationality has increasingly given way to instrumentalist rationality (Bourdieu, 2004; Flyvbjerg, 2001; Ralston Saul, 1993; Sandywell, 1996; Schn, 1983, 1987). What then are the implications of this trend for professional education and practice? And, what if anything can be done? We wondered whether, at the heart of the issue, might lie significant issues concerning how we conceive of knowledge in the professions. We questioned whether some corrective might be possible, whether something of importance might be recovered, perhaps through Aristotle and his conception of phronesis or practical wisdom. Numerous scholars have called for renewed attention to phronesis through various means, such as a reinvigoration of the concept within the professions; a reconceptualisation of professional knowledge that draws on phronesis; and even a reconceptualisation of social science itself (see, for example, Dunne, 1993, 1999; Eikeland, 2006, 2008; Flaming, 2001; Flyvbjerg, 2001; Frank, 2004; Gadamer, 1980, 1996; Kingwell, 2002; MacIntyre, 1982; Montgomery, 2006; Nussbaum, 2001; Polkinghorne, 2004; Schn, 1983, 1987; Smith, 1999; Stout, 1988; Taylor, 1999; Vanier, 2001). Consideration of these challenges led to the question at the centre of this inquiry: If we take phronesis seriously as an organising framework for professional knowledge, what are the implications for professional education and practice? We took the opportunity to invite a diverse group of interdisciplinary scholars to meet to discuss and debate this question and to formalise their responses in the chapters that comprise this book. Their responses open a multiplicity of understandings as to what is meant by phronesis and how it might be reinterpreted, understood, applied, and extended in a world radically different to that of the progenitor of the term, Aristotle.
E.A. Kinsella, A. Pitman (eds.), Phronesis as Professional Knowledge: Practical Wisdom in the Professions, 111. 2012 Sense Publishers. All rights reserved.
But what is phronesis? Phronesis (phron sis) is generally defined as practical wisdom or knowledge of the proper ends of life. In Aristotles scheme, phronesis is classified as one of several intellectual virtues or excellences of mind (Eikeland, 2008). Aristotle (trans. 1975) distinguished phronesis from the two other intellectual virtues of episteme and techne. In Aristotles conception, drawn below from Flyvbjerg (2001), episteme is characterised as scientific, universal, invariable, context-independent knowledge. The original concept is known today through the terms epistemology and epistemic. Techne is characterised as context-dependent, pragmatic, variable, craft knowledge and is oriented toward practical instrumental rationality governed by a conscious goal. The original concept appears today in terms such as technique, technical, and technology. Phronesis, on the other hand, is an intellectual virtue that implies ethics. It involves deliberation that is based on values, concerned with practical judgement and informed by reflection. It is pragmatic, variable, context-dependent, and oriented toward action. Through the process of developing this book, we have discovered that phronesis is a slippery concept, much more so than we had first anticipated. Rather than offering a neat corrective to instrumentalist rationality, the dialogues in these pages open a range of exciting conversations. This book does not present a tidy interpretation of phronesis. Rather, through the voices of the contributors, a diaspora of meanings is laid open. This is not to say that there are not commonalities between the ideas advanced: rather, the complexity of the search for an understanding of those forms of knowledge that are brought to, and are part of, professional practice has become clearer. The juxtaposition of chapters in this collection opens a space for dialogue and for the expression of divergent perspectives. We found ourselves wondering whether the classic epistemological metaphor of the blind men grasping at pieces of the elephant was inadequate: perhaps we are dealing with multiple elephants! What has emerged is a constellation of ideas that have a common concern related to the nature of professional knowledge. In particular, the concern focuses on what is missing from the official discourse: the practical disjuncture between the knowledge required for practice and professional schools current conceptions of what constitutes legitimate knowledge. Stephen Kemmis refers to this disjuncture as a negative spacea longing for something else that is not currently present (Kemmis, chapter 11, p. 157). The professions are plagued with a theorypractice gap, which seems to be at the centre of this discontent. Our task was to explore the possibilities of a positive space that could respond to this void. Each of the chapters in this collection responds in one way or another to this space, by considering the ways in which phronesis might (or might not) offer a generative possibility for reconsidering the professional knowledge of practitioners.
PHRONESIS IN CONTEMPORARY PROFESSIONAL PRACTICE: EMERGING THREADS AND JUXTAPOSITIONS
We do not live in Aristotles world. Gadamer explained the problem of historicity and interpretation well when he pointed out that we cannot fully understand the critique of a 19th-century critic of Shakespeare, let alone see what Shakespeare
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saw. Similarly, we cannot see the world as Aristotle saw it. At the core of this book is the recognition of the tensions inherent in any project that considers Aristotles ideas in a world vastly different from his. The book opens with Fred Elletts consideration of this topic in some depth. Ellett asks what might legitimately be recovered from Aristotles thought, what must be unequivocally rejected, and what might be modified for contemporary times. Aristotle lived in a world comprised of freemen and slaves. Races were deemed superior or inferior. Men and women were seen to have intrinsically different capacities that precluded women from involvement in serious intellectual work. The world was viewed as stable and eternal. The object of the intellect was to gain knowledge and, through knowledge, wisdom (sophia) and to develop a love for knowledge (philos). Hence, philosophy was the pursuit of the elite: the object was a society ruled by the wise philosopher king. In current times, while we may wish for wise, thinking political leaders, we do so in a fundamentally different social and philosophical world. In this world, in which theoretical work has been differentiated from the practical and technical, and a post-enlightenment framing of science dominates our world view, new understandings of the tentative nature of our law-like claims call into question, for example, the eternal verity of Aristotles episteme. In addition, the social constructions surrounding class, ethnicity, and gender with which we live differ vastly from those taken into consideration in the Athens of Aristotle. This difference has implications for thinking about professional practice in respect to the teleology of the good and of doing the good, as well as for assumptions about what that might mean, about who can take part in the practice, and for whom such practice is intended. The concern here is on two levels: one in which the focus is on phronesis as it relates to professional practice and its practitioners, the other on those engaged in meta-discussions about phronesis itself. Recognition of the social constructions surrounding class, ethnicity, and gender is, it would appear, key to any reconstitution of the notion of phronesis. Indeed, the whole understanding of what is the goodthe teleological objective of the whole exercisemust be reconsidered in light of the different positions and the situatedness of those engaged in professional practices. What cannot be recovered, as Ellett makes clear, is a moral essentialism of humankinds nature, purpose, and function, or a first philosophy that is fixed, timeless, and universally necessary. The naturalness of sexism, classism, and racism is emphatically rejected. We are then talking about an Aristotelian conception of knowledge in a world that Aristotle would scarcely recognise. What, then can be recovered and what must be added to a conception that holds relevance for contemporary times? Ellett argues that four aspects are recoverable in that: (a) phronesis typically involves judgement that is deliberative, typically indeterminate but not calculative; (b) phronesis is a virtue; (c) phronesis typically is an embodied social practice that has internal goods and excellences; and (d) phronesis typically involves complicated interactions between the general and practical. Ellett rejects (a) Aristotles metaphysical biology; (b) Aristotles first philosophy; and (c) recent Grand claims for practical rationality. Finally, he argues, given the centrality of probability in current conceptions of theoretical reason and practical rationality,
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that future conceptions of phronesis, should be worked together with the concept of probability. Phronesis, or the quest for practical wisdom, implies reflection, but what might processes of reflection oriented toward phronesis look like in professional practice? These are questions tackled in various ways by many of the authors in this book (Arthur Frank, Kathy Hibbert, Joy Higgs, Rob Macklin and Gail Whiteford, Derek Sellman, and Stephen Kemmis), but most directly, as a centre point of focus by Elizabeth Anne Kinsella. In thinking about how practitioners might enact phronesis, Kinsella contends that attention to reflection and judgement is key. Informed by the seminal reflective practice work of Donald Schn, Kinsellas work offers an extension. Kinsella proposes a continuum of reflection that informs professional action from (a) receptive or phenomenological reflection, to (b) intentional cognitive reflection, to (c) embodied or tacit reflection, to (d) critical reflexivity. Her analysis acknowledges that reflection can take many forms: it can be deep, interior, emotional, and introspective; it can be intentional and based in reason; it may also be tacit, embodied, and revealed in intelligent action; and, further, it may be used to critically interrogate assumptions about taken-for-granted understandings in professional life. Kinsella contends that the work of Schn provides a basis for an elaboration of thinking about the ways in which practitioners use reflection to make judgements and to inform action. She considers six criteria that might be seen as useful in orientating practitioners toward phronetic or wise judgement in professional practice: pragmatic usefulness, persuasiveness, aesthetic appeal, ethical considerations, transformative potential, and dialogic intersubjectivity. Arthur Frank presents a case for practical wisdom to be discovered in reflective health care practice. His writing shows the power of narrative as a means of reflection and as a means of revealing what phronesis looks like in practice. Franks writing calls for practitioners to reflect enough that maybe, eventually, a kind of practical wisdom will develop that can never be fully articulated ... but is felt as a guiding force (Frank, chapter 4, p. 57). This kind of practical wisdom, according to Frank, is phronesis. His writing moves beyond a linear articulation of what phronesis might be, to capture something more, to actually reveal the aesthetic texture of what phronesis looks like. Frank points out that in health care, practitioners have two choices: to look at the day as a big checklist and dont look back or even around ... as a way of getting through their day (Frank, p. 57), or to engage in reflection. He draws attention to how, in professional practice, reflection often begins with interruption: Reflection interrupts that flow. It is a carved-out space in which we ask ourselves what were doing, and who is doing the things that seem to be getting done (Frank, p. 54). Frank notes multiple claims on the health care practitioner, of which he names six: Practical claims address the expectation of an outcome from the consultation; professional claims that the practitioner will meet the expectations of peers, both institutionally and personally; scientific claims call on practitioners to act according to the science on which their practice is based, or to have very good
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reasons for any deviation (Frank, p. 56); commercial claims act on practitioners as employees, as investors and/or as owners of practices; ethical claims concern standards of practice, respect of patients, etc.; and moral claims call practitioners to moral actions, for example, witnessing the patients suffering. A procedural checklist, he suggests, does little to address these claims; but it does (if set down as a protocol) diminish the responsibility of the practitioner, under the guise of accountability. Arthur Frank calls for a phronesis that involves relationship and a call to witness the patients suffering. His preoccupation with the practitioner as witness and his call to practitioners to respond to patients in the face of their suffering illuminate a relational emphasis in his practical wisdom. Kathy Hibbert also takes up themes of reflection, narrative, and action, to consider what phronesis might offer our thinking about learning and diversity in professional education. Like others, her interest in phronesis began with her concerns about the increasingly instrumentalised contexts of professional practice. Hibbert offers a narrative of an experience that has haunted her and fuelled her interest in this area of scholarship: an era of professional practice where educators disseminate materials and reproduce received training, where information was scripted and delivered in a top-down system (Hibbert, chapter 5, p. 62). About her own experience as a teaching consultant, she writes, I recall feeling that this process of training represented the direct opposite of everything I know about good teaching, and it led to a sense of deprofessionalisation and demoralisation (Hibbert, p. 62), a disheartening digression from a vision of practice that engages practitioners as professionals and intellectuals (Hibbert, p. 62). Like Frank, Hibbert points out that reflection often begins in the disruption of routinised experiences. She argues that routinised experiences can be dangerous and that scrutinising ones actions in practice can influence future actions and decisions oriented toward phronesis. In particular, Hibbert considers how we might cultivate the capacity for phronetic action, drawing on Dewey to argue that phronetic action involves a whole-hearted and open-minded willingness to assume responsibility for ones actions. She agrees with Joseph Dunnes (1993) claim that phronetic action cant exist without both intellectual and moral conditions of the mind (p. 264). This theme linking reflection to moral action and its relationship to phronesis continue to weave explicitly and implicitly throughout the book. Joy Higgs also draws on the power of narrative and Socratic dialogue to reflect, through story, on the nature of phronesis. It has been said that we sometimes need fiction to reveal the truth. In Higgss fictional narrative of a dialogue between Veteratoris (the mentor) and Novitius (the initiate), phronesis is examined in the pursuit of wise practice and the generation of practical knowledge, which Higgs posits as an approach to balance the instrumentalist rationalities that hold pride of place in professional practice. Higgs observes that professional practice is characterised by the absence of certainty. Recognition of the complexity and uncertainty of practice is a theme that permeates this book and is reminiscent of the classic metaphor of the swamp used by Schn to illuminate the nature of practice. Phronesis, it seems, is located in Schns swamp:
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In the varied topography of professional practice, there is a high, hard ground overlooking a swamp. On the high ground, manageable problems lend themselves to solution through the application of research-based theory and technique. In the swampy lowland, messy, confusing problems defy technical solution. (Schn, 1987, p. 3) Higgs contends that practice is the precursor of knowledge. Practitioner observation, reflection, and experience bring together actions and ideas that are enacted in wise practice. For Higgs, wisdom is seen as the ineluctable nexus between practice, judgement, and knowledge (Higgs, chapter 6, p. 81); the hallmark of a professional is the capacity to make sound judgements (Higgs, p.79). In characterising practice knowledge, Higgs depicts it as the sum of the knowledges so used, including propositional as well as experiential knowledge: Here episteme, techne, and phronesis dance together (Higgs, p. 77). Within the spectrum of professional practices, Rob Macklin and Gail Whiteford investigate phronesis and qualitative research, arguing that scientific reason is not an appropriate test for interpretively oriented qualitative research. They define scientific reason in a manner consistent with Aristotles classic conception of episteme and with taken-for-granted views about scientific reasonas informing impartial, universal, and generalisable knowledge that permeates our culture. Macklin and Whiteford argue that while scientific reasoning appropriately underpins quantitative research, a different form of rationalitypractical rationalityis required to undertake and judge the practice of qualitative research. As such, they point out that the practice of qualitative research requires instruction in the practice of practical judgement and a quest for phronesis, as opposed to technical training and a focus on scientific rationality. For Macklin and Whiteford, the dominance of the epistemology of science presents fundamental problems for qualitative researchers. The basis for their position is that the criteria for judging qualitative research are irreducibly different from those of quantitative work. They describe the task of recognition and justification of qualitative research within a culture of science as Herculean; however, it might also be cast as the impossible task of Sisyphus, doomed to spend eternity pushing a block of marble uphill, always to have it roll back down. They argue instead for practical rationality as a more appropriate means for making judgements about qualitative research. Interestingly, a central theme in the work of Macklin and Whiteford, and in other chapters in this book, is the centrality of aporiaunresolvable dilemmas and uncertaintiesas a characteristic of the work of professional practice. Embracing rather than avoiding aporias troubles assumptions about the quest for certainty and the use of episteme alone as the gold standard in professional practice. Professional practitioners draw on relevant epistemological knowledge, but the application of that knowledge calls for a quite different form of knowledge from that of episteme alone, one that embraces the messiness of practice. However, doing so is not to deny the central role of episteme in the practice of a profession (i.e., a physician cannot know what to do without a good grounding in the relevant sciences, and a teacher cannot teach without content knowledge) but rather to point out that
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attention to a different form of knowledge rooted in attention to aporia is also fruitful for effective practice. There are particular assumptions about scientific reason, consistent with Aristotles conception, that permeate Macklin and Whitefords work. Interestingly, the work of philosopher of science Thomas Kuhn (1962) troubles conceptions of scientific reason and therefore of episteme, as impartial, universal, and generalisable. As pointed out by Farrukh Chishtie, scientific reason and the judgements that scientists make require a form of phronesis in and of itself. This tension about the lines between episteme and phronesis, in light of contemporary views of philosophy of science, is an interesting consideration opened up by the authors of this collection. The nature of phronesis within the practice of science becomes a topic of great interest, explored by Chishtie in his consideration of what phronesis might mean in a post-Kuhnian world dominated by science. Kuhns (1962, 1977) view of epistemic values leads to a position whereby the knowledge that constitutes the episteme of a disciplinary community is seen to be legitimated through the exercise of judgement based upon agreed values: the epistemic values of the community. This view constitutes a radical repositioning of the role of judgement within conceptions of scientific knowledge. Not only is judgement exercised on a day-today basis by practitioners but it is also deeply implicated in the generation of the scientific theories and epistemic frameworks upon which professional practice itself is based. Chishtie argues that, as a consequence, phronesis becomes significant not only in individual practice but also to conceptions of episteme itself. In a Kuhnian view, episteme can no longer be unproblematically viewed as universal, context-independent knowledge. The distinctions between episteme and phronesis blur as our understanding of science is challenged. An implication of this, as pointed out by Flyvbjerg (2001) and Chishtie, is that power relations become significant insofar as they contribute to the formation of the episteme and the policing of its boundaries. In light of a Kuhnian view of science, the assumptions that the professions and their governing institutions hold regarding the nature of episteme, and the place of phronetic judgment in scientific practice, become topics for further consideration and investigation. Derek Sellman reminds us that phronesis is Aristotles special virtue, one that straddles cognition and emotion, as well as intellect and character. Phronesis, closely related to wisdom, is the virtue that enables us to judge what it is we should do in any given situation. Sellman points out that the virtue of phronesis has a place in professional life distinguishable from its place in everyday life; he proposes the concept of professional phronimosthe professionally wise practitioneras significant for conceptions of professional competence. Sellmans aim is to reclaim the term competence from those who have commandeered it to describe skills-based learning. For Sellman, competence involves some form of emergent self-awareness or self-revelation. He argues that an expanded understanding of competence, one that includes phronesis, is necessary if practice is to be more than the mere routine application of technically derived protocols or algorithmic responses to the complex issues facing practitioners in
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everyday work environments. According to this view, competence both encompasses those practitioners who transcend purely technical approaches to solving or resolving messy practice situations and begins to operate in ways that cannot be adequately described in technical rational terms. Sellman also highlights the tensions between agency and structure in the quest for phronesis, a theme that resurfaces and is elaborated the chapter by Allan Pitman. In particular the dangers of calls for practitioners to develop phronesis in the absence of any recognition of the role of institutions in encouraging or discouraging such development in individual practitioners are of concern. If the structured constraints of practice are not recognized, practitioners may find themselves caught in an endless cycle of blame related to their incapacity to live according to the characteristics of the phronimosthe professionally wise practitioner. This theme of the structured constraints of practice is elaborated by Allan Pitman in his consideration of the hostile ground for growing phronesis in a time of excessive managerialism and accountability discourses in the professions. Pitman considers the challenges of enacting phronesis, including practical wisdom and professional judgement, in practice contexts in which professionals have numerous and frequently conflicting ruling bodies to which they are held accountable. Professional practice takes place in a social and political context, which is geographically and temporally located. Pitman highlights the situatedness of practice in its institutional and ideological contexts, in an age when discourses of accountability have enveloped professional work. He unpacks assumptions about professional knowledge in the teaching profession to examine the way in which the various accountability mechanisms create tensions for practitioners and potentially work against efforts toward phronesis. Pitman points out that any concern that advocates for a phronetic characterisation of professional practice is located in a dominant discourse of professional practice. As the era of trust in the actions of practitioners has waned, and the financial commitments of governments have grown, so too have arisen discourses of accountability and managerialism, and systems of surveillance. There is a paradox here, reflected in several chapters in this book, that as the mechanisms of professionalisation have been put in place, so too have the levels of prescription increased, thereby circumscribing the capacity of members to act autonomously in situations that demand the exercise of judgement. The danger of calling for phronesis and holding practitioners accountable for practical wisdom in contexts that may not support it, and that may actively mitigate against it, is that practitioners may face a double bind, where they are blamed for a failure of agency at the personal level, when the issues may well be structural and systemic. This underlines the essential need to consider calls for phronesis in light of what Kemmis (2005) has called the extra-individual features of practice, including the social, cultural, material-economic, discursive, political, and policy dimensions. Interestingly, Stephen Kemmis suggests that calls for phronesis might be seen as a response to a lack in the present thinking and discourse about professional practice; that is, a reaction to a disquiet about the realities in which professionals go about their work. He describes this lack as a negative space and suggests that
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phronesis might be seen as a placeholder for the something more that we are looking for in our thinking about the practice of professionals. Kemmis proposes that our longing for phronesis, for wisdom, is really a longing for something elsea longing for praxis. According to Kemmis, Praxis is a particular kind of action. It is action that is morally committed, and oriented and informed by traditions in a field (Kemmis & Smith, 2008, p. 4; emphasis in original); Praxis is the action itself, in all its materiality and with all its effects on and consequences for the cultural-discursive, material-economic, and socialpolitical dimensions of our world in its being and becoming. Praxis emerges in sayings, doings, and relatings (Kemmis, p. 150). Provocatively, Kemmis posits praxis as a prerequisite for phronesis and as the centrepiece of a morally committed practice. He suggests that it is the wrong way around to hope that if we develop phronesis in rising generations of practitioners, then praxis will follow. According to Kemmis, it is through experience and actionthrough praxisthat we develop phronesis; therefore, it is the happeningness of praxis that we must commit ourselves to if we want to learn or develop phron sis (Kemmis, p. 158). He suggests that phronesis as a virtue is evident in the honour and nobility of persons who have committed themselves to praxis as a way of life (Kemmis, p. 158). This raises conceptual tensions worthy of considered attention. One might ask: What is the nature of the relationship between phronesis and praxis? Where does one end and the other begin? Does one precede the other? To what extent are they symbiotic? Is morally committed action enacted through praxis, phronesis, or both? Perhaps at the heart of Kemmiss challenge lie contesting ideas about various types of reflection, action, and moral commitment and the ways in which they are related to and enacted in professional life through phronesis, or praxis, or both. For instance, one might ask whether phronesis implies a kind of knowledge that exists only in the heads of practitioners, a Cartesian kind of intentional reflection, separated from and followed by action; whereas, praxis implies a type of embodied reflection revealed through morally committed doings, sayings, and relating. Where exactly the conceptual lines in these two dimensions lie is subject to debate. In the context of professional practice, phronesis might be oriented slightly more toward morally committed thought, whereas praxis might be oriented slightly more toward morally committed action, but the lines between the two appear uncertain. It appears that both phronesis and praxis are desirable in morally committed practice. This raises issues concerning the various conceptions of both phronesis and praxis; ongoing work to tease out the lines of distinction and the overlap between the two concepts and the implications for professional practice is imperative. It is clear that the writers in this collection hold differing views about these conceptual lines, which have yet to be articulated in a definitive way. The boundaries are blurry! Of further note, Kemmis draws attention not only to individual phronesis, that of the practitioner, but to collective phronesis, the collective good that a professional community commits itself to through its practice as a profession. This notion of collective phronesis, and the implications it opens up for how professions envision
and enact what they do, raises a new area worthy of discussion amongst the epistemic communities of the professions at large.
CONCLUSION
The contributors to this book speak individually and collectively about what a transformed understanding of phronesis might require. The earlier chapters in the book speak about what might be recovered from Aristotles phronesis and offer examples about what phronesis, or practical wisdom, might look like in contemporary practicethrough reflection, professional judgement, phronetic action, narrative, dialogue, ethics, discernment, and relationship. The later chapters in the collection offer more critically oriented perspectives on taken-for-granted notions of phronesis, competence, and the relationship between phronesis, episteme, and praxis. In addition, the contributors discuss questions concerning the tensions between individual agency and the structures of professional practice and the potential constraints or hostile ground for phronesis. Finally, the possibility that phronesis might be enacted in ways that extend beyond the individual, at a collective level, is considered. Rather than offering closure on this topic, the chapters open a dialogue and point to many more questions than answers. We invite readers into this dialogue and confess that we find the chapters in this book far more interesting than we had first imagined: they are purveyors of far more tensions than they reconcile and are filled with the complexity and uncertainty that any practitioner oriented toward phronesis will acknowledge and embrace. We acknowledge that it is important in this consideration not to give the impression that phronesis is privileged at the expense of either episteme or techne. We wish to be explicit in suggesting that we believe all threeepisteme, techne, and phronesisare required for professional practice. The crisis, as we see it, is that episteme and techne are privileged, and the diminishing of phronesis diminishes the work that professionals aspire to do.
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Aristotle (1975). The Nicomachean ethics. Boston: D. Reidel. Bourdieu, P. (2004). Acts of resistance: Against the myths of our times. Cambridge, UK: Polity Press. Dunne, J. (1993). Back to the rough ground: Practical judgment and the lure of technique. Notre Dame, IN: University of Notre Dame Press. Dunne, J. (1999). Virtue, phronesis and learning. In D. Carr & J. Steutel (Eds.), Virtue ethics and moral education (pp. 4959). London: Routledge. Eikeland, O. (2006). Phronesis, Aristotle, and action research. International Journal of Action Research, 2(1), 553. Eikeland, O. (2008). The ways of Aristotle: Aristotlean phronesis, Aristotlean philosophy of dialogue, and action research. Bern, Switzerland: Peter Lang. Flaming, D. (2001). Using phronesis instead of research-based practice as the guiding light for nursing practice. Nursing Philosophy, 2, 251258. Flyvbjerg, B. (2001). Making social science matter: Why social inquiry fails and how it can succeed again. Cambridge, UK: Cambridge University Press. 10
ENGAGING PHRONESIS IN PROFESSIONAL PRACTICE AND EDUCATION Frank, A. (2004). Asking the right question about pain: Narrative and phronesis. Literature and Medicine, 23(2), 209225. Gadamer, H. G. (1980). Practical philosophy as a model of the human sciences, Research in Phenomenology, 9, 7485. Gadamer, H. G. (1996). Truth and method, (2nd rev. ed.). (J. Weinsheimer & D. Marshall, Trans.). New York: Continuum. Kemmis, S. (2005). Knowing practice: Searching for saliences. Pedagogy, Culture and Society, 13, 391426. Kemmis, S., & Smith, T. J. (2008). Personal praxis: Learning from experience. Chapter 2 in S. Kemmis & T. J. Smith (Eds.), Enabling praxis: Challenges for education. Rotterdam: Sense. Kingwell, M. (2002). Practical judgements: Essays in culture, politics, and interpretation. Toronto, ON: University of Toronto Press. Kuhn, T. (1962). The structure of scientific revolutions. Chicago: University of Chicago Press. Kuhn, T. S. (1977). The essential tension: Selected studies in scientific tradition and change. Chicago: University of Chicago Press. MacIntyre, A. C. (1982). After virtue: A study in moral theory. London: Duckworth. Montgomery, K. (2006). How doctors think: Clinical judgement and the practice of medicine. Oxford, UK: Oxford University Press. Nussbaum, M. (2001). The fragility of goodness: Luck and ethics in Greek tragedy and philosophy. Cambridge, UK: Cambridge University Press. Polkinghorne, D. (2004). Techne and phronesis. In Practice and the human sciences: The case for a judgment-based practice of care (pp. 97127). New York: State University of New York. Ralston Saul, J. (1993). Voltaires bastards: The dictatorship of reason in the west. Toronto, ON: Penguin Books. Sandywell, B. (1996). Reflexivity and the crisis of western reason: Logological investigations, (Vol. 1). London: Routledge. Schn, D. (1983). The reflective practitioner. New York: Basic Books. Schn, D. (1987). Educating the reflective practitioner. San Francisco: Jossey-Bass. Smith, R. (1999). Paths of judgement: The revival of practical wisdom. Educational Philosophy and Theory, 31(2), 327340. Stout, J. (1988). Ethics after Babel: The languages of morals and their discontents. Boston: Beacon Press. Taylor, C. (1999). Sources of the self: The making of modern identity. Cambridge, MA: Harvard University Press. Vanier, J. (2001). Made for happiness: Discovering the meaning of life with Aristotle. (K. Spink, Transl.). Toronto, ON: Anansi.
Elizabeth Anne Kinsella Faculty of Health Sciences and Faculty of Education The University of Western Ontario Allan Pitman Faculty of Education The University of Western Ontario
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I. INTRODUCTION
In the Western philosophical tradition, customary practice has been to distinguish theoretical reason, which is concerned to determine what one should believe, from practical reason (or practical rationality), where practical rationality is concerned to determine how one should act. In recent decades, there has been a renewed interest in Aristotles conception of practical rationality, or phronesis. My main task here is to explicate some of the important roles such a (recovered) concept can and should usefully play in the professions. To achieve this task, I begin by briefly characterising the concept of profession. I then briefly set out what can and should be legitimately recovered from Aristotles conception, what cannot be legitimately recovered, and what modifications must reasonably be made to develop a viable conception of practical rationality for the professions. I suggest that practical rationality is best seen as a placeholder term concerned with our being responsible in deciding what to do. Finally, I illustrate how phronesis can and should play a central and important part in professional teaching in Ontario.
II. ON BEING A PROFESSION
I begin by briefly setting out a plausible understanding of what we might, for our purposes here, usefully consider a profession to be. Here I draw freely from the Pitman and Ellett (2008) essay, Professionalism: Its ambiguity in the current [educational] reforms in Ontario. Many of the ideas expressed in the essay have built upon earlier educational works by McPeck and Sanders (1974), Carr and Kemmis (1989), and the early work by Lee Shulmani (1987/2004a). After their review of the literature, McPeck and Sanders (1974) plausibly argued that a profession has four requirements (my emphases): that there exists a specialized literature which forms an intellectual basis for practice; that the occupational group provides a needed social [or public] service as its raison d`tre; that there exists a set of standards designed to ensure, or certify, minimal competence in membership in the group; that there exists a broad range of autonomy both for the individual and for the occupational group to practice according to its own judgment. (p. 64)
E.A. Kinsella, A. Pitman (eds.), Phronesis as Professional Knowledge: Practical Wisdom in the Professions, 1333. 2012 Sense Publishers. All rights reserved.
So, then, these requirements state that the occupational group governs itself in important ways (by deliberating and setting its own ethical and competence standards and its own guidelines for certification and suspension, or expulsion) and that each individual member has autonomy of judgement built upon the bodies of specialised literature (knowledge or understandings) within the space set up by the groups ethical codes and guidelines. Although McPeck and Sanders (1974) held that there must exist a specialized literature which forms an intellectual basis for practice (p. 64), they did very little to explicate or codify what the literature might be for education. Here, Lee Shulmans work can be seen as adding to and drawing out the basic conceptual points for being a professional teacher. Shulman (1987/2004a) was responding in large part to calls for serious, educational reforms in the United States, calls made in the early 1980s about the nations being at risk; he helped lead the way in arguing that, in all these reforms, teachers should be seen as professionals. And he recognised that if one were to see teaching as a profession, then one would need to articulate the intellectual basis for practice, which are the forms of knowledge unique to teaching. Shulman defended several claims. First, he argued (1987/2004a, p. 227) that a good teacher has pedagogical content knowledge, which is a special amalgam of subject-matter content knowledge and pedagogical knowledge. It is the pedagogical content knowledge that is uniquely the province of teachers. Second, he argued (1987/2004a, pp. 232233) that one of the sources of (legitimate) knowledge comes from the wisdom of the practice itself. Although Shulman did not embrace action research in the manner of Carr and Kemmis (1989), he would surely agree with Carr and Kemmis that one of the major sources of best practice is to be found in the ongoing activities (work) of good teachers. Shulman helped lead efforts to study how novice teachers become masterful (or highly competent) teachersii. Finally, and most important for our purposes here, he argued (1987/2004a, pp. 233241) that typical cases of teacher activities involve pedagogical thinking (and reasoning), which should be seen as a kind of practical rationality. Although Shulmans theorising was basically correct in placing a kind of practical rationality at the centre of being a professional teacher, I argue that his views can be significantly enhanced and expanded by incorporating a conception of phronesis.
III. A RECOVERY OF PRACTICAL RATIONALITY AS PHRONESIS
Let me now turn to see what can and should be legitimately recovered from the conception of phronesis set out by Aristotle, what cannot be legitimately recovered, and what modifications need to made to the conception. I argue that one can (and should) legitimately recover four aspects: (1) Phronesis typically involves judgement (which is deliberative, typically indeterminate, but not calculative); (2) Phronesis typically is a virtue; (3) Phronesis typically is an embodied social practice, which has internal goods and excellences; (4) Phronesis typically involves complicated interactions between what is general and what is practical. I argue that one should legitimately reject (1) Aristotles metaphysical biology; (2) Aristotles
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First Philosophy; and (3) (the more recent) Grand claims for practical rationality. Finally, I argue that the conception needs to be modified in major ways to make room for our (much more recent) conception of probability. (So central is probability to our deciding what to do today that some have called probability the guide to life.) I also suggest that practical rationality is an open concept, which can and should function as a placeholder term concerned with our being responsible in deciding how we should act. Before I begin my account of the recovery and modifications of phronesis, let me make two brief remarks. First, please note that interpreting Aristotle is problematic so my remarks should be suitably tentativeiii. Second, as I have noted earlier, customary practice has been to distinguish theoretical reason, which is concerned to determine what one should believe, from practical reason (or practical rationality), which is concerned to determine how one should act. Still, let me caution the reader that almost all of the key terms have been used by different thinkers in different ways to talk about the same phenomenon: determining how one is to act. For example, when speaking about practical rationality, Jeffrey Stout (1990) used the quite common translation term, practical wisdom; when analysing the concept, Max Black (1972) used the term reasonableness; and in his widely read works, Alasdair MacIntyre (1984, 1988) used the term practical rationality. And though John Kekes recovers much from Aristotles views, Kekes (1989, 1995, 2002) used various terms to develop his positions. And one can plausibly argue that Dewey (1938/1997) used the terms freedom and self-control to refer to what others have called practical wisdom. Thus, one needs to be patient in clarifying what is actually being recovered and being argued. The central topic of interest here involves a conception of determining how one should act. Let us begin with a definition from one widely cited and authoritative source, D. D. Runes (1960): Phronesis: practical wisdom, or knowledge of the proper ends of conduct and of the means of attaining them; distinguished by Aristotle from theoretical knowledge or science, and from technical skill. (p. 235) Let us agree that for several thinkers, phronesis is indeed the rational capacity (ability) concerned to determine the proper end(s) of conduct and to determine the proper ends of ones life. I hope it is obvious how determining the proper ends of ones life has serious implications for the proper ends of ones conduct (activities) and ones means (actions) for achieving those ends. Black (1972), Kekes (1989, 1995, 2002), MacIntyre (1984, 1988), and Nussbaum (1986, 1990) are all concerned with the ultimate ends of a persons life. For our purposes here, we have no reason to oppose their views on these ultimate matters. But I suggest that for our considerations, we can and should restrict the term phronesis to coincide with the range and scope of professional judgements. Every professional being is, of course, a person who has a life to live. And I do agree that (some version of) phronesis is indeed the reasoning capacity that determines what are ones proper ends of ones lifeiv. I am thereby asserting that one can be a good professional and also be a good spouse, a good parent, or a good promoter of
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world-class university rowing. For most professionals, then, being a good professional is a very important part of living a good life and a part of living a good life that holds serious implications for ones self-identity and self-esteem. But being a good professional is usually only a part, though an important part, of making and living a good life. (I should note here that I think it plausible that most professionals can reliably pursue the goods and ends of their profession even if such activities do not furtherand perhaps, even, to some degree, conflict with their self-interest, a point to which I will return.) So, then, I suggest that for our considerations the term phronesis be suitably restricted to coincide with the range and scope of professional judgementsv. III.1 Recovering Phronesis: Deliberative Judgement (and Not a Calculation) As Runess (1960) definition correctly suggests, Aristotle broke with his teacher, Plato, in his holding (roughly) that the form of theoretical reason (or knowledge), which asks what should one accept (or believe)? differs from the form of practical rationality, which asks what should one do? and how should one act? Aristotle held (roughly) that theoretical reason is governed primarily by the rules of (formal) deductive logic; but he held that practical rationality typically takes the form of a deliberation: the weighing of pros and cons. And by holding that phronesis is a form of deliberation (or judgement), the most plausible account, in my view, argues that phronesis is not a mathematical calculation of any kind (nor a kind of formal, logical argument)vi. (This view stands in contrast to the views of such thinkers as John Stuart Mill, 1863/2001.) Although deliberation can be said to involve the weighing of pros and cons, the term weighing is used metaphorically. For example, Black (1972, pp. 5657), who used the term reasonableness in his recovery of Aristotles conception, has explicitly argued both that such a deliberation (judgement) does not involve the maximising of any quantity and that typically no determinate answer can be found to the question what is the most reasonable way to act? (see also Sen, 1995, 2009). Black also argued that persons in the same situation may judge differently and yet both can be reasonable. (Here, thinkers such as Black, 1972, and Sen, 1995, 2009, have argued that the so-called rational choice theory, which has been widely held in economics, is an inadequate model. They both see a more plausible model in Aristotles phronesis. I side with Black and Sen.) III.2 Recovering Phronesis: Practical Rationality as a Virtue (with Accompanying Virtues) As I have noted, some writers have set out to recover the key insights by using the term practical wisdom. In a very good discussion of these matters, Stout (1990) has argued that we should see nurses (and doctors) as engaging in social practices where practical wisdom is one of the central virtues. This notion leads to the second major recovery from Aristotle. According to Plato, Socrates claimed that if an agent knew what the right action was, then the agent would indeed perform that
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action; but both Plato and Aristotle rejected this Socratic claim. (Indeed, Aristotle held that a person could even do what one knew to be wrong.) Thus, the Aristotelian tradition has a special place for the (quasi-moral) virtues, where a virtue is a disposition that enables one to perform the action that one judges to be (practically) reasonable. For Aristotle, then, quasi-moral virtues enable a person to judge reasonably (such as being committed to gathering relevant evidence), whereas moral virtues (such as courage and temperance) enable one to perform the reasonable action to achieve ones endsvii. In his Ethics after Babel, Stout (1990, p. 269) attempted a recovery of phronesis as practical wisdom and argued that medical care is a social practice in MacIntyres sense (my emphasis), a social practice in which nurses and doctors should have the following virtues: practical wisdom (the ability to exercise sound medical judgement and discernment), justice (giving others their due), temperance, and courage. Stout also included the virtues of hope (the mean between despair and presumption), faith (trust in genuine authorities), and love of the good (properly ordered desire for goods internal to the practice, sought for their own sake) (p. 272). In advocating the virtue of love, Stout implicitly rejected both motivational hedonism (which holds that agents are solely motivated by hedonic pleasure and pains) and rational egoism (which holds that agents are rational if and only if they seek their own interests). As noted earlier, I basically agree with Stout here. I think it plausible to hold that most professionals can reliably pursue the goods and ends of the profession, even if such activities do not further (and perhaps even conflict to some degree with) the agents self-interest. I think that one of the attractions of phronesis, then, is its implicit rejection of motivational hedonism and rational egoism. The upshot is that the second recovery of Aristotles phronesis will see the professional as having not only the (cognitive) capacity to deliberate (judge) well but also the appropriate (affective) attitudes and dispositions (i.e., the virtues). Also notice that Stouts discussion provides us with a good example of how the term phronesis can legitimately be restricted to coincide with the range and scope of professional judgementsviii. Let us turn to the third recovery. III.3 Recovering Phronesis: Deliberative Judgement in Social Practice Embodied in Institutionsix Whether the concept of social practice should be regarded as properly Aristotelian or as mainly Alasdair MacIntyres recovery is a difficult question to answer. Whatever the case, MacIntyres conception of social practice has influenced many thinkers (see, for example, Kekes, 1989, 1995, 2002; Stout, 1990). In his After Virtue, MacIntyre (1984) drew out the role of internal goods in a social practice in the following way: By a [social] practice I am going to mean any coherent and complex form of socially established cooperative human activity though which goods internal to that form of activity are realized in the course of trying to achieve those standards of excellence which are appropriate to, and partially definitive of,
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that form of activity, with the result that human powers to achieve [internal] excellence, and human conceptions of ends and goods involved, are systematically extended. (p. 187, my emphasis) MacIntyre (1984) went on to articulate the concept by saying that arts, sciences, games, politics in the Aristotlean sense, the making and sustaining of family life, all fall under the concept (p.188), whereas taking long showers, playing tic-tac-toe, bricklaying, and planting tulips do not fall under the concept. The internal goods (and excellences) of a social practice stand in contrast to the socalled external goods: money, status, prestige, and their accompanying power relations. Of course, external goods are real goods (if only instrumental goods). Such external goods can be achieved in other ways or in ways that have little to do with achieving the excellences of the social practice (with achieving the internal goods of the practice). Although MacIntyre (1984) claimed that contemporary moral theorising tends to support the emotive theory, which holds that ethical (moral) statements are really just expressions of ones emotions, MacIntyres conception of social practice implicitly rejects both motivational hedonism and rational egoism. In other words, MacIntyre assumed it plausible to hold that most members of the social practice can reliably pursue the goods and ends of the social practice, even if such activities do not further (and perhaps even, to some degree, conflict with) the members self-interest. Again, I agree that MacIntyres position is a plausible assumption. Furthermore, MacIntyre (1984) has argued that social practices are almost always embodied in institutionsx, which, according to MacIntyre, typically trade in external (to the social practice) goods: money, status, prestige, and their accompanying power relations. Stout (1990) applied MacIntyres conceptions to the social practice of medical care as follows: Social practices are often embodied in institutions. In our [the U.S.] society, the practice of medical care is embodied in institutions such as professional associations, medical schools, partnerships, independent hospitals, and increasingly powerful commercial hospital chains. It is also closely related to broader institutions such as the capitalist market and governmental agencies. Without some sort of sustaining institutions, the practice would change dramatically for the worse, if not collapse altogether. (p. 274) As both MacIntyre and Stout have noted, although the good side of this discussion is that such institutions do indeed help sustain the social practice, the bad side is that such institutions, since they trade in external goods, often seriously corrupt (or distort or disrupt) the achievement of the internal goods of the social practice. Now, in Ontario, the duties and responsibilities of the elementary and secondary public school teachers are primarily set out in the provinces Education Act and the acts Regulations. Furthermore, elementary and secondary public school teachers are also members of two different institutions: respectively, the Ontario College of Teachers and the Ontario Teachers Federation. Many see the Ontario College of
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Teachers as having been set up explicitly to promote teaching as a profession, whereas the Ontario Teachers Federation is seen as being primarily concerned with wages, pensions, and other working conditions. Here, then, at least two important questions arise. How far (and in what ways) does the Ontario College of Teachers actually enable teachers to act professionally? How far (and in what ways) does the Ontario Teachers Federation conflict with (or undermine) teachers abilities to act professionally? (I shall return to these matters below in Section V.) (In Ontario, nursing is similarly related to two institutions, the College of Nurses and the Ontario Nursing Association.) III.4 Recovering Phronesis: Deliberative Judgements Involving Complex Interactions of the Generals and Particulars Another of the well-known writers who have tried to recover the key ideas from the Aristotelian tradition is Martha Nussbaum. Many good yet short characterisations illustrate the complex interactions between all the generals and the particulars involved when the agent is trying to decide (judge) the reasonable action to perform in a concrete situation. I hope you will find Martha Nussbaums characterisation to give a good sense of what is going on here. In trying to draw out the similarities between the views of Aristotle and the novelist Henry James, Nussbaum (1990) drew upon one characters actions in the book by Henry James, The Golden Bowl. She wrote: In ethical terms, what [the stories articulated imply] is that the perceiver [agent] brings to the new situation a history of general conceptions and commitments, and a host of past obligations and affiliations (some general, some particular), all of which contribute to and help to constitute her [the perceivers] evolving conceptions of good living [good acting].... Perception, we might say, is a process of loving conversation between rules and concrete responses, general conceptions and unique cases, in which the general articulates the particular and is in turn further articulated by it. The particular is constituted out of features of both repeatable and nonrepeatable; it is outlined by the structure of general terms, and so it contains the unique images of those we love. (pp. 9495) From this passage, I hope it is clear that Nussbaum held that using literature is a good way to sensitise and initiate students (and professionals, too) into what is important in the moral realm. In favourably comparing Aristotles views with Jamess depictions, Nussbaum also held that literature is a kind of moral philosophy. I believe that an adequate characterisation of good scientific judgements can be seen as typically deliberative judgements involving complex interactions of the generals and particulars (see Elgin, 1996; Hooker, 1995). I further maintain that an adequate characterisation of good professional judgements can be seen as typically deliberative judgements involving complex interactions of the generals and particulars.
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III.5 Modifying Aristotles Phronesis: Rejecting the Moral Essentialism Nussbaum plausibly shows noteworthy similarities between the ethical views of Aristotle and the ethical stances involved in Henry Jamess depictions. For some reason, however, Nussbaum totally neglects to deal with one of the key features of Aristotles views. As we have seen above, many have given the following kind of definition (e.g., Runes, 1960, p. 235, my emphasis): Phronesis: practical wisdom, or knowledge of the proper ends of conduct and of the means of attaining them; distinguished by Aristotle from theoretical knowledge or science, and from technical skill. This definition is misleading in important ways, for it fails to make clear that, for Aristotle, the ultimate, proper end of the good life is determined by theoretical reason and not by practical reason. Furthermore, for Aristotle, theoretical reason holds that all things must have a form (and function), and that the form for humans enables the philosopher to show that the highest good for all humans is the contemplation of knowledge. Aristotles position here is often called moral essentialism (or moral cognitivism). This position has generated many critiques (an early refutation came from Kant.) Here, it is useful to note that MacIntyre himself rejected this position. Although MacIntyre (1984, 1988) has indeed argued that much of Aristotle can be recovered, he has provided good reasons for rejecting Aristotles moral essentialism. As MacIntyre (1984) summed it up, we must reject Aristotles metaphysical biology, the position that holds that mankind has an essential nature and an essential purpose or function (p. 88). As Kekes (1995, 2002) argued in many of his works, deciding how one should live ones life is as much a matter of making as finding. (The alternative position to essentialism is often called moral pluralism.) In my judgement, such thinkers as Dewey, Kant, Kekes, Margolis, MacIntyre, and Stout provide good reasons to reject the essentialist position. So, this discussion leads to our first rejection: the rejection of Aristotles moral essentialism. III.6 Modifying Aristotles Phronesis: Rejecting the First Philosophy MacIntyre (1988) unwittingly leads us to our second rejection. MacIntyres work, After Virtue, had set out to recover something like an Aristotelian conception of virtue, but he recognised he needed some account of rational inquiry. In his Whose Justice? Whose Rationality? MacIntyre (1988) set out to defeat the contemporary liberal political theories by advancing an account of practical rationality as socially and historically determinedxi. MacIntyre (1988) put it this way: a number of analytic philosophers (primarily the American John Rawls) have held that rationality requires . . .that we first divest ourselves of allegiance to any one of the contending theories and abstract ourselves from all those particularities of social relationship . . . Only by so doing . . . shall we arrive at a genuinely neutral, impartial, and . . . universal point of view . . . . [This] conception of
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ideal rationality as consisting of principles that a socially disembodied being would arrive at illegitimately ignores the inescapably historically and socially context-bound character which any substantive set of principles of rationality, whether theoretical or practical, is bound to have. (pp. 34) In my judgement, MacIntyres account is indeed the (comparatively more) plausible account of theoretical and practical rationality, one that conceives of reason as some kind of power preformed by the social-historical context. Yet, even though MacIntyre defended the view that both theoretical and practical reason are in some ways historical artifacts, he also tried to show that such a view of reason leads to a First Philosophy of the kind found in the Aristotelian-Thomistic moral tradition. Now a First Philosophy is one that holds there must be fixed, timeless, and universally necessary First Principles by which to guide ones thoughts and actionsxii. But it is not a contradiction to hold that moral (and rational) inquiry has no such First Philosophy. And given that theoretical and practical rationality is pre-formed by the social-historical context, it is comparatively implausible that such a First Philosophy exists. Richard Bernstein (1971, 1983, 1993) is a thinker who has also argued that theoretical reason and practical rationality are best seen as historical artifacts. He, too, has argued that it is comparatively implausible that such a First Philosophy exists. And Bernstein (1993) has argued that MacIntyres position actually leads to an objectivism (the position that in each domain there must exist a uniquely correct theory). In my judgement, Bernstein has provided another reason to hold that MacIntyres recovery of a first philosophy cannot be legitimated. (In the moral realm, see the works of Margolis, 1996, 2004, and Sen, 2009.) So far, I have been concerned with what we can and should legitimately recover from Aristotles conception of phronesis. But a related and perhaps wider conception of practical rationality has played a key role in recent philosophical work on legitimating (liberal) principles of justice. This wider body of work comes primarily from Kants use of practical rationality, which is at the core of his ethical theory. As I noted above, Kant explicitly set out to reject Aristotles claim that all humans have a unique, ultimate end. He set out to reject this moral essentialism, arguing that we can live our lives in many reasonable ways; he was one of the first pluralists to acknowledge the crooked timbre of humanity (see Berlin, 1991). Let me try to briefly summarise these recent inquiries. First, Kant himself set out to show that in moral matters all practically rational agents must be committed to the categorical imperative. Kant gave several formulations of this (allegedly) necessary principle. Consider the formal formulation, the formula of the universal law, which says Act only in accordance with the maxim through which you can at the same time will that it become a universal law. Now in the past three decades of Anglo-American philosophy, several good reasons have been given for holding that no formal account can use practical rationality to derive any interesting moral principles. In other words, there is no a priori defence of moral principles. (For a review of the literature, see Wood, 1999, chapter 3xiii.) The more recent philosophers really intend to avoid a priori approaches, and they also try to see practical rationality as some kind of socio-cultural artifact. One
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of the most influential of these thinkers is Habermas, a late member of the Frankfurt School, which advanced views about rationality as being historical. Habermass early work (1979) was built around the notion of an ideal speech situation, which defined truth as what the community of inquirers would arrive at in the long run. Yet Quine (1960) had early on argued that such a (pragmatic) conception of truth could not be defended. And Geuss (1981) has more recently argued that if Habermas has been pursuing a transcendental approach, then that approach cannot succeed (see Nielsen, 1992). In his more recent discourse ethics, Habermas (1990) has tried to show that all rational agents are necessarily bound to such principles: All affected can accept the consequences and the side effects its [that is, every valid norm] general observance can be anticipated to have for the satisfaction of everyones interests (and these consequences are preferred to those of known alternative possibilities for regulation). (pp. 6566) But Habermass attempts fail because they cannot overcome Berlins (1991) point that no matter what structure a society has, there is no society in which all good lives can be promoted and advanced. In the United States, John Rawls (1970) had also hoped to find a unique set of principles of justice that were necessarily binding on all practically rational agents. But in Rawlss later work (1993), he seems to admit that his original project (1970) cannot succeed. Rawls (1993) fails to deal with Berlins concern: even in a liberal society, there will always be individuals whose reasonable interests will not be fostered by a liberal society. In such a context, then, no hope is possible for even a limited consensus of practically rational agents. But Rawls and especially Habermas must face a more serious problem: how to derive the necessary moral principles (binding on all rational agents) if practical rationality is some kind of a socio-historical artifact. Rawls and Habermas have failed to address the deep implications of the question. In recent work, Sen (2009) has argued that even if Rawlss search for a perfectly just society could succeed (which Sen doubts), this ideal would not help us make a society more just. Sen also argued that no conception of a perfectly just society is needed to make ones society (or the world) more just. Sens work provides a plausible case for showing how theoretical reason and practical rationality (phronesis) can be useful in making a society more just, even if we can devise no conception of the ideally just society (see also Margolis, 1996, 2004.) I have a second reason for discussing these recent attempts to develop a plausible theory of a just society using the concept of practical rationality. As I have noted earlier, the requirements (for being a professional) state both that the occupational group governs itself in important ways, by deliberating and setting its own ethical and competence standards and its own guidelines for certification and suspension (or expulsion), and that each individual member has autonomy of judgement built upon the bodies of specialised literature (knowledge or understandings) within the space set up by the groups ethical codes and guidelines. John Rawlss attempts to create the principles for a just society should
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be recognised as attempts to create the legitimate principles for collective choice in the society. A professional group also needs to create a set of legitimate principles for collective choice in the professional group. Although I judge the work by Margolis (1996, 2004) and Sen (1995, 2009) to be (comparatively more) plausible, much can be learned from the works of Rawls and Habermas about how to go about generating such legitimate principles to govern (justly) the group and its members. Here the groups collective choices should, of course, concern how its own internal activities can be fair. And the members of the professional group also need to cooperate with other citizens, relevant experts, and politicians to help develop plans to meet the needs of its clients in a just manner (see Daniels, 1985). III.7 Modifying Aristotles Phronesis: Incorporating Probability One additional, major, modification needs to be made to Aristotles phronesis: it involves the concept of probability. Today, many have argued that probability is the guide to life. The concept of probability is widely acknowledged to play major roles in theoretical reason (in both the content of major theories and in the statistical methods for testing theories) and in practical rationality (determining what to do when under risk and under uncertainty). Much has been written about these roles (for example, see Benn & Mortimore, 1976; Black, 1972; Cherniak, 1986; Elgin, 1996; Hooker, 1995; Moser, 1990; Sen, 1995, 2009). Thus, our use of probability has revised in major ways how we think about theorising and acting. But our conception of probability came into being (emerged) in the mid-1600s, and it has since undergone several modifications (or revisions) (for an account, see Hacking, 1975). At any rate, whatever can and should be recovered from Aristotles phronesis, must be worked together (in major ways) with the (modern) concept of probability. (Black, 1972, believed his work did exactly this kind of working together. Let me also add that our modern use of probability helps show why a First Philosophy is not needed for inquiry, which is always fallible and open to revision.)
IV. A DIGRESSION OF SORTS: THEORETICAL REASON
What are we to make of a domain of inquiry that has no necessary principles that are binding on all rational agents? To get a balanced sense of the problems and possibilities, let us turn to the theoretical domain and to the physical sciences. As noted above, Aristotle argued that the form of theoretical reason (or knowledge) is quite different from the form of practical rationality. And he held that theoretical reason is governed primarily by the rules of (formal) deductive logic, but that practical rationality typically takes the form of a deliberation. (Again, notice that Aristotle had no notion of an inductive logic that uses probability; see Hacking, 2001.) In the last half century, Western thinkers and, in particular, Thomas Kuhn (1970, 1977), have argued that Aristotle was quite wrong about theoretical reason. For example, Kuhn has argued that theoretical reason itself has the form of
23
practical rationality (phronesis). In the current philosophy of science literature, then, a widely held (if not the dominant) view is that theory choice itself takes the form of practical rationality, in which the scientist has to weigh (comparatively) the key epistemic values: for example, simplicity, explanatory power, predictiveness, and agreement-with-what-we-have reason to accept so far. Thinkers such as Elgin (1996), Hacking (1999), Hooker (1987, 1995), Kuhn (1970, 1977), and Scheffler (1997) have argued that the (earlier) positivistic and Popperian views are inadequate in large part because such accounts cannot allow scientists any serious role in making value judgements involving the epistemic values. These principles are not universal and neutral; they are actually general principles whose meanings are largely specified by the current theories and standards in the socio-historical context. Thus, scientific theory choice is itself best seen as a kind of practical rationality. And, as I noted above, an adequate characterisation of good scientific judgements will view as typically deliberative those judgements involving complex interactions of the generals and particulars (see Elgin, 1996; Hooker, 1995). (And given the way practical rationality is open to revisions and new developments, it should be regarded as a placeholder term concerned with scientists being responsible in deciding what to do.) I hope you will find my digression into theoretical reason helpful. I have been considering what is recoverable from Aristotle; but Aristotles account of theoretical reason is seriously inadequate, and it cannot be recovered. V. Teaching and Educating as a Social Practice Embodied in Institutions Let me now show how the recovered conception of phronesis (or practical rationality), which centrally involves deliberative judgements in a social practice, can greatly enhance our conception of professional actions and especially professional reasoning (or judgement). I want to show that an adequate characterisation of good professional judgements can and should be seen as involving complex interactions of the generals and particulars. Here I focus on teaching and follow the lead of Lee Shulman (1987/2004a) who argued for the central role of a kind of practical rationality in the activities of a professional teacher. My contribution is to extend and deepen his work by developing a much more complex conception of practical rationality. My recovery of Aristotles phronesis yields a conception with a complex model of judgement, where judgement is at the heart of being a (good) professional. And, as noted above, Jeffrey Stout (1990) has also provided some very good steps for enhancing our conception of the role of phronesis in nursing (caring and doctoring). Recall that from Stout we recover the practical wisdom along with the related virtues (all of which a good professional teaching program should foster). I gratefully use and extend his work in the educational setting: teaching as an (embedded) social practice. My first step is to make plausible that teaching (as a professional activity) is a social practice (in MacIntyres sense) by drawing out its internal goods and standards of excellence, which I think can be done by modifying (to some degree)
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John Deweys view of teaching (see Dewey, 1938/1997; Frankena, 1965). For Dewey, a students learning almost always has extrinsic value, for what the student has learned will often be highly useful later in life. But Dewey also wanted the learning (now) to have intrinsic (or internal) value. And I think we can use the following remarks by Dewey to get closer to an understanding of this intrinsic value. As Dewey (1938/1997) put it: [real] freedom . . . is a power: the power to frame purposes, to judge wisely, to evaluate desires by the consequences which will result from acting upon them; power to select and order means to chosen ends into operation. Natural impulse and desires constitute . . . the starting point. But there is no intellectual growth without some reconstruction, some remaking, of impulses and desires . . . . This remaking involves inhibition of impulse . . . What has been said [above] explains the meaning of the well-worn phase selfcontrol. The ideal aim of education is the creation of power of self-control. (p. 64) First, I hope it is clear that what Dewey means by freedom (as a power) and self-control is very similar to, if not the same as, the recovered conception of phronesis. Second, if the ideal aim of education is the development of the power of self-control, where both the teacher and the learner share this aim, then the student (the learner) and also the teacher should and will likely see the development of self-control as having internal (or intrinsic) value. Finally, since educational activities are governed by such moral values as caring and respect, these activities can and should be seen as having internal (or intrinsic) value. Thus, the activities of teachers and students (and the results of those activities) have both extrinsic and internal (or intrinsic) values related to the internal goods and excellences. Here I can draw from Stouts (1990, p. 272) discussions. I hold that teaching can and should be a profession because it can and should be a social practice in which teachers (and principals) have the relevant virtues. Teachers (and principals) should have practical wisdom (the ability to exercise sound educational judgement and discernment), a sense of justice (the capacity and disposition to give others their due), and the attitudes of temperance and courage. And teachers and principals should also have hope (the mean between despair and presumption), faith (trust in genuine educational and moral authorities), and love of the good (properly ordered desire for goods internal to the practice, sought for their own sake). These, then, are my arguments for holding that the teaching profession can and should be a social practice. Elsewhere, Pitman and I (2008) have argued that, on balance, teaching in Ontario should be, and is overall, a professional enterprise. In the next few paragraphs, I want to illustrate the range and scope of practical rationality (or phronesis) in teachers professional activities. (Here I will be concerned only with elementary and secondary public schools.) First, in Canada, the Constitution Act of 1867 gives the provinces the right to control public education. And in Canada, the provinces (by and large) control
25
elementary and secondary public schools by means of a major legislative statute called the Education Act and the so-called Regulations to the Education Act. The Education Act also sets out the duties and powers for teachers, principals, school boards, the Ministry of Education, and the Minister of Education. (Recall that the Education Act enables and restricts what teachers can do.) Here I shall start with Ontarios Education Act (sec. 264) and the related Regulation 298 (sec. 20), which set out (most of) the primary duties and responsibilities for being a teacher. The Education Act, sec. 264.1.c actually states that teachers are to inculcate by precept and example respect for religion and the principles of Judaeo-Christian morality. How can this statement be legitimate in a pluralistic, democratic society? Well, the Ministry of Education has issued Policy/Program memorandum (PPM) 112, which states that a teachers trying to get a student to accept any religious doctrine (in the secular) public schools is indoctrination and that such action is forbidden. And this PPM 112 reflected adequately what the Ontario courts have ruled about teaching religion: a teacher can teach about religions, but cannot try to get a student to accept any particular religious doctrine. Still the (provincial and federal) courts have stated that they do expect teachers to inculcate basic morality and the basic principles and values of a democratic society (as largely set out in the Canadian Charter of Freedoms and Rights). The Education Act Regulation 99 states that teachers must treat students equitably and with respect. Now in setting out these teacher duties, teachers are assumed to have the background knowledge and understandings to judge wisely (to deliberate wisely) so that the teacher may act morally and treat students fairly and respectfully. In 1996, the Ontario government passed the Ontario College of Teachers Act, an act explicitly designed to promote teaching as a profession and as a social practice with internal goods and excellences. Although the Teaching Profession Act had been passed in 1943 and had established that all teachers must belong to one of the teacher federations, over the years, many had come to believe that the federations were acting mostly as a union in which the primary concerns were working conditions, pay, and pensions. In other words, many had come to believe that the federations focus was primarily on the external goods. (Both of these acts are still on the books; and both acts continue to, in various ways, both enable and restrict teachers.) Let me draw out briefly the responsibilities of the Ontario College of Teachers (OC of T). The OC of T now has sole responsibility for credentialing, reviewing, and disciplining its members. To help carry out these tasks, it has produced Foundations of Professional Practice (2006), which has three parts, one of which is The Ethical Standards of the Teaching Profession. The ethical standards are grouped into four major categories: care, respect, trust, and integrity. The ethical standard for the category of care states: The ethical standard of Care includes compassion, acceptance, interest, and insight for developing students potential. Members express their commitment to student well-being and learning through positive influence, professional judgment and empathy in practice (p. 9). I maintain that such moral values constitute (some of) the standards for judging the
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goods and excellences internal to the social practice of teaching. Here, again, teachers are assumed to have the background knowledge, understandings, and commitments to judge wisely (to deliberate wisely) so that the teacher may live up to these professional values. In the last decade or so, some teachers were found to be having sexual relations with their students. The OC of T subsequently produced Professional Advisory: Professional misconduct related to sexual abuse and sexual misconduct (2002), which clarified the key terms and established that a teacher has a professional (and often a legal) obligation both to refrain from having sexual relations with students and to report (to various bodies) a teacher colleague if the teacher has reason to believe such inappropriate sexual relations are occurring. Here, a teachers carrying out the obligation to report such activities helps to either maintain or restore the internal goods of the practice. Ontario teachers are also bound by Education Act Regulation 181 to understand the needs of special education students and to implement the Individual Educational Plan (IEP) for all special education students in the class. I have not explicitly stated what should be obvious: teachers typically interact with many students at a time. A typical class has approximately 25 students; and, in such a class, a teacher may well have more than a few special education students who have been judged to be exceptional and who have a suitable IEP. In such a class, then, teachers are expected to understand the various kinds of exceptionalities and the related IEP, to develop ways to carry out each students IEP, and to treat each student in caring and respectful (and professional) ways. It should be clear that to carry out these duties, teachers must have the appropriate background knowledge and commitments, be able to judge wisely, and be ready to act upon these reasonable judgements. A teachers helping the special education students to meet their learning needs is an internal (or intrinsic) good in the social practice. Let me give an example of another kind of case in which practical rationality and its related virtues are centrally involved. Here I will need to provide a bit of the historical background. The Ontario government has passed the Child and Family Services Act (CFSA) 1990, which requires that all professionals, teachers included, report child abuse. In the original version of CFSA, the key words were reasonable grounds to believe. So, then, in fulfilling ones duty under the original CFSA, a teacher needed to understand the typical symptoms of child abuse and report when the teacher has reasonable grounds to believe that child abuse has occurred (or is likely to occur). Thus, a teacher must be able to interpret in a reasonable way what a students actions and statements might mean and be able to judge whether there exist reasonable grounds to believe that child abuse has occurred. In the original version of the CFSA, however, the standard reasonable grounds to believe was apparently interpreted by most professionals to constitute a good deal of evidence (perhaps enough evidence for one to infer that it was more probable than not that child abuse had occurred.) Those who were concerned about child abuse, however, came to worry that such a high standard of evidence would likely mean that serious cases of child abuse would go unreported (and thereby uninvestigated), so they urged revision of the
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CFSA. In the revised (current) version, in fulfilling ones duty under the CFSA, a teacher must understand the typical symptoms of child abuse and report when the teacher has reasonable grounds to suspect. And here reasonable grounds to suspect was not meant to be anywhere near the evidence for holding that abuse was more likely than not to have occurred; the phrase was meant to signify a (comparatively) weak set of evidence. The revision to the CFSA was deliberately intended to lower the amount of evidence a professional needed to thereby increase the likelihood that many more cases of (potential) abuse would be reported. The revised CFSA knowingly put teachers (more) on the side of the student and in potential conflict with parents. Since the revised standard reason to suspect was meant to lower the amount of evidence a teacher would need to report a case of child abuse, when comparing the original CFSA with the lowered reporting standard of the revised CFSA, the current CFSA will likely have many more reports but will also likely, overall, lead to many more reports being made in error. Thus, if a teacher were to judge (using the revised standard, have reason to suspect) that a parent were guilty of child abuse, the teacher needs to understand that the probability of a report being an error is now rather high. Therefore, a teacher will need integrity and courage to interact with the parent in a respectful and caring way if the report turns out to be in error. In such situations, the carrying out of a teachers legal and moral duties (which are internal goods) is likely (unintentionally) to lead to moral harms (and injuries). (Such moral harms are internal to the social practice.) Other kinds of cases in which practical judgement is central involve teachers carrying out school safety rules. Under the Education Act Regulation 298, teachers have the duty to use reasonable means to protect the safety of the students in their school. In difficult cases, this duty can lead to the teacher having to search a student if the teacher has reason to believe that the student, say, is carrying a weapon or illegal drugs. Here, again, teachers must judge whether they have reason to believe, which is the first part of the two-prong test set out by the Supreme Court of Canada for the legitimate searches of students. At any rate, a teachers protecting students from harm is another internal (or intrinsic) good in the social practice. Now, then, I hope it is clear that in the context of this massive and complex web of rules and standards, it would be very good (even necessary) for teachers to have the virtue of phronesis (and its related virtues) to make sense of the situations, to deliberate well about what to do, and to then act accordingly. In these situations, the professional teacher should use deliberative judgement to decide how to reasonably deal with cases involving complex interactions of the generals and particulars. But these examples illustrate only part of the story. In Ontario today, the cost of health care has been ever rising and pulling monies away from other ministries. This situation leads to serious questions about whether the provinces various educational policies and programs are being adequately funded. For example, many ask whether the special education programs are being adequately funded. This possibility of underfunding has major implications for teachers who may have either more than a few students who have not yet been identified or students for whom the suitable educational assistant has yet to be funded. In such a context, teachers will find it very difficult (if at all possible) to judge what to do to fulfill
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their duty to treat students equitably and respectfully. And in such a context, a professional teacher and the professional group (the OC of T) will need to judge wisely about what a professional should do when the government has inadequately funded its programs and policies. Members of the teaching federations, of course, often use work-to-rule tactics to express their dissatisfaction with the external goods provided by the government. But what are the appropriate and fair ways for a professional to express dissatisfaction with the government (or school board) when the internal goods of the practice are being undermined (or not being secured)? Clearly, to carry out these various duties in such difficult situations, teachers must have the appropriate background knowledge and commitments, be able to judge wisely, and then be ready to act upon their reasonable judgements. In summary, I hope my remarks in this section have made it plausible that in such complex educational contexts, it would be very good if teachers (as good professionals) were to have the virtue of phronesis (and its related virtues) to make sense of the situation, to deliberate well about what to do, and to act accordingly.
VI. CONCLUDING REMARKS
In recent decades, there has been much renewed interest in Aristotles conception of practical rationality, phronesis. In section II, I briefly characterised the concept of profession. In the next sections, I considered what roles the concept phronesis can and should play in the professions. In answering these questions, I have set out what can and should be legitimately recovered from Aristotles conception, what cannot be recovered, and what modifications need to be made to it. I have argued that practical rationality is best seen as a placeholder term concerned with our being (morally and legally) responsible in deciding what to do. Finally, I have tried to show that phronesis can and should play a very important role in teaching as a profession in Ontario.
NOTES
i
ii
iii iv v
In his later works, Shulman did explicate the concept of profession (see Shulman (1998/2004c), especially pp. 529535; Shulman (1997/2004b). His conception of a profession is basically the same as ours. Shulman (1987/2004a) added the following in his footnote 2: Central to my conception of teaching are the objectives of students learning how to understand and solve problems, learning to think critically and creatively as well as learning facts, principles, and rules of procedure. Shulmans objectives are not held by every state (or province). In his 1987 essay, Shulman was concerned to set out the basic forms of knowledge and reasoning. In his later works, Shulman did properly recognise that being a professional also involves moral understanding and commitments see Shulman, 1998/2004c, p. 530.) The recent National Academy of Education book edited by Darling-Hammond and Bransford (2005) also holds that being a professional teacher involves knowledge, know-how, and moral commitments. See Frankena (1965) and Randall (1960) for a discussion of some of the difficulties. In a viable recovery, making and creating are as important as finding (see Kekes, 1995, 2002). And, of course, ones ultimate ends may conflict with ones professional obligations. For this chapter, I ignore the moral and ethical issues involved in such a conflict.
29
vii
viii
ix x
xi xii
xiii
For example, J. S. Mill held that, when deciding what to do, one essentially measures the amount of happiness and pain and then aggregates these quantities. Utilitarians such as Mill (1863/2001) hold that deciding essentially involves a calculation. In one of his more famous papers on moral development, Kohlberg (1971, p. 288) began with a scathing attack on the bag of virtues approaches. In his neo-Kantian approach, Kohlberg no doubt saw Aristotle as the main target; but Kohlberg failed to realise that Kant himself, in his later works, put the duties of virtue at the centre of his moral views (see Wood, 1999)! As noted above, in his early work (1987/2004a), Shulman was concerned mostly with explicating the forms of knowledge involved in being a good, professional teacher. In his later work (1998/2004c, pp. 530531), Shulman correctly acknowledges the crucial role of quasi-moral and moral dispositions and commitments. Perhaps this account is MacIntyres recovery of Aristotles praxis by way of Karl Marx. I should acknowledge that in MacIntyre and Dunne (2002), MacIntyre reiterated his claim that teaching is a not social practice. At the heart of his view is that real education initiates students in the forms of the various knowing, but that initiation per se is not a social practice. He holds that teaching in todays schools cannot even initiate students into the forms of knowledge because the (crude) materialism of society overwhelms any real educative efforts. I believe MacIntyre is mistaken to claim that teaching is not a social practice. Although I too am concerned with the impacts of general cultures on teacherstudent activities, I believe teachers can use caring and respectful ways to help students to become critical and responsible practically rational agents. In contrast to MacIntyre, who seems to take theoretical knowledge as the goal, I hold that the goal of a good education is to create practically rational agents. If my views can be defended, then the claim can also be defended that internal goods and excellences in the teaching situation comprise a social practice. Here I tend to side with another Catholic thinker, Jacques Maritain (1943/1960). See also Section V below. Here MacIntyre is acknowledging that this concept can be recovered from Karl Marxs thought. Or, put another way: a First Philosophy conceives of inquiry as needing a set of necessary axioms (and necessary rules) by which to govern its activities. There are good reasons for holding that modern science does not need such a First Philosophy (see Elgin, 1996; Hacking, 1999; Kuhn, 1970, 1977; Quine, 1960). Since L. Kohlbergs (1971) highest level, stage six, involves such a formal, universalisability principle, Kolhbergs views fail, too. And this recent work provides reasons for concluding that the Karl-Otto Apels (1980) approach, which is also a priori, cannot succeed.
REFERENCES
Apel, K.-O. (1980). Towards a transformation of philosophy (G. Adey & D. Frisby, Trans.). London: Routledge and Kegan Paul. Benn, S. I., & Mortimore, G. W. (1976). Rationality and the social sciences. London: Routledge and Kegan Paul. Berlin, I. (1991). The crooked timbre of humanity. New York: Knopf. Bernstein, R. J. (1971). Praxis and action. Philadelphia: University of Pennsylvania Press. Bernstein, R. J. (1983). Beyond objectivism and relativism. Philadelphia: University of Pennsylvania Press. Bernstein, R. J. (1993). The new constellation: The ethical political horizons of modernity / postmodernity. Cambridge, UK: Cambridge University Press. Black, M. (1972). Reasonableness. In R. F. Dearden, P. H. Hirst & R. S. Peters (Eds.), Reason: Part 2 of education and the development of reason (pp. 4457). London: Routledge and Kegan Paul. Carr, W. F., & Kemmis, S. (1989). Becoming critical: Education, knowledge and action research. London: The Falmer Press. Cherniak, C. (1986). Minimal rationality. Cambridge, MA: MIT Press.
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PRACTICAL RATIONALITY AND A RECOVERY Daniels, N. (1985). Just health care. Cambridge, UK: Cambridge University Press. Darling-Hammond, L., & Bransfod, J. P. (Eds.). (2005). Preparing teachers for a changing world. San Francisco, CA: Jossey-Bass. Dewey, J. (1997). Experience and education. New York: Touchstone. (Originally published by Kappa Delta Pi, 1938) Elgin, C. Z. (1996). Considered judgment. Princeton, NJ: Princeton University Press. Frankena, W. K. (1965). Three historical philosophies of education. Glenview, IL: Scott, Foresman, and Company. Geuss, R. (1981). The idea of a critical theory. Cambridge, UK: Cambridge University Press. Habermas, J. (1979). Communication and the evolution of society (T. McCarthy, Trans.). Boston: Beacon Press. Habermas, J. (1990). Moral consciousness and communicative action (C. Lenhardt & S. W. Nicholsen, Trans.). Cambridge, MA: The MIT Press. Hacking, I. (1975). The emergence of probability. Cambridge, UK: Cambridge University Press. Hacking, I. (1999). The social construction of what? Cambridge, MA: Harvard University Press. Hacking, I. (2001). An introduction to probability and inductive logic. Cambridge, UK: Cambridge University Press. Hooker, C. A. (1987). A realistic theory of science. Albany, NY: SUNY Press. Hooker, C. A. (1995). Reason, regulation and realism. Albany, NY: SUNY Press. Kekes, J. (1989). Moral tradition and individuality. Princeton, NJ: Princeton University Press. Kekes, J. (1995). Moral wisdom and good lives. Ithaca, NY: Cornell University Press. Kekes, J. (2002). The art of life. Ithaca, NY: Cornell University Press. Kohlberg, L. (1971). Indoctrination versus relativity in value education. Zygon, 6(4), 285310. Kuhn, T. S. (1970). The structure of scientific revolutions (2nd ed.). Chicago: University of Chicago Press. Kuhn, T. S. (1977). The essential tension: Selected studies in scientific tradition and change. Chicago: University of Chicago Press. MacIntyre, A. (1984). After virtue. Notre Dame, IN: University of Notre Dame. MacIntyre, A. (1988). Whose justice? Whose rationality? Notre Dame, IN: University of Notre Dame. MacIntyre, A., & Dunne, J. (2002). Alasdair MacIntyre on education: In dialogue with Joseph Dunne. Journal of Philosophy of Education, 36(1), 119. Margolis, J. (1996). Life without principles. Cambridge, MA: Blackwell Publishers. Margolis, J. (2004). Moral philosophy after 9/11. University Park, PA: The Pennsylvania State University Press. Maritain, J. (1960). Education at the crossroads. New Haven, CT: Yale University Press. (Original work published 1943) McPeck, J. E., & Sanders, J. T. (1974). Some reflections on education as a profession. The Journal of Educational Thought, 8(2), 5566. Mill, J. S. (2001). Utilitarianism (G. Sher, Ed.). Indianapolis, IN: Hackett Publishing Company, Inc. (Original work published 1863) Moser, P. K. (Ed.). (1990). Rationality in action. Cambridge, UK: Cambridge University Press. Nielsen, K. (1992). On the status of critical theory. Interchange, 23(3), 265284. Nussbaum, M. C. (1986). The fragility of goodness. Cambridge, UK: Cambridge University Press. Nussbaum, M. C. (1990). Loves knowledge: Essays on philosophy and literature. New York: Oxford University Press. Pitman, A., & Ellett, F. S., Jr. (2008). Professionalism: Its ambiguity in the current reforms in Ontario. In J. M. Mangan (Ed.), Social foundations of education coursebook, 20082009 (pp. 133141). London, ON: Althouse Press. Quine, W. V. O. (1960). Word and object. Cambridge, MA: MIT Press. Randall, J. H., Jr. (1960). Aristotle. New York: Columbia University Press. Rawls, J. (1970). A theory of justice. Cambridge, MA: Belknap Press. Rawls, J. (1993). Political liberalism. New York: Columbia University Press. 31
F.S. ELLETT, JR. Runes, D. D. (Ed.). (1960). Dictionary of philosophy. Totowa, NJ: Littlefield, Adams, and Co. Scheffler, I. (1997). Symbolic worlds. Cambridge, UK: Cambridge University Press. Sen, A. (1995). Rationality and social choice. The American Economic Review, 85(1), 124. Sen, A. (2009). The idea of justice. Cambridge, UK: Belknap of Harvard University. Shulman, L. S. (2004a). Knowledge and teaching: Foundations of a new reform. In L. S. Shulman, The wisdom of practice, and the education of professionals (S. M. Wilson, Ed.) (pp. 217248). San Francisco, CA: Jossey-Bass. (Reprinted from Harvard Educational Review, 1987, 57(1), 122) Shulman, L. S. (2004b). Professing the liberal arts. In S. Shulman, The wisdom of practice, and the education of professionals (S. M. Wilson, Ed.) (pp. 545566). San Francisco, CA: Jossey-Bass. (Reprinted from Education and democracy: Re-imagining liberal learning in America, pp. 151173, by R. Orrill, Ed., 1997, New York: College Entrance Examination Board) Shulman, L. S. (2004c). Theory, practice, and the education of professionals. In L. S. Shulman, The wisdom of practice, and the education of professionals (S. M. Wilson, Ed.) (pp. 521544). San Francisco, CA: Jossey-Bass. (Reprinted from The Elementary School Journal, 1998, 98(5), 511 526) Shulman, L. S. (2004d). The wisdom of practice: Essays on teaching, learning, and learning to teach (S. M. Wilson, Ed.). San Francisco, CA: Jossey-Bass. Stout, J. (1990). Ethics after Babel. Boston, MA: Beacon Press. Wood, A. (1999). Kants ethical thought. Cambridge, UK: Cambridge University Press.
LEGAL DOCUMENTS
Federal Legislation
Constitution Act, 1982 [en. by the Canada Act 1982 (U.K.), c. 11, s. 1], pt. I (Canadian Charter of Rights and Freedoms).
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INTRODUCTION
Dominant conceptions of professional knowledge appear to have largely forgotten Aristotles conception of phronesis and its place in considerations of what it means to know in professional life. Aristotle draws attention to phronesis as a form of reflective practical wisdom that complements techne, technically oriented approaches, and episteme, scientifically oriented approaches, in considerations of what it might mean to develop and enact professional knowledge. This chapter proposes an elaboration of Donald Schns reflective practice in light of Aristotles phronesis. Beginning with the seminal work of Schn, I argue for a reinvigoration of phronesis through attention to a continuum of reflection and practitioner judgement in professional practice. Reflection is considered along a continuum that includes Schns intentional and embodied reflection, and extends the notions of reflection to attend to phenomenological reflection and critical reflexivity. Also explored are the implicit criteria by which practitioners might make phronetic judgements in professional practice. Thinking of reflection as a continuum, and making explicit the criteria by which practitioners might make phronetic judgements, offers a generative framework for thinking about how reflection and judgement are implicated in the development of professional knowledge characterised as phronesis.
PHRONESIS
Aristotle highlighted three orientations or dispositions to knowledge: episteme, techne, and phronesis. Episteme is characterised as scientific, universal, invariable, context-independent knowledge. Techne is characterised as context-dependent, pragmatic craft knowledge and is oriented toward practical rationality governed by conscious goals. Phronesis is sometimes referred to as practical wisdom or practical rationality. Phronesis is defined in different ways but usually in ways that imply the significance of reflection, both tacit and explicit; that highlight a relationship to morality; and that convey a relationship between reflection and action. Phronesis emphasises reflection (both deliberative and that revealed through action) as a means to inform wise action, to assist one to navigate the variable contexts of practice, and as directed toward the ends of practical wisdom.
E.A. Kinsella, A. Pitman (eds.), Phronesis as Professional Knowledge: Practical Wisdom in the Professions, 3552. 2012 Sense Publishers. All rights reserved.
E.A. KINSELLA
Table 1. Continuum of Reflection Receptive Reflection Intuition Poetic worldmaking Intentional Reflection Thought Constructivist; individual worldmaking Neutral pragmatic world Embodied Reflection Action Located/situated worldmaking Reflexivity Interrogation Social constructivist; social praxis & language in worldmaking Sociality of world reference Meaning socially negotiated Deconstructing & becoming Reflects on social nature of knowledge construction Critical/skeptical Performative Intersubjective Discursive Performative Power Relations Sociality, historicity of theory formation Dialogic
Pre-reflective world Meaning revealed, received autopoesis Being Raw material for reflection and reflexivity A-rational Contemplative Intuition Insight Emotion Wonder Implicit theories
Contextual world
Meaning individually Meaning constructed in actions Thinking Reflects on personal experience, evidence and technique Rational Reason Cognition Doing Reflects in/on actions
Presence
Monologic/dialogic
Connection to Other Connection to Other through connection to through thought self Present to action Examined action
Connection to Other Connection to through action Other through dialogue Tacit action Intelligent action Knowing how Knowing-in-action Socially informed, critical, thoughtful action Deconstructing knowing
Knowing that
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In the scholarship of contemporary professional education, Donald Schn is a key thinker. His writings on reflective practice (1983, 1987) are widely considered to be the most influential works produced in professional education in recent years (Eraut, 1995). Donald Schn critiques the predominant emphasis on technical rationality as the modus operandi for the generation of professional knowledge. He points out that the failure, of what Aristotle might call episteme and techne, to deliver solutions to complex contemporary problems has created a crisis of confidence in the professions. In response, Schn calls for a new epistemology, one rooted in reflection both in and on practice, and one that recognizes the messy, complex, and conflicted nature of practice itself (see Kinsella, 2007a, 2007b, 2009, 2010, for elaboration). This way of conceiving of professional knowledge, as garnered through reflection in and on practice, has much to commend it and might be argued to have much in common with what Aristotle had in mind when he conceived of professional knowledge as phronesis. In this chapter, I examine conceptions of reflection in Donald Schns theory of reflective practice and the implicit criteria he identifies as important for practitioner judgement. I argue that in the interest of phronesis, Schns conception of reflection is important, but that it does not go far enough. I propose an elaboration of ways of thinking about reflection as a means of thinking about how reflection might be thought about in the interests of phronesis. In addition, I explicate the criteria that Schn implies practitioners use to make professional judgements, and propose three additional criteria that practitioners might consider in making judgements oriented toward phronesis in professional life. Whatever else phronesis might be, we can safely say that it involves reflection. In addition, it involves a disposition toward certain kinds of judgements, which Kemmis, in Chapter 11, suggests cannot be taught. I wonder if by making more explicit the criteria by which practitioners make judgements, and by encouraging the conscious adoption of criteria oriented toward phronetic ideals, practitioners might move toward phronetic judgements in professional practice. What criteria might we consider when using reflection to make judgements and to discern action oriented toward phronesis? If phronesis cannot be explicitly taught, might the disposition toward phronesis be encouraged, and the modes of thinking that work against it be revealed?
A CONTINUUM OF REFLECTION
This chapter proposes a continuum of reflection for phronesis in professional life. Such a continuum includes central dimensions of Schns conceptions of reflection, yet extends Schns view in two directions: first toward a deeper consideration of the inner life of the practitioner, and second toward a more rigorous interrogation of the sociality of world reference (see Table 1). This chapter considers two domains of reflection evident in Schns workintentional reflection and embodied reflectionand proposes an elaboration along two domains significant for professional lifereceptive reflection and reflexivity. Bill Green (personal communication, May 11, 2009) has suggested that this continuum
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might be thought of as a pulsating quadrant in which any piece might overlap with another at any time; I concur with this insight. While each dimension is presented separately for purposes of discussion, they are viewed as interrelated and interwoven and joined through what Sandywell (1996) characterises as an interminable, dialogic praxis. Intentional Reflection Intentional reflection is depicted in the second column of Table 1. Schn (1992) states that in the midst of writing The Reflective Practitioner, he realised he was reworking Deweys theory of inquiry by adopting reflective practice as his own version of Deweys reflective thought (p. 123). Many articles about reflective practice recognise the legacy of Deweys work in Schns theory, and include a description of reflection that draws on Dewey, usually citing one of two classic books: How We Think: A Restatement of the Relation of Reflective Thinking to the Educative Process (1933) or Experience and Education (1938). Schn (1992) acknowledges his debt both to Deweys thought and to the link Dewey put forth between intentional reflection and intentional action. Dewey (1933) explains the concept of reflection in terms of reflective thought, which he describes as active, persistent and careful consideration of any belief or supposed form of knowledge in light of the grounds that support it and further conclusion to which it tends (p. 9). According to Dewey, reflective thought converts action that is merely appetitive, blind and impulsive into intelligent action (p. 17). In this way, Dewey articulates, and lays the ground for, a link between intentional reflection and intelligent action, which is also found in the work of Schn. Schn integrates intentional reflection with action in three of his pivotal constructs: reflective practice, reflection-in-action, and reflection-on-action. In each instance, reflection occurs in and on actions that occur in practice, in a dialectic fashion. Schn (1983) describes reflective practice as a dialectic process in which thought and action are integrally linked. It is a dialogue of thinking and doing through which I becomemore skillful (Schn, 1987, p. 31). While reflective practice is his umbrella term, reflection-in-action and reflection-onaction are distinguished by their temporality; the first occurs in the midst of practice, whereas the latter occurs retrospectively. Schn (1992) contends that reflection-in-action is central to the artistry of competent practitioners who conduct on-the-spot experiments in what he calls the action-present. He notes that this process need not employ the medium of words. Schn likens the process of reflection-in-action to that of a jazz pianists improvisation of a melody or a basketball players instant manoeuvring in response to a surprising move by an opponent. Reflection-on-action, is more closely aligned with Arendts (1971) stop-and-think; here, thought turns back on itself in relation to the action carried out by the practitioner, and thereby has the potential to influence future action (Schn, 1992). In summary, the concepts of reflective practice and reflection-onaction may each be seen as invoking, and reflection-in-action may be seen as
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partially invoking, a form of intentional rationality which may be characterised as a mode of intentional reflection on the part of the practitioner. The emphasis on intentional reflection of the practitioner is further emphasised in the constructivist underpinnings of reflective practice. Schn draws on the work of Nelson Goodman (1978) to emphasise a constructivist orientation (Kinsella, 2006). Constructivists generally agree that knowledge is constructed, at least in part, through a process of reflection; that cognitive structures are activated in the process of construction; that cognitive structures are under continual development; that purposive activity induces transformation of those structures; and that the environment presses the organism to adapt (Noddings, 1990). Constructivists are concerned with the ways that worlds are made. Goodman argues that the symbols we construct inform the facts that we find and structure our understanding of them (Elgin, 2000). According to his famous dictum, worlds are made, not found. Such making involves active intentional reflection on the part of the worldmaker. The constructivist underpinnings of reflective practice therefore appear to inform what may be characterised as an intentional form of reflection. Embodied Reflection In this section, I consider locations wherein Schn explores ways of engaging in reflection that are outside of the realm of intentional reflection. These reflections are depicted as embodied modes of reflection because they arise in the embodied experience of the practitioner and are revealed in action (see Kinsella, 2007b, for an extended discussion). Embodied reflection is depicted in the third column of Table 1. In addition to discussing intentional reflection and its relationship to professional knowledge, Schn notes that skillful practice may also reveal a kind of knowing that does not stem from a prior intellectual operation but is revealed through intelligent action (knowing-how), or tacit knowledge. The influence of philosophers Michael Polanyi (1967) and Gilbert Ryle (1949) can be seen in the development of these ideas. Both Polanyi and Ryle challenge conceptions of knowledge that recognise only propositional knowledge. Polanyi focuses on that which people are unable to say, knowledge that is tacit, whereas Ryle is concerned with overcoming dualities between mind and body. He links intelligence and action through knowing-how. Tacit knowledge (Polanyi, 1967) and knowing-how (Ryle, 1949) are central themes in Schns constructs of theories-in-use and knowing-in-action, and are briefly considered below. In The Tacit Dimension, Polanyi (1967) sets out to reconsider human knowledge by starting from the assumption that we can know more than we can tell (p. 4). A famous example of tacit knowledge frequently used by Schn (1983, 1987) is that of face recognition. Polanyi observes that we can know a persons face and can recognise that face among a million faces, yet we usually cannot tell how we recognise a face we know. So, most of this knowledge cannot be put into words. Schn refers to tacit knowledge in his early work with Argyris (1992/1974), in which they examine the implications of tacit knowledge for professional practice.
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In Theory in Practice, the terms implicit knowledge and tacit knowledge are used interchangeably, and are taken to mean that we know more that we can tell and more than our behaviour consistently shows (1992/1974, p. 10). Argyris and Schn contend that tacit knowledge is particularly useful for understanding theories-in-use. In their view, each practitioner develops a theory of practice, whether or not he or she is aware of it. Such a theory is composed of both explicit knowledge, what one is able to say about what one knows, and theories-in-use, which may be unconscious and are revealed through behaviour. Theories-in-use tend to be tacit structures whose relation to actions can be compared to the relationship of grammar-in-use to speech; theories-in-use contain assumptions about self, others, and environment, which constitute a microcosm of everyday life (pp. 2930), and may have both negative and positive elements. Philosopher Gilbert Ryle (1949) seeks to dispel what he refers to as Cartesian dualism, which he contends sets up a dualism between body and mind. Ryle states that the exercise of intelligence cannot be analysed by first considering operations with the mind and then executing them with the body; rather, the mind and body are much more integrated. Ryle resists dualistic thinking with respect to the separation of activities of the mind and activities of the body by directing attention to the doings of persons, such as playing chess, knot-tying, car-driving, theorising, and other activities. Ryle finds mind revealed in the doings of persons, doings that are explainable by the doers aims, not by ghostly inner causes. He writes: The statement the mind is its own place as theorists might construe it, is not true, for the mind is not even a metaphorical place. On the contrary, the chessboard, the platform, the scholars desk, the judges bench, the lorydrivers seat, the studio and the football field are among its places. These are where people work or play stupidly or intelligently. Mind is not the name of another person, working or frolicking behind an impenetrable screen; it is not the name of another place where work is done or games are played; and it is not the name of another tool with which work is done, or another appliance with which games are played. (Ryle, 1949, p. 51) One can see resonances of these ideas in Schns knowing-in-action. Schn (1987) coins the term knowing-in-action to refer to the sorts of know-how revealed in intelligent action, in such publicly observable, physical performances as riding a bicycle and in such private operations as an instant analysis of a balance sheet. In these situations, according to Schn, the knowing is in the action and is revealed by spontaneous, skillful execution of the performance, which one is characteristically unable to make verbally explicit (Schn, 1987, p. 25). With respect to knowing-inaction, Schn (1983) points out that although we sometimes think before acting, it is also true that in much of the spontaneous behaviour of skillful practice we reveal a kind of knowing which does not stem from a prior intellectual operation (p. 51). Implicit within this knowing-in-action, which does not stem from a prior intellectual action, is a tacit dimension, an implicit knowing-how. Rather than invoking intentional reflection, knowing-in-action and theories-in-use illuminate a
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different kind of reflection, revealed in knowing-how, which is characterised for the purposes of this discussion as embodied reflection. Because tacit knowledge and knowing-how are revealed in the actions, the doings, of the individual practitioner, I suggest they may be characterised as embodied modes of reflection (see Kinsella, 2007b, for an elaboration), distinct from the intentional mode highlighted earlier. Through his conceptions of knowing-in-action, theories-inuse, and partially through reflection-in-action, Schn invokes this type of embodied reflection, and attends to the duality, with respect to a separation of mind and body, that has frequently been re-inscribed following Descartes. Receptive Reflection Although Schn elaborates beyond intentional reflection by highlighting an embodied dimension, a duality continues to exist between the modes of reflection to which Schn refers, and the pre-reflective experience (Greene, 1995; MerleauPonty, 1967; Sandywell, 1996), receptive reflection (Willis, 1999), or contemplative reflection (Miller, 1994) depicted by others. Receptive reflection is depicted in the left-hand column in Table 1. Willis (1999) makes a distinction between active/reductive and intuitive/receptive modes of reflection. He observes that the more one thinks about it, the more one is confronted with a proactive and a contemplative dimension. In the proactive stance, a thinker takes in and names experiences, orders them, and locates them into categories of language and ways of seeing the world. Willis contrasts this stance with an intuitive/contemplative stance, which highlights receptive and aesthetic ways of attending to the world. The receptive stance holds back discriminatory analytic thinking, in favour of a more contemplative process, in which the mind acts more like a receptor, receiving ideas, images, and feelings, and being moved by them. In a receptive stance, the mind does not seize upon the object to analyse and subdue it but attempts to behold it, to allow its reality, its beauty and its texture to become more and more present (p. 98). This approach holds the thinking mind back from closure and returns again and again to behold the object, allowing words and images to emerge from the contemplative engagement (p. 98). Willis makes a useful distinction between intentional reflection and the type of reflection that emerges from receptivity or contemplation. With respect to this notion of receptive reflection, physicist David Bohms (2003) ideas are of interest. He discusses the way in which thought can generate illusions, and suggests the possibility of moving beyond this illusion-generating structure to what he refers to as a response from the emptiness. He writes: When one internally imitates an illusion-generating structure, one is thereby immediately lost in illusion, so that whatever one does is worse than useless. Therefore, what is called for is an ending of the response of thought, which is too mechanical. Rather, what is needed is response from the emptiness, which sees the structure of illusion generation, without imitating this structure. (p. 234)
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Bohm (2003) uses the analogy of the mind as an ocean that is stirred up and stormy on the surface but peaceful at the bottom. He suggests: The mind may have a structure similar to the universe, and in the underlying movement we call empty space there is actually a tremendous energy, a movement. The particular forms which appeal in the mind may be analogous to the particles, and getting to the ground of the mind might be felt as light. The essential point is not that its light but rather this free, penetrating movement of the whole. (p.157) MacInnes (2001) observes receptive reflection through meditation. She suggests that in meditation we endeavour to stop linear thinking, even to avoid entertaining random thoughts, and all such mental activities (p. 83). Such an approach complements intentional forms of reflection. MacInnes views meditation as a process in which individuals disengage the Psyche from all its busy-ness (p. 83), a shift she describes as gargantuan in todays world, where she characterises an overactive mind as the disease of our times (p. 77). She believes that the nonthinking state achieved in meditation gives our whole being freedom to experience a deep sense of unity and the freedom to do its thing (p. 22). Thus, according to this perspective, the insight achieved in meditation and the practice of disengagement from the mind have the potential to inform action in a new way. Miller argues that Schns reflective practice, while valuable, continues to perpetuate dualities, whereas contemplative modes of reflection focus on overcoming such. Miller contrasts Being, a concept rooted in Heideggers (1962) philosophy, with intentional reflection: Being is experienced as unmediated awareness. This awareness is characterized by openness, a sense of relatedness, and by awe and wonder.When we experience Being, duality drops away and as teachers we see part of ourselves in our students. At the deepest level we may experience brief moments of communion with our students. (Miller, 1994, p. 25) Others focus on the arts as a vehicle for uncovering such prereflective or receptive landscapes. As educational philosopher Greene (1995) notes, engagement with the arts may provoke us to recall that rationality is itself grounded in something prerational, prereflectiveperhaps in a primordial, perceived landscape (p. 52). Drawing on Merleau-Ponty (1964), Greene suggests that the prereflectivethat is, what we perceive before we reflect on itbecomes the launching pad for rationality. She contends that we must take account of our own landscapes if we are to be truly present to ourselves and engage in authentic relationships. It is on primordial ground that we recognize each other; that ground on which we are in direct touch with things and not separated from them by the conceptual lenses of constructs and theories (p. 75). Schn attends to an intentional cognitive type of reflection and an embodied type of reflection revealed in action, yet never explores the significance of receptive reflection to practice. He hints at related concepts, such as the tacit, artistic, intuitive performance of successful practitioners, yet never fully confronts this realm.
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With respect to professional action and the busyness of practice, I wonder about the relevance of receptive reflection as an opening for new ways of seeing and for informing wise action. To what extent can the capacity to disengage from what MacInnes (2001) calls the disease of our times, an overactive mind, contribute to how practitioners might reframe the problems of practice and discern wise action in practice? What, I wonder, is lost by failing to acknowledge receptive reflection in professional practice? How might attention to receptive reflection inform other modes of reflection and offer hope for contributing to practice environments that are more humane and that transcend purely instrumentalist ideals? Reflexivity Reflexivity is depicted in the right-hand column of Table 1. Schn (1992) states that Dewey never fully confronts the ontological differences in our ways of seeing situations and construing them as problematic or not (pp. 122123, italics in original). Some social theorists might say something similar of Schn: that he fails to attend to reflexivity. Social theorists might argue that Schn never fully confronts the ontological implications of the agent as embedded in social, cultural, historical, and linguistic communities, and the implications of such for ways of seeing situations and construing them as problems or not. In other words, although Schn acknowledges that we each have different ways of seeing situations and constructing the world, he does not appear to fully acknowledge the background and social conditions that implicitly influence and contribute to our ways of seeing, what Kemmis (2005) refers to as the extra-individual features of practice; nor does he direct practitioners attention to a critical consideration of such background conditions. Rather, drawing on Nelson Goodmans (1978) constructivist ideas in Ways of Worldmaking, Schn focuses attention on individual constructions (Kinsella, 2006) in his epistemology of practice. Schn takes Goodmans ideas about the ways in which worlds are made and applies these ideas to considerations about the world of professional practice. Underlying this notion of worldmaking, in the work of both men, is a constructivist orientation that emphasises individual reflection as opposed to social constructions, and focuses on viability within the subjects experiential world. The practitioner in this account tests out actions for their fit within the system within which he or she participates. Thus, in Schns conception, within a particular created world, he suggests one can discover the consequences of ones moves, make inferences, and establish by experiment whether ones way of framing the situation is indeed appropriate. An implicit assumption in this approach is a focus on the individual person as the locus of meaning construction. While individual reflection is important, one of the critiques of reflective practice is its focus on the individual practitioners constructions of knowledge without adequately attending to the material, social, or discursive dimensions of practice knowledge (Kemmis, 2005). In this way, reflective practice relies primarily on the practitioners own resources (Taylor & White, 2000). Yet, professional practice occurs within a variety of communities (Wenger, 1998) and is shaped by
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social relations and discursive codifications (Bourdieu & Wacquant, 1992; Kemmis, 2005; Taylor, 2003; Taylor & White, 2000). Inherent in this tension is the question of how meaning is constructed. The words of philosopher Merleau-Ponty (1967) are striking: because we are in the world, we are condemned to meaning (p. xix, italics added). In professional practice, too, we are condemned to meaning; therefore, the question of how meaning is constituted is significant. Is meaning constructed within the solitary practitioner? To what extent is meaning construction a dialogic or social process? How are constructions of meaning influenced by historical conditions, contexts, and discursive practices? Philosopher Richard Kearney (1988) highlights the intersubjective nature of meaning construction. He argues that meaning does not originate within the narrow chambers of its own subjectivity, but emerges as a response to the other, as radical interdependence (p. 387). Does reflective practice, with its focus on practitioner subjectivity and worldmaking, have the potential to occlude this response to the other in the construction of meaning? In Sandywells (1999) view, this is indeed a danger; he believes that individual reflection can fail to consider the accounts of Others. Sandywell notes that, since Descartes, cognition appears as a type of inner contemplation, conducted by the solitary meditator, and is distinct from older dialogical views of existence, which, he suggests, have been displaced in favour of a proprietary conception of objects constituted through acts of introspective cognition (Sandywell, 1999). Solitary reflection, according to Sandywell, carries with it the danger of objectifying the other. In response, he proposes a form of dialogic reflexivity. Sandywell (1996) observes that whereas reflection posits a neutral world of entities, reflexivity reminds reflection of the sociality of all world reference (p. xiv). He notes: In day-to-day living we plan and negotiate our ordinary affairs against a relatively fixed background of pregiven relations and structures whose origins and workings are not typically subject to critical reflection. As finite beings we are even unaware that the narratives we use to describe the world actively constitute its otherness as intelligible experience. Yet by virtue of their located and embedded character, forms of world-interpretation are in principle revisable constructs. (p. xiii) Thus, Sandywell highlights the social nature of worldmaking implicit in its located and embedded character. Whereas Schn and Goodman might agree with the located and embedded nature of worldmaking, their focus is on the individual agents activity as opposed to considering the sociality of world reference that Sandywell highlights. With respect to a social dimension to worldmaking, Bohm (1996) points out that thought is both a collective and an individual process. He writes: We could consider two kinds of thoughtsindividual and collective. Individually I can think of various things, but a great deal of thought is what we do together. In fact most of it comes from the collective background. Language is collective. Most of our basic assumptions come from our
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society, including all our assumptions about how society works, about what sort of person we are supposed to be, and about relationships, institutions, and so on. Therefore we need to pay attention to thought both individually and collectively. (p. 11) This view has significant implications for considerations of how meaning is constructed in practice. Attending solely to individual thought, as in the thought of the practitioner, becomes insufficient without a consideration of the collective background. Rather, it becomes important to attend also to the collective thought that implicitly informs the backdrop to the process of an individuals worldmaking in practice. In addition, even the construction of disciplinary knowledge has itself been portrayed as a social process (Harding, 1991; Kuhn, 1962, 1977). Although Schn appears to acknowledge the role of applied science and technique in the education of professionals, and to critique the unreflective application of such, he does not emphasise practitioner reflexivity, defined by social philosopher Sandywell (1996) as the act of interrogating interpretive systems (p. xiv). Reflexivity goes beyond reflection to interrogate the very conditions under which knowledge claims are accepted and constructed, and it recognises the sociality of that process. Sandywell writes: Where reflective orientations tend to adopt an empiricist orientation to their world domains and a pragmatic attitude toward their own authority, reflexive perspectives approach first-order reality work as a constructive process. Reflection posits a neutral world of entities, reflexivity reminds reflection of the sociality of all world reference. (p. xiv) According to Sandywell (1996), for reflection, objects are simply things; for reflexivity, however, things are materialised significations, the outcome of social constructions and translation procedures, and require critical interrogation (p. xvi). Epistemic reflexivity is a phrase used by Bourdieu (in Bourdieu & Wacquant, 1992) to denote reflection and critical interrogation of the social conditions under which disciplinary knowledges come into being and gain credibility. Greene (1995) describes this invisible process of signification using the metaphor of a noxious cloudthe cloud of givenness. She writes that in the interpretive act, we have to relate ourselves somehow to a social world that is polluted by something invisible and odorless, overhung by a sort of motionless cloud. It is the cloud of givenness, of what is considered natural by those caught in the taken-for-granted, in the everydayness of things. (p. 47) Greene (1995) notes communicative distortions (as defined by Habermas, 1971, p. 164) in the language of costs and benefits and in the language of instrumental reason by which phenomena are explained by powerful purveyors of an indecipherable reality of signs and symbols (p. 46). She laments that too few people are enabled to crack the codes, to uncover that in which they are embedded (p. 48). This is the goal of reflexivity, to enable practitioners to begin
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to crack the codes, to consider together the invisible cloud that pervades everyday life and everyday practice, and from this location to envision new possibilities together (Kinsella & Whiteford, 2009). Bohm (1996) refers to the need for relentless questioning of everything that does not make sense in all of ones given presuppositions, assumptions, and taken-for-granted knowledge. Sloan (1983) similarly claims that a major task of the education of professionals is to create a climate of trust in which radical questioning can take place without fear (p. 146). Sloan implies that this questioning should be in the context of service to the positive possibility of gaining new perceptions, and insights, as opposed to the endless spiralling of negative critique. Thus, while Schns concept of reflection focuses on individual constructions, it neglects to consider the materialised significations, the outcomes of social constructions and translation procedures, which Sandywell (1996) refers to as the sociality of world reference, in any depth. An important example of the significance of reflexivity in the health professions is the type of radical questioning that is beginning to take place with respect to clinical trials funded by pharmaceutical companies. Recently increased media and professional attention has focused on the implications of privately funded clinical trials. The questioning of how such results are constructed and presented to physicians, and the implications for how pharmaceuticals come to be accepted and prescribed, is an example of critical reflexivity. Although Schn focuses on reflection, he does not go so far as to advocate this type of reflexivity. Reflection: An Interminable Dialogue Reflection and reflexivity do not, however, form the terms of a binary opposition. Indeed, Sandywell (1996) imagines a continuum between prereflective, reflective, and reflexive experience: Prereflective experience already contains the primitive forms of embodiment, tacit interpretations and imaginary formations which provide the horizon for more reflective systems of action. Human experience is to this extent an interminable dialogue between prereflective experience, reflective practices, and reflexive action. (p. xiv) This interminable dialogue between different dimensions within a continuum of reflection are proposed as a central underpinning of how we might think of reflection as important for practical wisdomphronesisin professional life. The proposed continuum of reflection retains Schns intentional reflection and embodied reflection, as depicted in the two central columns of Table 1. However, a continuum of reflection also includes sensitivity to receptive modes of reflection, those open to revelation, intuition, emotion, aesthetics and contemplation, as depicted in the left-hand column of Table 1. Further, attention is drawn to reflexivity (Bourdieu & Wacquant, 1992), in the sense of critical discernment of the social conditions under which disciplinary knowledges are constructed, and an ongoing interrogation of these conditions. As such, the practitioner oriented toward practical
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wisdom is cognisant of the extra-individual features of practice (Kemmis, 2005); the role of power, discourse, and intersubjectivity in the construction of versions of reality in practice; and mindful of the imperative of reflexive attention and dialogue in this regard. Reflexivity is depicted in the right-hand column of Table 1. Although this continuum of reflection is presented in a static form for purposes of presentation, the proposed character is much more dynamic and iterative. It embraces an interminable dialogic praxis (Sandywell, 1996) between different types of reflection. The different types of reflection in the continuum might be thought of as dimensions of reflection, in the sense that they always comprise a mixture of types of reflection, and rarely, if ever, is there a pure enactment of just one type or another. The continuum might be envisioned more as a pulsating quadrant (I am indebted to Bill Green for proposing this image), a messy interacting mixture of different dimensions of reflection alive in professional practice.
CRITERIA FOR PHRONETIC JUDGEMENT: THE DISPOSITION TOWARD PHRONESIS
Reflection is implicated in professional practice through the judgements and actions it informs in the lives of practitioners. How might such judgements and actions be informed with a phronetic quality? Many scholars contend that professional practices are interpretive practices (Montgomery, 2006; Polkinghorne, 2004; Schn, 1983, 1987), centrally concerned with how practitioners make judgements. If this is so, it raises questions about the grounds on which practitioners make judgements, and how practitioners might orient such judgements in the direction of phronesis. Schn (1987) suggests, drawing on Spence (1982), that all interpretations are essentially creative and that any number of different interpretations, equally coherent and complete, might be provided for any particular clinical event. In this view, right interpretations have a power to persuade grounded in their aesthetic appeal. They may also acquire pragmatic usefulness, grounded in the expectation that they will lead to additional clarifying clinical material (Schn, 1987, p. 229). Schn draws attention to three criteria for professional judgement: pragmatic usefulness, persuasiveness, and aesthetic appeal. Illuminating the implicit criteria by which practitioners make judgements may be a useful way both to conceive of, and make explicit, the balancing act in which professionals continually engage, and to begin to think about what types of considerations might lead practitioners beyond instrumental approaches and toward practical wisdom in their interpretations and judgements in practice. In the following discussion, I briefly consider the criteria of pragmatic usefulness, persuasiveness, and aesthetic appeal, and propose three further criteriaethical imperatives, dialogic intersubjectivity, and transformative potentialwhich might be worth considering in the quest to engage phronesis through wise judgements in practice. This list is not meant to be exhaustive or to suggest that some normative criteria for phronetic judgements might be found; rather, this discussion is an
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exploratory consideration of possible criteria that might guide practitioners in the disposition toward phronetic judgements in practice. Pragmatic Usefulness The first criterion that Schn highlights by which practitioners make judgements in practice is the criterion of pragmatic appeal. His notion of pragmatic usefulness refers to the idea of practice fit or viability within the practitioners experiential world. Furthermore, Schn draws on a pragmatic philosophical tradition: his works are grounded in the pragmatic philosophy of John Dewey, and the assumptions implicit within that tradition are evident in his perspective. Persuasiveness The second criterion identified by Schn is persuasiveness. I assume here that Schn refers to persuasiveness with respect to the course of action a practitioner chooses in light of his or her reflections within a particular practice context and within a particular disciplinary community. Such a view may be likened to philosopher of science Thomas Kuhns (1962, 1977) insight that persuasiveness within a scientific community is one of the key criteria by which scientists make judgements about which theory to adopt or accept. In practice, persuasiveness within the disciplinary community and the practice context is a criterion by which practitioners make judgements. Aesthetic Appeal A third criterion is aesthetic appeal. Dewey (1929) suggests the word artistic be used to designate the activities by which works of art (including practice) are brought into being, and the term aesthetic be used for the appreciation of such works (p. 5). Thus, an aesthetic vision of experience views professional practice as an art, and the appreciation of that art as the aesthetic. Such a conception recognises more than instrumentalist and efficiency-based views of practice (Stein, 2001) and includes realms that fall outside of traditional epistemic lines. The aesthetic serves as a way of considering the experience of practice itself, in the sense that successful practice may be conceived of as an art form. Ethical Imperatives A fourth proposed criterion is ethical imperatives. Ethics receives little direct attention in the work of Schn, despite its centrality in Deweys writings (see Dewey, 1972/1897, Dewey & Tufts, 1978/1908). I suggest this area requires significantly more attention with respect to considerations of how practitioners reflect in practice and the criteria by which they make decisions. Many decisions that fall within the indeterminate or grey zones of practice are infused with ethical concerns. For example, when I speak to front-line health practitioners, they
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frequently express concerns about ethical issues and ethical relationships in their practices. Many suggest that it is their connection and care for other human beings that keep them in their vocations despite difficult and morally complex conditions. In an increasingly complex world, in which the infiltration of corporate values in health care (and other environments) is frequently a reality (Stein, 2001), the time and opportunity for reflection on ethical issues can easily become displaced, or simply silenced amid the vast cacophony of other voices. If one is to take phronesis as professional knowledge seriously, then ethics is of central concern. When considering the criteria by which practitioners might make phronetic judgements in practice, consideration of ethical concerns appears to lie at the centre. Dialogic Intersubjectivity I propose that phronetic judgements recognise the sociality of consciousness, such that reflection is viewed as an individual and a social process, considered in light of both individual and collective thought. To simply reflect on ones own interpretations, without a consideration of what Levinas refers to as the face of the other (Kearney, 1988, p. 362), and an acknowledgement of the Others interpretation of meaning, raises ethical questions (Kinsella, 2005). An ethics of care (Nodding, 1984) and answerability (Bakhtin, 1993) recognise the dialogic nature of identity and the practitioners responsibility to others in this regard. It draws attention to the imperative within practice to attend to the powerful intersubjectivity that is always at play. Dialogic intersubjectivity recognises both the negotiation of meaning within practice settings and the role of discourse in this process. Thus, a fifth proposed criterion by which practitioners might move toward phronetic judgement in practice is through recognition of dialogic intersubjectivity: the extent to which the dialogic nature of interpretation is acknowledged and the extent to which Others versions of reality are given a hearing. The practitioner oriented toward phronesis is aware of and concerned with not only his or her own interpretations in practice but also the dialogic possibilities implicit in the recognition of the interpretations of clients, co-workers, and others. Transformative Potential A sixth proposed criterion for phronetic judgement is attention to the transformative potential within the practice situation. Rather than looking solely for pragmatic fit within the traditions of practice, one might also consider the power of imagination and the transformative potential of a situation. Such a perspective embodies the idea of the practitioner as a transformative intellectual (Giroux, 1988) and attends not only to pragmatic or practical interests but also to emancipatory interests and possibilities (Habermas, 1971) within the situation at hand. Rather than accepting received views, the practitioner oriented toward practical wisdom critically considers why things are as they are, examines the taken-for-granted, and engages with possibilities for transforming the situation at hand, in the interest of justice.
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In summary, I highlight six criteria by which practitioners might move toward phronetic judgements as they engage in processes of reflection in practice. These criteria do not claim to be exhaustive or normative in any way. However, if we accept that professional practices are interpretive practices, centrally concerned with how practitioners engage in reflection to make judgements, perhaps it behooves us to begin to think about and make explicit the implicit criteria by which such judgements are weighed. Beginning first with three criteria discussed by Schn, I propose an elaboration to six criteria that might foster practitioner reflection in ways that move toward phronesis or practical wisdom: pragmatic usefulness, persuasiveness, aesthetic appeal, ethical imperatives, dialogic intersubjectivity, and transformative potential. These criteria are offered not as the final word but rather as a means to open a conversation about how phronetic judgements might be cultivated in professional life.
CONCLUSION
In this chapter, I have proposed an elaboration of Schns reflective practice in light of Aristotles phronesis. It is my hope that this chapter will spark further conversation about how we might extend conceptions of reflection and think about practitioner judgements and the implications for phronesis. I propose that reflection, in the interest of phronesis, might usefully be conceived as a continuum, and have begun to articulate what that continuum might look like (see Table 1). This continuum is not meant to be linear or hierarchical, and indeed it might better be imaged as a pulsating, overlapping, quadrant. In addition, I have examined the criteria for professional judgements identified by Schn, and propose an elaboration, recognising that this is just the beginning of a scholarly conversation in this realm. These criteria are not meant to be an exhaustive list, nor are they meant to imply that a normative schema can be identified; rather, this discussion is offered merely as a means of opening an important and largely unarticulated conversation. Schn (1992) noted that philosophers remain alive for us, in so far as we are inspired to rethink and renew the meanings of the ideas they plant in our minds. The same may be said of Schn and Aristotle; both have left us with important legacies. It is our job to rethink and renew the meanings of these ideas in light of contemporary theoretical conversations and complex practice contexts, and to do so with as much practical wisdom as we can muster. Perhaps it is through our efforts to engage such conversations, as much as in any insights that we might garner, that we will find phronesis!
REFERENCES
Arendt, H. (1971). The life of the mind: Vol. 1. Thinking. New York: Harcourt Brace, Jovanovich. Argyris, C., & Schn, D. (1992). Theory in practice: Increasing professional effectiveness. San Francisco: Jossey-Bass. (Original work published 1974) Bakhtin, M. (1993). Toward a philosophy of the act. Austin, TX: University of Texas Press. Bohm, D. (1996). On dialogue. (L. Nichol, Ed.). London: Routledge. Bohm, D. (2003). The essential David Bohm (L. Nichol, Ed.). London: Routledge. 50
PRACTITIONER REFLECTION AND JUDGEMENT AS PHONESIS Bourdieu, P., & Wacquant, L. (1992). An invitation to reflexive sociology. Chicago: The University of Chicago Press. Dewey, J. (1929). Experience, nature and art. In J. Dewey, A. Barnes, L. Buermeyer, T. Munro, P. Guillaume, M. Mullen & V. deMazia (Eds.), Art and education (pp. 312). Rahway, NJ: Barnes Foundation Ltd. Dewey, J. (1933). How we think: A restatement of the relation of reflective thinking to the educative process. Boston: Heath & Co. Dewey, J. (1938). Experience and education. New York: Collier Books. Dewey, J. (1972). Ethical principles underlying education. In J. A. Boydston (Ed.), The early works, 18821898: Vol. 5. Early essays (pp. 5483). Carbondale, IL: Southern Illinois University Press. (Original work published 1897) Dewey, J., & Tufts, J. (1978). The middle works, 18991924: Vol. 5. Ethics (J. A. Boydston, Ed.). Carbondale, IL: Southern Illinois University Press. (Original work published 1908) Elgin, C. (2000). Goodman, Nelson. In Concise Routledge encyclopedia of philosophy (pp. 321322). London: Routledge. Eraut, M. (1995). Schn shock: A case for reframing reflection-in-action. Teachers and Teaching: Theory and Practice, 1(1), 922. Giroux, H. (1988). Teachers as transformative intellectuals. In Teachers as intellectuals: Towards a critical pedagogy of learning (pp. 121128). Granby, MA: Bergin & Garvey. Goodman, N. (1978). Ways of worldmaking. Sussex, UK: The Harvester Press. Greene, M. (1995). Releasing the imagination: Essays on education, the arts, and social change. London: Routledge. Habermas, J. (1971). Knowledge and human interests. London: Heinneman. Harding, S. (1991). Whose science? Whose knowledge?: Thinking from womens lives. Ithaca, NY: Cornell University Press. Heidegger, M. (1962). Being and time (J. Marquarrie & E. Robinson, Trans.). New York: Harper. Kearney, R. (1988). The wake of imagination. London: Routledge. Kemmis, S. (2005). Knowing practice: Searching for saliences. Pedagogy, Culture and Society, 13(3), 391426. Kinsella, E. A. (2005). Constructions of self: Ethical overtones in surprising locations. Medical Humanities, 31, 6771. Kinsella, E. A. (2006). Constructivist underpinnings in Schns theory of reflective practice. Reflective Practice, 7(3), 277286. Kinsella, E. A. (2007a). Technical rationality in Schns reflective practice: Dichotomous or nondualistic epistemological position. Nursing Philosophy, 8, 102113. Kinsella, E. A. (2007b). Embodied reflection and the epistemology of reflective practice. Journal of Philosophy of Education, 41(3), 395410. Kinsella, E. A. (2009). Professional knowledge and the epistemology of reflective practice. Nursing Philosophy, 11(1), 314. Kinsella, E. A. (2010). The art of reflective practice in health and social care: Reflections on the legacy of Donald Schn. Reflective Practice: International and Multidisciplinary Perspectives, 11(4), 565 575. Kinsella, E. A., & Whiteford, G. (2009). Knowledge generation and utilization: Toward epistemic reflexivity. Australian Occupational Therapy Journal, 56(4), 249258. Kuhn, T. (1962). The structure of scientific revolutions. Chicago: University of Chicago Press. Kuhn, T. S. (1977). Objectivity, value judgement, and theory choice. In T. Kuhn (Ed.), The essential tension (pp. 320339). Chicago: University of Chicago Press. MacInnes, E. (2001). Zen contemplation: A bridge to living water. Ottawa, ON: Novalis, Saint Paul University. Merleau-Ponty, M. (1964). The primacy of perception. Evanston, IL: Northwestern University. Merleau-Ponty, M. (1967). Phenomenology of perception (C. Smith, Trans.). New York: Humanities Press. 51
E.A. KINSELLA Miller, J. (1994). The contemplative practitioner. Westport, CT: Bergin & Garvey. Montgomery, K. (2006). Rationality in an uncertain practice. In K. Montgomery (Ed.), How doctors think: Clinical judgment and the practice of medicine (pp. 310). Oxford, UK: Oxford University Press. Noddings, N. (1984). Caring a feminine approach to ethics & moral education. Berkeley, CA: University of California. Noddings, N. (1990) Constructivism in mathematics education. In R. B. Davis, C. A. Maber & N. Noddings (Eds.), Constructivist views on the teaching and learning of mathematics (pp. 718). Reston, VA: National Council of Teachers of Mathematics. Polanyi, M. (1967). The tacit dimension. London: Routledge. Polkinghorne, D. (2004). Practice and the human sciences: The case for a judgment-based practice of care. New York: State University of New York. Ryle, G. (1949). The concept of mind. London: Hutchinson. Sandywell, B. (1996). Reflexivity and the crisis of Western reason: Logological investigations, (Vol. 1). London: Routledge. Sandywell, B. (1999). Specular grammar: The visual rhetoric of modernity. In I. Heywood & B. Sandywell (Eds.), Interpreting visual culture: Explorations in the hermeneutics of the visual (pp. 3056). London: Routledge. Schn, D. (1983). The reflective practitioner. New York: Basic Books. Schn, D. (1987). Educating the reflective practitioner. San Francisco: Jossey-Bass. Schn, D. (1992). The theory of inquiry: Deweys legacy to education. Curriculum Inquiry, 22(2), 119 139. Sloan, D. (1983). Insight-imagination: The emancipation of thought and the modern world. Westport, CT: Greenwood Press. Spence, D. (1982). Narrative truth and historical truth: Meaning and interpretation in psychoanalysis. New York: W.W. Norton & Company. Stein, J. G. (2001). The cult of efficiency. Toronto, ON: Anansi Press. Taylor, C., & White, S. (2000). Practising reflexivity in health and welfare: Making knowledge. Buckingham, UK: Open University Press. Taylor, C. (2003). Narrating accounts and the textual construction of reality. Journal of Advanced Nursing, 42(3), 244251. Wenger, E. (1998). Communities of practice: Learning, meaning and identity. Cambridge, UK: University Press. Willis, P. (1999). Looking for what its really like: Phenomenology in reflective practice. Studies in Continuing Education, 21(1), 91112.
Elizabeth Anne Kinsella Faculty of Health Sciences and Faculty of Education The University of Western Ontario
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ARTHUR W. FRANK
Phronesis comes into being but has no specific beginning; we evoke it, but any description seems incomplete. One evocation of phronesis is illustrated in a story retold by the Zen teacher and poet Norman Fischer. The story involves a dialogue between two Zen mastersits important to note this dialogue is not between a student and a teacher but between two mastersGuishan, also referred to as Shan, and Daowu, also called Wu. Guishan asked Daowu, Where are you coming from? Daowu said, Ive come from tending the sick. Shan said, How many people were sick? Wu said, There were the sick and the not sick. Isnt the one not sick you? Guishan asked. Daowu said, Being sick and not being sick have nothing to do with the True Person. Speak quickly! Speak quickly! Guishan said, Even if I could say anything, it wouldnt relate. Later Tiantong commented on this, saying, Say something anyway! (Fischer, 2008, p. 66) Fischer (2008) offers several observations about this story, although he presents the story less as a text to analyse and more as what Id call a companionthat is, a story to live with over time and in the different circumstances that life presents. Fischer recommends letting [such stories] work on us, instead of us working on them (p. 63). But such an approach doesnt exclude a level of interpretation that begins with Fischer noting that although visiting the sick is a great spiritual practice, its possible that Daowu was not visiting the sick at all. Instead, sick in this dialogue is used in the sense of the first Noble Truth of Buddhismthat all beings suffer. The teaching question, or koan, that Fischer takes from the story is: Who is sick? This question is not intended to be answered in so many words; again, the
E.A. Kinsella, A. Pitman (eds.), Phronesis as Professional Knowledge: Practical Wisdom in the Professions, 5360. 2012 Sense Publishers. All rights reserved.
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point is to let the question work on us, instead of us working on it. But as the last part of the dialogue emphasises, although nothing relevant can be said, silence also is not an option. So Fischer (2008) offers a sort of answer to his koan: Who are the sick? The ones who have forgotten the stories of suffering and pain, who think that they themselves are not sick. These are the sick ones; these are the ones who suffer a lot. Who are the ones not sick? These are the ones who know the stories, who know that they are sick, that we all are sick, and who have sympathy. They know the world is a hospital ward and we are doing nothing but tending the sick, ourselves included. (pp. 6667) Fischer would be the first to acknowledge that he didnt discover any of this. It is very ancient teaching. When I had cancer back in the 1980s, Id read enough of this teaching to attempt to say some of the same sorts of things in the book I wrote about my own illnesses, At the Will of the Body (Frank, 1991). My working title for that book was A Dangerous Opportunity. One danger of being diagnosed with a disease is thinking that only now you are sick, and that being sick with a disease is something special. One opportunity you have is to realise all the ways your life has always been sick, and then expanding that realisation to recognise that the sick are all around you. Sickest of all are those people who are most convinced that they exist on the other side of some great divide between themselves and your condition of illness. I begin with Fischers (2008) story of Shan and Wu for two reasons. First, I want to say to healthcare workers: Take this questionWho is sick?and keep it close by so that it can work on you. Let it in, and become shaped by it. Mainstream medicine reduces the answer to this question to the identification of a diagnosable disease. Like all reductions, that answer is useful, but it also authorises us to stop thinking at the point at which wisdom needs to supersede knowledge, which is when phronesis begins. My second reason is to exemplify one form of reflective practice before I talk about reflective practice, which I will now do. *** Reflective practice begins with interruption. I remember once talking to a clinical ethics colleague, William May, about my frustration with one of the oncologists who had treated my mother-in-law when she was dying. This oncologist simply would not stop and listen to her questions, or the familys questions, or anything. You threw him off his rhythm, Bill said to me, and that reply expressed considerable wisdom about medical practice. All of us have a rhythm as we go through our daily tasks, and we resent anything that throws us off. In the course of any present task, we are anticipating the next task, and the pace of the present task takes that anticipation as its metronome. Living in such anticipation is a very unZen way to be, always subordinating the present moment. But it gets things done, whether that task is house cleaning or medical rounds. Reflection interrupts that flow. It is a carved-out space in which we ask ourselves what were doing, and who is doing the things that seem to be getting done. In these reflective moments, the subject of action and the object of action are linked; not quite merged, but fully dependent on each other. You cant think about one without
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questioning the other. Daowu and Guishan both know this, which is one reason why Guishans questionIsnt the one not sick you?is very funny, in the spirit of koan questions to which you can answer neither yes nor no. Both answers are true and not true, which is why the question does not require an answer as a response, at least in any usual sense of an answer. What the question does require might be better described as an interruption. In the space of this interruption, we need to ask what more is being asked than can be addressed by any answer. What needs to be interrupted is the temporal flow in which what is supposed to happen next dominates the present. And beyond that, what gets interrupted is what sociologists call typification, which is one of the main ways that humans make manageable the unmanageable complexity of the reality we face, especially the reality of other people in all their differences. The biographical uniqueness of every other person is simply too complex for humans to deal with, so we categorise people into types, usually according to what we think they expect of us or what we expect of them. Each type has its rules of interaction: how much time to spend, what to say and what need not be said, and so forth. The sociologist Harvey Sacks (1974) took the idea of typification further and talked about membership categorisation devices. What Sacks (1974) noticed was that in much ordinary conversation, speakers refer to people in ways that require the listeners to decide what membership category those people belong to. Sackss famous example was a childs very short story, The baby cried. The mommy picked it up (Sacks, 1974, p. 216). No personal pronoun restricts the noun mommy, so the story is ambiguous as to whose mother is referenced. Sacks claimed and subsequent scholars agree that most of us hearing that story assume the woman who picks up the crying child is that childs mother. She could be another childs mother, but most of English-language speakers will intuitively decide she is the mother of the child she picks up. And here is Sackss point: having made the membership-categorisation decision, we will stick to it and require considerable persuasion before we entertain other possibilities. So, this story shows another way we make an unmanageable world sufficiently manageable to live in, again, whether we are cleaning house or practising medicine. Reflection first interrupts the temporal flow of yielding to the demands of next, and then it disrupts the processes of typification. Reflection asks: Who am I putting in this category of sick? What makes them members of this category, and others not members? What is the principle of my categorisation? I want to emphasise what was gently pointed out to me by the observation that my questions were disrupting the oncologists rhythm. To stop somebody who is going about his or her business and ask them what they are doingand worse yet, who is doing thatis beyond annoying. Such interruptions recall why people were sufficiently annoyed with Socrates to execute him. In his distinctively rational but Zen sort of way, Socrates practised interrupting people and asking them to reflect on what they were taking for granted, especially the categories they used to account for their activity. Those who practise Socratic interruption risk Socratess untimely demise. That is exactly what I will now risk, as I try to specify more closely what kinds of questions healthcare workers might ask themselves, if they were to practise
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reflection. Who is sick? is a fine question for meditation, but professional reflections can also be more task-specific. At the end of these more specific questions, however, we can still return to Who is sick? *** During the last decade, I have had the opportunity to spend a lot of time talking to nurses and physicians about their work. One realisation for me has been the many different responsibilities clinicians have in any encounter with a patient. I think these responsibilities are usefully thought of as claims on the healthcare worker. Each claim calls on the clinician to act a certain way. Some of these claims are complementary, but some can be antithetical to other claims. My list has six claims, and these six are not exhaustive. First, practical claims. Patients, but also colleagues and insurance companies, expect an outcome. The healthcare workers are supposed to get something done, whether that task is diagnosis or intervention. Second, professional claims. Physicians work under the most stringent expectations to meet the anticipated judgements of their peers, both locally and extensively; the professional claims on nurses seem more institutional and teambased. These expectations might be explicitas in best-practice guidelines issued by professional associations and to which physicians are legally responsibleor they might be implicit, as in what colleagues say about you in the lounge or locker room. I have to remind myself how incredibly peer-oriented medical culture is, which I perpetually underestimate. Third, scientific claims. Medical practice is supposed to be based on science, both basic science and the more specific clinical findings known as evidence, as in the phrase, evidence-based medicine. Physicians, as those who have the final responsibility to prescribe treatment, expect themselves to fulfill those responsibilities according to science, or to have very good reasons for any deviation. Fourth, commercial claims. Included here are many claims, from the sorts of direct financial interests that raise the eyebrows of ethicistssuch as physicians having significant personal investment in the pharmaceutical company whose drugs the physician prescribesto the more mundane claims of sustaining office income. The latter may involve being answerable to an office manager who monitors the physicians productivity, or, if the physician owns his or her own practice, she or he needs to respect the claims of office staff whose employment depends on the financial viability of the practice. Fifth, ethical claims. Here, I use ethics in the sense of bioethics: partially codified standards of practice concerning matters such as patient autonomy and consent, confidentiality, respect for dignity, and, at the extreme, non-maleficence. Physicians have all sorts of power with respect to patients, who have all sorts of vulnerabilities. Ethical claims involve the non-abuse of that power. For that reason, such claims are largely negative, phrased as prohibitions. Finally are what I could call moral claims, using moral in the sense that Arthur Kleinman (2006) may have done most to refine in his writings on medicine. The moral claim that I emphasise most in my own writing is to witness the patients suffering. In a perfect world, this claim would be complementary to the first
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expectation that physicians do something with a practical benefit, but a tension can exist between the two, as each makes fundamentally different demands in the physicianpatient relationship. The moral claim often involves a very difficult task for physicians: Dont just do something, stand there. Or, better yet, sit there. Quietly. Either allow the patient to speak, or allow the silence to hold you both together. If the practical claim presupposes the greatest distance between the practising subject and an object that is practised upon, the moral claim understands what both subject and object share in their common humanity. They are both sick and both not sick. They both suffer and they both know stories that address that suffering. Again, these six claims hardly exhaust all the responsibilities imposed upon and experienced by healthcare workers. Six are enough for now, and you can think about others. You can also think about which of these claims support other claims and which undermine other claims; when do healthcare workers find themselves in conflict as to which claim to honour? Reflection, in a more focused, applied sense, can begin by asking which claims are relevant in any medical encounter. Which claims ought to have priority in this encounter? How are different claims backed up, and do those backings give certain claims undue force, vis--vis other claims? How can each claim best be honoured, and when must some claims be allowed to fall into the background, perhaps the deep background? Let me emphasise three points that seem to me to be crucial. First, at least all these six claims will be relevant in any physicianpatient encounter. Second, in most encounters that I can imagine, some claims will militate against others. Third, no decision algorithm can prioritise among the claims. As I see it, the physician has pretty much only two choices. One choice is to organise the days according to a default setting with respect to which claims are honoured how. That is, look at the day as a big checklist and dont look back or even around, which is one description of residency training that imprints itself on physicians as a way of getting through their day. The other choice is to reflect enough that maybe, eventually, a kind of practical wisdom will develop that can never be fully articulatedagain, its never an algorithmbut is felt as a guiding force. The name that is increasingly given to that practical wisdom is Aristotles term, phronesis. *** Why are professionals in diverse fields looking to phronesis as some kind of solution to problems they face? What do these people hope that phronesis can do for us? All kinds of answers are useful to consider, but I will propose only one. Simply put, consider the project of thinking that lifes decisions can be made by plugging them into an algorithm; sociologists would call it the routinisation project. Unfortunately, solutions along these lines seem to cause as many problems as they resolve. Let me illustrate with several stories. The first is a fairly obvious story of what could be called non-phronesis or even anti-phronesis practice, and the later stories show the need for phronesis because what ought to be done is by no means clear. An experienced dialysis nurse described a patient who did not speak English and was both especially apprehensive about dialysis treatment and in pain. He was agitated and pulling at the dialysis lines, so he was given a breakthrough dose of narcotic, according to a protocol. He fell into a calm sleep. As the treatment
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progressed, a floor nurse came by, noted on the patients chart that the protocol called for him to receive an oral pain pill, and proposed to wake him up to administer the dose. The dialysis nurse objected that this was ridiculousthe patient was already asleep. She also pointed out that the patients chart indicated a choking hazard. The floor nurse returned with a supervisor; the patient was woken and given the pill, by mouth, despite the choking hazard that was charted and written on a sign over the bed. People tell clichd jokes about hospital patients being woken up to receive pills so that they can sleep. But sometimes, it is not a joke. Regular medication to prevent breakthrough pain is good practice. But breakthrough pain was not the risk for this dialysis patient. The issue was not the patients needs but the needs of the protocol. I call this story anti-phronesis because its about overriding the claims of practical wisdom in favour of routines that have been decided upon without reference to the situation at hand but which are nevertheless applied. The story is almost too much of a clich to be useful, but it did actually happen. And that it happenedthat the protocol was so obviously lacking as a guide to actionis why people turn to phronesis as a better way of doing things. What also needs to be emphasised is that phronesis does not do what protocols are intended to accomplish, which is to decrease personal responsibility for decisions that might be challenged. If, for this dialysis patient, the protocol had been followed and things had gone badly, the nurses would have been accountable, but they had a defence. If things had gone badly and the protocol had not been followed, their level of accountability would have increased. So accountability trumps both the patients interest and the nurses self-respect as a professional. Phronesis offers no such formal, juridical accountability. On the contrary, phronesis is precisely about taking personal responsibility that is based on expertise. My other stories come from Tony Miksanek (2008), a physician practising in Illinois. Miksaneks article is titled On Caring for Difficult Patients, and the patients he describes really are difficult. Willy is a diabetes patient who demands that Dr. Miksanek do nothing more than renew his prescription for insulin and syringes. He refuses any examination or care. If his chart is ever reviewed by the insurance company for quality of care, Dr. Miksanek writes, Im going to get dinged (p. 1424). He concludes: What makes me an ineffective physician in my mind is exactly the quality Willy deems vital in his primary care doctor. Im easy (p. 1424). At the other end of the patient spectrum, the difficulty of caring for Mrs. Thomasina is that she exemplifies what Dr. Miksanek (2008) calls testophilia (p. 1424). She is convinced she needs every medical test she hears of, and she calls weekly to demand more tests. Those tests that Medicare will not cover she pays for herself. Dr. Miksanek writes: Her faith in technology and medical science approaches medical devotion (p. 1425). He also recognises that if she isnt single-handedly bankrupting the healthcare system, Mrs. Thomasina is definitely putting a small dent in it (p. 1425). He tries to resist her demands, Yet she has a way of wearing me down (p. 1425). The third patient is Max, who not only has but also is a pain in the neckthe metaphoric nature of the physical symptom is significant. Max is angry with his
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employer and with workers compensation. Max sees himself as a victim, Dr. Miksanek (2008) writes; Now I feel just like himpessimistic (p. 1426). Their appointments have a ritual quality: Dr. Miksanek fills out forms, and he gives Max a pep talk, although, as he writes, he does not believe it himself. At the end of their session, We nod at one another without speaking a word (p. 1427). Care of these patients can be provided only on the basis of phronesis because these patients dont fit the accepted models of practice. But here we reach an impasse that I see as undecidable. Some might argue that what all three patients need is precisely to have a protocol imposed on them to force them to accept good care or to accept reasonable limits to care. I am convinced that such attempts would alienate the patients and either drive them to other physicians, where the same cycle would repeat itself, or drive them out of the medical system entirely. Unless that risk is takenand in the not too distant future it may become an acceptable riskneither phronesis advocates nor protocol advocates can claim to be right. Dr. Miksaneks stories do not lead to any conclusion for improved care. No magic intervention is offered to make things right for any of these patients. Dr. Miksanek suggests that longer, less frequent visits might help, but those who reimburse the visits do not see things that way. He concludes: Difficult patients and their frustrated physicians fail each other. We flop together. We lose hope. And there is no more worthless doctor than one who has lost all hope. Same holds true for a patient (Miksanek, 2008, p. 1428). Where, you might ask, is the possibility of phronesis in the care of these all-too-real patients, who might also be students, or social-work clients, or any other type of what the British and Irish call service-users? *** To paraphrase Portia in Shakespeares The Merchant of Venice, the wisdom of care is all too often strained, but nevertheless it continues to fall as the gentle rain from heaven. Thats a miracle we should celebrate. I hear that rain falling in Dr. Miksaneks stories of difficult patients. The quality of phronesis that I hear in these stories is the recognition that these people need care not in spite of all the ways they resist good medical practice but precisely because of that resistance. To put it in more abstract terms, Dr. Miksaneks practical wisdom informs his courage to remain in dialogue with imperfect patients, even to the point of recognising how their imperfections instigate his own. Here, then, is a final koan about reflective practice. In Dr. Miksaneks closing, despairing comments about flopping together, is he dragged down by his patients, or is he dragged up? Say either and you miss the point. Speak quickly, as Daowu says. And, if you can think of nothing to say that relates, say something anyway, as Tiantong says you must, because these stories happen and your silence is not an option. Phronesis is what enables these sad, depressing stories to be equally stories of liberation, of duty, and of calling. Phronesis does not make these stories any less sad or less depressing, but might enable the professional who finds himself or herself living such stories to persevere.
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REFERENCES
Fischer, N. (2008, March). Phrases and spaces. Shambhala Sun, 6267. Frank, A. W. (1991). At the will of the body: Reflections on illness. Boston: Houghton Mifflin Company. Kleinman, A. (2006). What really matters: Living a moral life amidst uncertainty and danger. New York: Oxford University Press, Inc. Miksanek, T. (2008). On caring for "difficult" patients. Health Affairs, 27(5), 14221428. Sacks, H. (1974). On the analysability of stories by children. In R. Turner (Ed.), Ethnomethodology (pp. 216232). Harmondsworth, England: Penguin.
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KATHRYN HIBBERT
CULTIVATING CAPACITY:
Phronesis, Learning, and Diversity in Professional Education
Your assumptions are your windows on the world. Scrub them off every once in a while, or the light wont come in. Alan Alda
INTRODUCTION
In this chapter I consider phronesis in terms of what it has to offer our thinking about learning and diversity in professional education. I approach the topic as an educator who has participated in professional education contexts in both medicine and education. I begin with a brief narrative to situate my thinking and illustrate one way in which I work to disrupt assumptions about professional education in the educational context. As the chapter progresses, I consider what it might take to cultivate the habits of mind needed to build capacity for phronetic action in the professions.
PROFESSIONAL EDUCATION
I began teaching in 1982. At that time in Ontario, Canada, regional professional education was largely the domain of teacher federations. Teachers were routinely surveyed about their professional needs so that professional development days could be planned in response to those needs. Typically, sessions began with a motivational keynote address that led to much discussion over the days and weeks to follow. Numerous breakout sessions were offered, and teachers chose those sessions that addressed the subject area or pedagogical needs for which they were seeking support. The sessions were frequently participatory, and we looked forward to spending these days working with colleagues from other schools, talking about ideas we had, and sharing the strategies we were using in the classroom. Further opportunities were available for dialogic interaction around our subject area by participating in one of the teams writing curriculum. I looked forward to working on these projects because of the meaningful opportunities for learning and the engaging discussions about our practice. By the mid-1990s, much had changed. A standardised curriculum had been introduced, followed quickly by standardised assessment and evaluation procedures and a standardised electronic reporting process. The number of days allocated for
E.A. Kinsella, A. Pitman (eds.), Phronesis as Professional Knowledge: Practical Wisdom in the Professions, 6171. 2012 Sense Publishers. All rights reserved.
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professional education via school districts was reduced, and the increase in mandated changes shifted both the control and focus of the experiences from professional development that emerged from regional needs, to training in the new provincial standards. By then, I was working as one of the central program staff at the Board of Education. Responsibility for generating the new curriculum guidelines and procedures was assumed by the Ministry of Education and Training in a much more significant way. The support staff role (previously considered a position of additional responsibility) transformed into a position that required us to disseminate materials and reproduce our received training in a train-the-trainer format. Information was scripted and delivered in a top-down system, which, for me, was the antithesis of teaching. All teachers, regardless of years of experience, level of education, or competence in the classroom were subjected to identical sessions. I recall feeling that this process of training represented the direct opposite of everything I knew about good teaching, and it led to a sense of de-professionalisation and demoralisation. How could we expect teachers to create engaging and stimulating learning environments for students when they werent themselves being engaged as professionals and intellectuals? How could we ask them to differentiate their instruction on the basis of student needs when we completely ignored their differences and needs? The train-the-trainer experience has haunted me ever since, and I continue to return to it in my research time and time again.
EDUCATING PROFESSIONALS: AN EXAMPLE FROM A FACULTY OF EDUCATION
Educating professionals brings with it a set of assumptions about its learners. At the faculty of education where I serve as a teachereducator, students and faculty bring assumptions into their learning environment. Gaining access to the program is highly competitive. Recognising this admissions context, I typically gather information from my students early in a course. For example, in an English Language Arts class, I ask the following questions: Tell me about your literacy background. What led you here? What are your long-term goals? List a sample of the texts that you enjoyed this summer. What would you like me to know about you as a learner? This information allows me to plan my teaching in a way that accesses the student-as-informant (Harste, Woodward, & Burke, 1984), and the results are always instructive. Eventually, I began to consider other ways to use the information that students provided to educate the classroom community. Gathering such information and making it visible became a first step toward accessing the knowledge of practitioners in ways that could help them to problematise their current understandings and begin to negotiate the gaps in their knowledge. For example, I developed mini challenges to help teacher candidates prepare for their work with students in classroom settings, such as the Case of Hsilgne, below:
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I share this case with my class and encourage them to discuss their responses in small groups. When we come back together as a whole class, the suggestions in response to this activity typically include the following: This student sounds like she is immature, and maybe has a learning disability. Hsilgne is highly anxious and has a lot of learning problems and it appears that there are some socio-emotional ones as well. She will need a lot of support. She seems to have a good grasp on what it is that she needs in order to learn, so perhaps someone has been helping her develop learning strategies along the way. She sounds like a typical teenager, struggling with competing identities. After some discussion about the possible problems that Hsilgne may or may not be challenged by, I pause and look at the class for a moment without speaking. Then, I tell them that I want them to listen very carefully to what I am about to say and remember these words as they enter the teaching profession: Hsilgne, I tell them, is YOU. It is the word English spelled backward, and she is a composite of the things that you have told me that you want me to know about you as learners. Without fail, this brief activity serves as a startling disruption to some of the assumptions that teacher candidates bring to their professional education environmentnamely, that those who have already completed an undergraduate degree with sufficient success to gain acceptance into a very competitive
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professional education program must all be independent learners requiring little in the way of direct instruction or differentiated learning strategies. The activity serves to spatialise the conventional narrative, and to relocate the autobiographical in its social and cultural landscape (Kamler, 2001, p. 2) in ways that open their thinking to alternative perspectives and experiences.
EDUCATING MEDICAL PROFESSIONALS
The need to acknowledge and clarify the assumptions we bring to our professional practice becomes even more pronounced when we move into what have long been considered the elite professions, such as medicine. What does it mean to move knowledge about teaching into a global medical education community in ways that demonstrate complex understandings of diversity? Over the past few years, my work in a professional education capacity with physicians has revealed that, like our work with teacher candidates, we must first convince medical educators that diversity in learning exists at all levels. The faculty in many academic medical institutions have increasingly witnessed a growing diversity in the classroom (e.g., in terms of gender, class, age, culture, and language). The greater challenge is to better understand what is not as visible, that is, the complex ways in which people learn. As an educator working with residents and physicians in a highly competitive field, I have observed that assumptions about who residents are as learners often becomes conflated with their intellectual ability. Both physician-educators and the residents themselves are often surprised that despite having qualified to enter a highly competitive program, some struggle with the learning. The typical response by most faculty (and often the students themselves) to their struggle is to pathologise the learner; in other words, to focus responsibility for the struggle on those activities that the learner may or may not be doing. Residents have sought help repeatedly (from across the country and usually with a promise of anonymity) under a cloud of fear and shame, seeking support, first, to understand why they are struggling and, second, to negotiate ways to address their needs. For many, the new learning context they encounter in their residency is their first experience of struggling academically. As a result, we focus much of our work on helping medical faculty to question their assumptions about learners and to ensure that, as educators, we share a collective responsibility to find ways to address the learning needs of our students. The impetus to increase diversity in medical programs and to build and maintain competent and sustainable human resources in our own communities and in outreach settings must, for ethical reasons, include a parallel commitment to develop professionals and programs that are adequately prepared and supported to meet the learning needs encountered in this increasingly diverse context. Disrupting assumptions borne from a more monolithic educational past becomes even more critical as the participants, the contexts, and the knowledge needed are increasingly responsive to an everchanging context of global needs and the diversity entailed by such demand.
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In the Nicomachean Ethics, Aristotle examined the conditions wherein moral responsibility might be ascribed to individuals. I wonder, might Aristotles notion of phronesis offer a unifying and essential habit of the mind (Birmingham, 2004, p. 314) to guide the work of medical educators in todays global context? Eikeland (2006) suggests that a return to Aristotle springs from a deeply felt desire for finding concepts to grasp kinds of knowledge and skills that are directed towards understanding and acting in accordance with requirements of the concrete situations we find ourselves in. The search is for non-technical, non-mechanical ways of recognizing the sovereignty and independence of our everyday cognitions and judgments, without constantly being referred and subordinated to science. Phronesis appears to be a concept with great potential for this. (p. 6) Phronesis, as Aristotle defined it, is a state of grasping the truth, involving reason, concerned with action about what is good or bad for a human being (Aristotle, trans. 1999, p. 154). In professional practice, and medical education is no exception, the dominant discourse has long been steeped in the language of technical and scientific approaches (Schn, 1983). Physicians in particular, are trained to aim for maximal certainty and are rewarded for efficiency, technical skill, and measurable results (Phillips, 1994, p. 1). Instrumental rationalism, however, can only take us so far. Anne Phelan (2005) has fittingly noted that educators must learn to recognize that generalizable knowledge is fragile in the face of practice (p. 353). Because medical residents have been inculcated into a reverence for generalisable knowledge during their undergraduate medical training, difficulties emerge in practice when they need to apply clinical judgement or the exercise of practical reasoning in the care of patients (Montgomery, 2006, p. 37). Montgomery further argues that the obstacle they encounter is the radical uncertainty of clinical practice: not just the incompleteness of medical knowledge but, more important, the imprecision of the application of even the most solidseeming fact to a particular patient (p. 37). At this point, it may be instructive to consider what is meant by practice. MacIntyre (1984) describes it as: any coherent and complex form of socially established cooperative activity through which goods internal to that form of activity are realized in the course of trying to achieve those standards of excellence which are appropriate to, and partially definitive of that form of activity, with the result that human powers to achieve excellence, and human conceptions of the ends and goods involved, are systematically extended. (p. 187) Practice, and professional practice in particular, is therefore both an intellectual and a moral enterprise. In their clinical education, physicians are trained to expect the unexpected; to make decisions in the absence of information and in the presence of conflicting information. How might we encourage those who mentor, supervise, and
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teach residents to apply such contextualised understanding to the pedagogical practices in their resident education programs? In other words, how might we shift the architecture of medical education training at the residency level, in particular, to a design that positions learners as professionals participating in improving their education, and therefore their ability to make informed decisions? Donald Schn (1973) suggests that a social system learns when it acquires new capacity for behaviour . . . and must also learn to create the systems for doing so (p. 109). He later considers practitioners capacity for reflection on their intuitive knowledge in the midst of action and use this capacity to cope with the unique, uncertain, and conflicted situations of practice (Schn, 1983, viiviii). Reflexive analysis of practice (what Schn calls reflection on action) offers a means for practitioners to deliberate about the ends and goods involveda deliberation sorely lacking in a purely technical approach. Indeed, Pring (1996) has argued that practitioners no longer deliberate about the aims of education as part of their professional responsibility; instead they deliberate about the means to achieve externally imposed ends as part of their craft (p.110). Reflective practice as a means to knowledge construction is often criticised for its subjectivity in having educators come to understand their practice initially through personal interpretive lenses. The longer one teaches, the greater the likelihood the theoretical underpinnings to practice will become tacit and the practices routine. While routines can be beneficial by helping us to manage the complexities of our day without attending to every detail, routinised practices are more likely to then remain unexamined (Tripp, 1993). Yet, it is precisely the process of examining those routine practices that opens the door to the work of reflective practice. Further scrutinising those actions is highly likely to influence the future actions and decisions made by professionals in ways that may directly affect the experiences of patients or students, an activity that Tait (2008) argues is the impetus for reflective practice (p. 153). Once educators are able to acknowledge and articulate the theories and assumptions that underpin their practice, they are in a better position to critique their practice and to subsequently act upon the insights gained. Birmingham (2004) suggests that reflection is centered on the personal character of the individual, but is expressed in actions such as critically examining instructional goals, caring for students, and ensuring just treatment for students (p. 316). She insists that the model of reflection needed is one in which knowing and thinking are inextricably bound up in action, emphasising [Schns] terms reflection-in-action and reflectionon-action (p. 316). The capacity to understand precisely which action is best suited to a particular situation draws on the notion of phronetic action.
PHRONETIC ACTION IN CONTEXT: THE 21ST CENTURY LEARNER
More than ever before, learners who come before us no longer rely solely on an individual instructor or a particular text to gather their information. Access to information, even in developing countries, is growing and is radically changing the way learners think about situations and the prior knowledge, skills, and experiences
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they bring to a teaching and learning context. Conversely, the expectations that many faculty continue to bring to the teaching and learning environment too often reflect a passive learner from a different generationa learner who took notes, followed directions, and progressed in predictable and controllable ways. In todays global society, our classrooms are increasingly multicultural, and our students, especially the younger generation, engage in their learning and interaction in ways not experienced by an older generation. Returning to Aristotle (as cited in Flyvbjerg, 2001), we are reminded that phronesis is that intellectual activity that focuses on what is variable, on that which cannot be encapsulated by universal rules, on specific cases; it requires consideration, judgment and choice (p. 57). A first step in moving away from the more traditional, orthodox teaching approach involves shifting the culture of institutional and professional educators expectations in ways that acknowledge the fluidity and complexities of the global learning environment and its students. The shift in cultural awareness requires a concurrent willingness to assume professional responsibility for ones actions. Dewey (1932, 1933) refers to this willingness as a whole-heartedness and open-mindedness that I argue better positions educators to act phronetically, that is, in ways that enhance the quality of the teaching and learning experience for the entire community. To act phronetically requires a shift in thinking about both our learners and our pedagogical responsibilities for their professional education. Expect learners to arrive with diverse skills, knowledge, and abilities that go beyond the prerequisite training from their undergraduate medical preparation. Plan their educational experiences in ways that acknowledge these differences, and model the precise kind of phronetic action you expect them to apply in their clinical practice. As educators, we are teaching in every interaction, every decision, and every responseincluding every silence. To act phronetically is to behave in a way that demonstrates ethical practicality; doing what is needed, when it is needed, to bring about the desired ends through our actions. Acting phronetically is both intellectual and moral work. Indeed, Dunne (1993) claims that phronetic action cant exist without both intellectual and moral conditions of the mind (p. 264), conditions that may counter the overreliance on techne seen in skills-based movement[s] (p. 268). Briefly, Narvaez (2005, 2006) finds a moral expert to be someone who demonstrates high levels of: (1) ethical sensitivity (e.g., connecting with others, awareness of peoples feelings, controlling ones social biases, understanding moral and social situations); (2) ethical judgement skills (e.g., applying a code of ethics, reasoning about what needs to be done, determining the best course of action); (3) ethical focus (e.g., making morality a priority, aligning ones moral values with ones identity, being an active community member, deriving meaning from living a moral life); and (4) competence in ethical action (e.g., implementing morally related knowledge and action, engaging in moral leadership, showing courage and resiliency in the face of hardship). In many ways, the characteristics of a moral expert run parallel to the aims of clinical education that seeks to transform students into reliable practical reasoners as they work out what is best to do for a particular patient (Montgomery, 2006,
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p. 5). Furthermore, Montgomery claims that it is the conjunction of the two: the rational, clinical experience, and scientifically informed care of sick people but notes that its essential virtue is clinical judgment, the practical reasoning or phronesis that enables physicians to fit their knowledge and experiences to the circumstances of each patient (p. 33). How might we adapt that same capacity for phronesis that is needed to care appropriately for individual patients and apply it to pedagogical decision-making for students and residents? To begin, we need to disrupt the assumptions that medical educators bring to this role. As illustrated with the Case of Hsilgne, we need to break down the misconceptions that exist about teaching and learning in the professions. Since most medical educators have little or no professional educational preparation (e.g., teaching and learning theories and strategies, curriculum development, and assessment and evaluation), they are more likely to re-inscribe forms of pedagogy that they themselves have experienced (including deficit forms). Typically, in our research, this re-inscription translates into traditional, teacher-centred approaches that view learners as a homogeneous group. Helping medical educators to understand diverse learning needs and the varying approaches to meet those needs is a significant challenge. Aristotle held that experience was essential to developing phronesis. Within the current structure of many medical education institutions, gaining the kind of educational experience that may lead to phronetic action is difficult. Traditional undergraduate medical education scenarios involve large classes often taught by a long roster of highly trained physicians or specialists who present to the class as infrequently as once per year. The lack of teacherlearner interaction inhibits the formation of relationships necessary to inform teacher practice and decision-making. For example, ratings on teacher effectiveness and data measuring students learning are typically shared with faculty, but not until long after their class is over and in a numeric format that has been described by some as utterly meaningless. In a residency program for physician specialists, the opportunities for individual and small group instruction prevail. However, effective pedagogical feedback continues to be limited or non-existent (Amman, Van Deven, & Hibbert, 2010). Since phronesis evolves from experience, the need for pedagogical feedback is critical. Once we descend to particular cases, Dunne (1993) explains, we are no longer securely in the governance of techne, which is always limited to general rules (p. 259). The need to take action must include an ability to combine those general rules that guide our practice with a more sophisticated ability to discern the unique characteristics of the particular case or context. Kathryn Montgomery (2006) has introduced a framework for building capacity for phronetic action in medical education as it relates to patient care. In her book, How Doctors Think (Montgomery, 2006), she makes the case that medicine is not a science, but a practice that draws on science, and that the physicians best clinical instrumentdiagnostic or therapeuticis the physician herself (p. 162). The same is also true for teaching. Just as residents must recast the biology they have spent years learning into clinically relevant cases (p. 51), medical educators must recast what they know (have learned) clinically into diverse and pedagogically
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relevant teaching practices in order to successfully mentor and instruct the next generation of physician-educators.
CAN DOCTORS THINK?
Creating pedagogically engaging experiences for students requires a willingness to think deeply about the complexities of practiceboth clinical and educational. In a 2008 issue of The Lancet, Anthar Yawar asks the question, Can doctors think? He eventually concludes that doctors might benefit from training in ideas[to] develop the flexibility and depth ordinarily attributed to insightful philosophers (p. 1286). However, if we intend to develop the type of professional, reflective thinking that will support phronetic action, more than training is required. We need to cultivate an institutional culture and conditions wherein thinking, reflection, and ideas thrive and are modelled by all members in the profession. Montgomery (2006) reminds us that if medicine were only a science, physicians could establish their clinical competence by answering test questions correctly (p. 138). In many institutions, answering test questions correctly is the dominant accountability system used to measure competency. The test-competency-as-gatekeeper tradition permeates the concerns of residents, whose overriding focus is successfully passing their board exams. Medicine after all, is not, by and large, a reflective profession (Klaus, 2007, p. xiv). Disrupting well-established assumptions and cultivating a different culture takes time, energy, and the support of key champions within the institution who are dedicated to educational reform. Cultivating a culture that promotes both reflection and the ethical responsibility required to improve the conditions for learning for all students should be an easy alliance for professionals educated in an ethic of care. However, the rigid hierarchical system in medicine that Montgomery observes for medical students and residents can be made even more palpable when nonphysician educators are introduced. Integrating new ways of thinking can be likened to introducing new dance steps into a well-rehearsed routine. If we can help doctors remember that in their profession, they are eternally both a student and a teacher and also help them to reconnect with what it means to be a learner, our work has begun. In Treatment Kind and Fair: Letters to a Young Doctor, Perri Klaus (2007) offers sage advice to her son as he follows her example and enters the medical profession: When all else fails, look at the patient (p. 62). The same advice can be offered to medical educators. Basic skills do not define a profession. Choosing a profession includes accepting all the intellectual and moral responsibilities that accompany that profession as we will need to decide what to do, in each situation for the good of humankind. In medicine, these responsibilities do not end with patient care. These responsibilities extend to the profession as a whole, and to ensuring that those who follow us are better prepared than we were, to engage in an increasingly diverse world. We cannot fully grasp our responsibilities without first scrubbing off our windows on the world.
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NOTE
The epigraph to this chapter is drawn from The Wilderness of Your Intuition, a commencement address by Alan Alda at Connecticut College, New London, Connecticut, May 20, 1980, available at http://aspen.conncoll.edu/programs/pfr. cfm.
REFERENCES
Amman, J., Van Deven, T., & Hibbert, K. (2010). Building capacity within a residency program. In T. Van Deven, K. Hibbert & R. Chhem (Eds.), The practice of radiology education: Challenges and trends. Heidelberg, Germany: Springer. Aristotle. (1999). Nicomachean ethics. (T. H. Irwin, Trans.). Indianapolis, IN: Hackett. Birmingham, C. (2004). Phronesis: A model for pedagogical reflection. Journal of Teacher Education, 55(4), 313324. Dewey, J. (1932). Theory of the moral life. New York: Holt, Rinehart, and Winston. Dewey, J. (1933). How we think: A restatement of the relation of reflective thinking to the educative process. Boston: D. C. Heath. Dunne, J. (1993). Back to the rough ground: Practical judgment and the lure of technique. Notre Dame, IN: University of Notre Dame Press. Eikeland, O. (2006). Phronesis, Aristotle and action research. International Journal of Action Research, 2(1), 553. Flyvbjerg, B. (2001). Making social science matter: Why social inquiry fails and how it can succeed again. London: Cambridge University Press. Harste, J. C., Woodward, V. A., & Burke, C. L. (1984). Language stories and literacy lessons. Portsmouth, NH: Heinemann. Kamler, B. (2001). Relocating the personal: A critical writing pedagogy. Albany, NY: State University of New York Press. Klaus, P. (2007). Treatment kind and fair: Letters to a young doctor. New York: Basic Books. MacIntyre, A. (1984). After virtue. Notre Dame, IN: University of Notre Dame Press. Montgomery, K. (2006). How doctors think: Clinical judgment and the practice of medicine. London: Oxford University Press. Narvaez, D. (2005). The neo-Kohlbergian tradition and beyond: Schemas, expertise, and character. In C. Gustavo & C. P. Edwards (Eds.), Moral motivation through the life span (pp. 119163). Lincoln, NE: University of Nebraska Press. Narvaez, D. (2006). Integrative ethical education. In M. Killen & J. G. Smetana (Eds.), Handbook of moral development (pp. 703732). Mahwah, NJ: Lawrence Erlbaum Associates. Phelan, A. (2005). A fall from (someone elses) certainty: Recovering practical wisdom in teacher education. Canadian Journal of Education, 28(3), 339358. Phillips, S. (1994). Introduction. In S. Phillips and P. Benner (Eds.), The crisis of care: Affirming and restoring caring practices in the helping professions (pp. 117). Washington: Georgetown University Press. Pring, R. (1996). Values and education policy. In M. J. Taylor (Ed.), Values in education and education in values (pp. 104121). London: Falmer Press. Schn, D. A. (1973). Beyond the stable state: Public and private learning in a changing society. Harmondsworth, UK: Penguin. Schn, D. A. (1983). The reflective practitioner: How professionals think in action. New York: Basic Books. Tait, J. (2008). Teachers practical judgment: Acting in the face of uncertainty. Unpublished doctoral dissertation, University of British Columbia, Vancouver. Retrieved February 2010 from https://circle.ubc.ca/bitstream/handle/2429/7723/ubc_2009_spring_tait_joyce.pdf?sequence=1 70
CULTIVATING CAPACITY Tripp, D. (1993). Critical incidents in teaching: Developing professional judgment. New York: Routledge. Yawar, A. (October, 2008). Can doctors think? The Lancet, 372, 12851286.
Kathryn Hibbert Faculty of Education, and Schulich School of Medicine & Dentistry The University of Western Ontario
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