I think each of us, sometime in our life, has wanted to paint a picture. –Bob Ross1
I’m a former arts teacher who ended up working in health professions education (HPE) research. I absolutely love my job, but I never could have imagined I’d end up working in this field. And what a pleasure it is to be part of this community—it’s a wonderful world, full of generous, thoughtful people. I love that HPE research allows me to combine my interest in thinking critically about education with my drive to do creative work. Planning a research project—taking an idea from concept to publication (or some other product)—is an immensely satisfying way to paint a unique and detailed picture of an educational issue.
The more time I spend working in HPE, the more I hear different versions of the same story. For many of us, academic medicine wasn’t the destination we had in mind. But here we are. Tasked, in one way or another, with contributing to the education of health professionals. This is no small responsibility. It merits our focused attention, our critical perspectives, and our rigorous attention to detail, particularly when it comes to research.
The various paths our community members have taken to arrive in the world of HPE make it so very rich and interesting! We’re clinicians, psychologists, educationalists, sociologists, psychometricians, designers, and the list goes on. I’m pretty confident that regardless of how or why we ended up in HPE, we, as a community, are committed to educating competent, caring health professionals. But we certainly have different ideas about how best to do that and how to study it.
I often find myself meeting with people from various disciplinary backgrounds who have great ideas for education research projects, generally based in real experiences from the everyday world of HPE—interesting challenges, perennial conundrums, innovative breakthroughs. When we discuss what it might mean to turn those ideas into rigorous research projects, people are always enthusiastic, that is, at least until they start thinking about two things: (1) time and (2) philosophical principles. With respect to time—well, what can I say? The struggle is real. Good work requires an investment of time. I don’t really see a way around that. But philosophical principles? That one, we can work with!
For some, the idea that good research is rooted in a strong philosophical base seems, well, unnecessary and perhaps even inconvenient. I’ve heard theory, for example, described as a “hoop” that needs to jumped through. And so, increasingly, I’m asked questions like, “Could you just tell me which theory I should use to get this published?” This is not unlike saying, “Just tell me which brush will help me to paint the most lifelike petal.” As through the brush alone were enough.
What’s missing from this perspective is the overarching, reflective element. While there’s some debate, we’re generally convinced that there’s value in reflective practice when it comes to education and clinical practice. Likewise, I believe there’s value in taking a reflective approach to education research. Rather than asking, which paint brush, we could be asking bigger questions: Do I want to produce a bucolic landscape or am I more interested in making something that challenges our ideas about what art should be? Do I want perfect technique, or do I want to see what happens when I turn a canvas on its side while the paint’s still wet? Am I open to a Bob Ross–style “happy accident?” Or, am I trying to reproduce an iconic masterpiece? My point is, before jumping to “which brush,” there are a whole series of other elements to consider.
And ultimately, that’s what the Philosophy of Science Series,2–11 introduced in my colleague Lara Varpio’s and my recent Academic Medicine article,2 is all about. We designed the series to help people understand the guiding principles in some of the most popular paradigms characterizing HPE research—both for use in their own work and for when they’re reading the work of others who are from disciplinary backgrounds different than their own. We want researchers and consumers of research to remember that at the heart of every rigorous study is a set of ontological (What’s the nature of reality?), epistemological (What’s the relationship between the knower and the known?), methodological (What tools can we use to discover or create knowledge?), and axiological (What are the values inherent in our work?) principles. And, perhaps most importantly, we hope the series helps readers appreciate that the philosophical and theoretical principles of rigorous HPE research are more than tools. They are the foundations that lend structure and artfulness to our work. And that’s a beautiful thing.
By: Anna MacLeod, PhD
A. MacLeod is professor of continuing professional development and medical education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Twitter: @ammacleod.
- Zeaous Art. 50 Bob Ross Quotes to Life Your Spirit. https://zealousart.com/50-bob-ross-quotes-lift-spirit/. Accessed February 5, 2020.
- Varpio L, MacLeod A. Philosophy of Science Series: Harnessing the multidisciplinary edge effect by exploring paradigms, ontologies, epistemologies, axiologies, and methodologies [published online ahead of print December 24, 2019]. Acad Med. doi: 10.1097/ACM.0000000000003142
- Park YS, Konge L, Artino AR Jr. The positivism paradigm of research [published online ahead of print November 26, 2019]. Acad Med. doi: 10.1097/ACM.0000000000003093
- Young M, Ryan A. Post-positivism in health professions education scholarship [published online ahead of print November 19, 2019]. Acad Med. doi: 10.1097/ACM.0000000000003089
- Paradis E, Nimmon L, Wondimagegn D, Whitehead CR. Critical theory: Broadening our thinking to explore the structural factors at play in health professions education [published online ahead of print December 3, 2019]. Acad Med. doi: 10.1097/ACM.0000000000003108
- Rees CE, Crampton PES, Monrouxe LV. Re-visioning academic medicine through a constructionist lens [published online ahead of print December 3, 2019]. Acad Med. doi: 10.1097/ACM.0000000000003109
- MacLeod A, Ajjawi R. Thinking sociomaterially: Why matter matters in medical education [published online ahead of print December 24, 2019]. Acad Med. doi: 10.1097/ACM.0000000000003143
- Ellaway RH. Postmodernism and medical education [published online ahead of print December 17, 2019]. Acad Med. doi: 10.1097/ACM.0000000000003136
- Ellaway R, Kehoe A, Illing J. Critical realism and realist inquiry. Acad Med. In press.
- Varpio L, Paradis E, Uijtdehaage S, Young M. The distinctions between theory, theoretical framework, and conceptual framework [published online ahead of print November 12, 2019]. Acad Med. doi: 10.1097/ACM.0000000000003075
- MacLeod A, Ellaway RH, Paradis E, Park YS, Young M, Varpio L. Being edgy in health professions education: Concluding the Philosophy of Science Series. Acad Med. In press.