What’s Wrong with Doctors
by Richard Horton
The New York of Review of Books, May 31, 2007, pp. 16-20.
(A review of How Doctors Think by Jerome Groopman, Houghton Mifflin)
Impressive as the recent progress of SLA research is, the progress of medical science is no comparison of it. The success of modern medicine is indeed phenomenal. It would take more than huge optimism to hope that SLA research will, say, in twenty or thirty years, reach the stage that current medical science has reached so far.
That does not mean that medical doctors, on the stage that SLA researchers and practitioners can only dream of, are free from any problems. In the review article by Hortton (the editor of Lancet), Groopman, a cancer specialist and occasional writer for The New Yorker, claims that “there is a common flaw that undermines much of contemporary medical education and training, as well as the partnership between patient and doctor and even the professional values of medicine.” (p. 16). In Groopman’s view, the evidence-based approach, with all statistics, guidelines, and algorithms, may be “ill-informed by the realities, complexities, and uncertainties of medical practice.” (p. 16). With more emphasis on the evidence-based approach in medical education and training, doctors may simply stop observing the patient carefully.
http://en.wikipedia.org/wiki/The_Lancet
http://en.wikipedia.org/wiki/Evidence_based_medicine
Communication between the doctor and the patient, which was not necessarily encouraged with enthusiasm in the past, actually helps the doctor to observe the patient more, and to reflect upon his own practice more.
More observation and reflection through communication.
Have we not heard this elsewhere? Isn’t this also what is required for language teachers? If medical doctors need more observation and reflection through communication with patients despite the heap of the scientific ‘evidence’ in medical science, language teachers, with far less scientific understanding of their field, need far more of them through communication with learners.
How much and how well have you communicated with your students today?
Are our professional values sound enough?
Wednesday, May 30, 2007
Saturday, May 12, 2007
Understanding ‘understanding’
The following is a reconstruction of my oral report of the session “understanding ‘understanding’” on Day 3 of the 1st Oxford-Kobe Seminar (March 17th, 2007). The session was called for by Prof. Leo van Lier when he expressed some concern with the central notion of ‘understanding’ in Exploratory Practice after the plenary speech by Dr. Dick Allwright was delivered on Day 1. My oral report was presented in the final plenary session of the seminar.
****
Good afternoon, ladies and gentlemen. This is a report of the session “understanding ‘understanding.’”
For literally 90 minutes, we kept talking about the notion of understanding. For me, it was one of the best intellectual discussions that I’ve ever participated in. And now your request is to summarize the whole 90 minute argument in a few minutes. What a demand! So you have to forgive me that what I’m going to report from now is my version of summary.
OK, let’s start with a hypothetical episode.
A good teacher understands her class very well. When asked what she really understands, though, she may be lost for clever words. “I know my kids.” She may say. “I understand what’s going on in my classroom.” However, she may stop there.
Is she stupid? No, I don’t think so.
She knows what to do in her classroom and how to do it, both in usual situations and in problematic situations. She’s a wise practitioner with a good understanding of her practice. What does this discrepancy between words and deeds suggest?
What I believe it suggests is that we need to distinguish the following two: a representation of understanding and understanding itself.
A representation of understanding here means roughly articulated understanding or an explanation of understanding in words. My theory is that a representation of understanding is different from understanding.
First, let’s think about understanding itself. Understanding shows itself in perception and action in the world, as Prof. van Lier clarified this morning. A person with a good understanding knows what to do in the world. The better she understands, the better she sees and acts. The better she sees and acts, the better she understands. Understanding, perception and action work interactively in this ‘lived world.’ Understanding in this sense is acting in the world. It is living in the world. If we dare to use a Heideggerian term, understanding is being in the world.
http://en.wikipedia.org/wiki/Heidegger
http://en.wikipedia.org/wiki/Being_and_Time
http://en.wikipedia.org/wiki/Being-in-the-world#Being-in-the-World
http://en.wikipedia.org/wiki/Dasein
http://en.wikipedia.org/wiki/Hermeneutics
http://en.wikipedia.org/wiki/Hubert_Dreyfus
If understanding is acting, living or being in the world, this explains how difficult it is for a practitioner to explain her understanding to an outsider or third person, someone who does not belong to the world, by means of words which are only abstraction from her being in the world. That someone does not act together in the world. He is not in the same world. If only he acts together, live together, is together, he’d probably understands better.
Is it impossible, then, to show our understanding to an outsider altogether? No, again. Understanding shows itself in our action, life and being in the world. If you’re making your classroom a better place to live in, it means your understanding is good and valid.
Also, a representation of understanding isn’t necessarily useless. Dialogue with your colleagues or inner dialogue with yourself in the form of reflective writing probably leads to a better understanding. By verbalizing your understanding, you become more explicitly aware of your being, living and acting in the world, although there always remains some part that is ‘too deep for words.’ What it is like to be in a classroom is a difficult question to answer in words. However, by trying to answer that question, you make your understanding clearer in a different way from leading and showing the life of your classroom.
Trying to understand understanding is a never-ending process (and perhaps a never-successful endeavor). To repeat, understanding is not equal to a representation of understanding. Relating to that point, I’d like to tell a joke about a ballet dancer who was interviewed what she wanted to express in ballet dancing. She allegedly answered that if she was able to express that in words, she wouldn’t dance! Any words would fail to explain your understanding completely, too.
To sum up, understanding is acting, living, and being in the world. It is different from a representation of understanding. But trying to represent our understanding may sometimes help us for a better understanding, thus a better life. Perhaps we should not stop trying to understand our understanding in our open dialogue.
On the last note, I’d like to mention what Prof. Dick Allwright said towards the end of our session. He suggested that perhaps in our discussion we limited ourselves to an intellectual or conceptual understanding. What we may need more may be an empathetic understanding.
Thank you for your attention.
****
Good afternoon, ladies and gentlemen. This is a report of the session “understanding ‘understanding.’”
For literally 90 minutes, we kept talking about the notion of understanding. For me, it was one of the best intellectual discussions that I’ve ever participated in. And now your request is to summarize the whole 90 minute argument in a few minutes. What a demand! So you have to forgive me that what I’m going to report from now is my version of summary.
OK, let’s start with a hypothetical episode.
A good teacher understands her class very well. When asked what she really understands, though, she may be lost for clever words. “I know my kids.” She may say. “I understand what’s going on in my classroom.” However, she may stop there.
Is she stupid? No, I don’t think so.
She knows what to do in her classroom and how to do it, both in usual situations and in problematic situations. She’s a wise practitioner with a good understanding of her practice. What does this discrepancy between words and deeds suggest?
What I believe it suggests is that we need to distinguish the following two: a representation of understanding and understanding itself.
A representation of understanding here means roughly articulated understanding or an explanation of understanding in words. My theory is that a representation of understanding is different from understanding.
First, let’s think about understanding itself. Understanding shows itself in perception and action in the world, as Prof. van Lier clarified this morning. A person with a good understanding knows what to do in the world. The better she understands, the better she sees and acts. The better she sees and acts, the better she understands. Understanding, perception and action work interactively in this ‘lived world.’ Understanding in this sense is acting in the world. It is living in the world. If we dare to use a Heideggerian term, understanding is being in the world.
http://en.wikipedia.org/wiki/Heidegger
http://en.wikipedia.org/wiki/Being_and_Time
http://en.wikipedia.org/wiki/Being-in-the-world#Being-in-the-World
http://en.wikipedia.org/wiki/Dasein
http://en.wikipedia.org/wiki/Hermeneutics
http://en.wikipedia.org/wiki/Hubert_Dreyfus
If understanding is acting, living or being in the world, this explains how difficult it is for a practitioner to explain her understanding to an outsider or third person, someone who does not belong to the world, by means of words which are only abstraction from her being in the world. That someone does not act together in the world. He is not in the same world. If only he acts together, live together, is together, he’d probably understands better.
Is it impossible, then, to show our understanding to an outsider altogether? No, again. Understanding shows itself in our action, life and being in the world. If you’re making your classroom a better place to live in, it means your understanding is good and valid.
Also, a representation of understanding isn’t necessarily useless. Dialogue with your colleagues or inner dialogue with yourself in the form of reflective writing probably leads to a better understanding. By verbalizing your understanding, you become more explicitly aware of your being, living and acting in the world, although there always remains some part that is ‘too deep for words.’ What it is like to be in a classroom is a difficult question to answer in words. However, by trying to answer that question, you make your understanding clearer in a different way from leading and showing the life of your classroom.
Trying to understand understanding is a never-ending process (and perhaps a never-successful endeavor). To repeat, understanding is not equal to a representation of understanding. Relating to that point, I’d like to tell a joke about a ballet dancer who was interviewed what she wanted to express in ballet dancing. She allegedly answered that if she was able to express that in words, she wouldn’t dance! Any words would fail to explain your understanding completely, too.
To sum up, understanding is acting, living, and being in the world. It is different from a representation of understanding. But trying to represent our understanding may sometimes help us for a better understanding, thus a better life. Perhaps we should not stop trying to understand our understanding in our open dialogue.
On the last note, I’d like to mention what Prof. Dick Allwright said towards the end of our session. He suggested that perhaps in our discussion we limited ourselves to an intellectual or conceptual understanding. What we may need more may be an empathetic understanding.
Thank you for your attention.
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