Title: Sociomateriality in medical practice and learning: attuning to what matters
Abstract: Medical EducationVolume 48, Issue 1 p. 44-52 "…there is art to medicine…" Sociomateriality in medical practice and learning: attuning to what matters Tara Fenwick, Corresponding Author Tara Fenwick School of Education, University of Stirling, Stirling, UKCorrespondence: Professor Tara Fenwick, School of Education, University of Stirling, Stirling, FK9 4LA, UK. Tel:+44 (0) 1786 467 611;E-mail: [email protected]Search for more papers by this author Tara Fenwick, Corresponding Author Tara Fenwick School of Education, University of Stirling, Stirling, UKCorrespondence: Professor Tara Fenwick, School of Education, University of Stirling, Stirling, FK9 4LA, UK. Tel:+44 (0) 1786 467 611;E-mail: [email protected]Search for more papers by this author First published: 11 December 2013 https://doi.org/10.1111/medu.12295Citations: 98Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract Context In current debates about professional practice and education, increasing emphasis is placed on understanding learning as a process of ongoing participation rather than one of acquiring knowledge and skills. However, although this socio-cultural view is important and useful, issues have emerged in studies of practice-based learning that point to certain oversights. Methods Three issues are described here: (i) the limited attention paid to the importance of materiality – objects, technologies, nature, etc. – in questions of learning; (ii) the human-centric view of practice that fails to note the relations among social and material forces, and (iii) the conflicts between ideals of evidence-based standardised models and the sociomaterial contingencies of clinical practice. Discussion It is argued here that a socio-material approach to practice and learning offers important insights for medical education. This view is in line with a growing field of research in the materiality of everyday life, which embraces wide-ranging families of theory that can be only briefly mentioned in this short paper. The main premise they share is that social and material forces, culture, nature and technology, are enmeshed in everyday practice. Objects and humans act upon one another in ways that mutually transform their characteristics and activity. Examples from research in medical practice show how materials actively influence clinical practice, how learning itself is a material matter, how protocols are in fact temporary sociomaterial achievements, and how practices form unique and sometimes conflicting sociomaterial worlds, with diverse diagnostic and treatment approaches for the same thing. Conclusions This discussion concludes with implications for learning in practice. What is required is a shift from an emphasis on acquiring knowledge to participating more wisely in particular situations. This focus is on learning how to attune to minor material fluctuations and surprises, how to track one's own and others' effects on 'intra-actions' and emerging effects, and how to improvise solutions. 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