In this post Roger Kneebone (HEA National Teaching Fellow) talks to Jenni Carr about his use of simulations in learning and teaching and the relationship between public engagement activities and learning and teaching.
Roger is Professor of Surgical Education & Engagement Science at Imperial College London (firstname.lastname@example.org).
In your work you have developed the use of simulations in learning and teaching. Could you say a little about your motivations for this approach and how you think this enhances the student experience?
I see simulation as a way of showing what words alone cannot describe. In order to understand any practice – whether performing a surgical operation, playing a musical instrument, drawing a picture or sewing a button onto a jacket – you need to experience it physically.
For many years I’ve been exploring different approaches to simulation in the world of medicine. At first my focus was on insiders – especially those in surgical teams. Working with colleagues at Imperial I developed Distributed Simulation – portable, low-cost yet realistic operating theatres that allowed surgeons, nurses and others to ‘perform’ procedures.
From there we moved to Sequential Simulation, which shows sequences of care – a patient (played by an actor) at home getting chest pain, say, then calling the ambulance, being admitted to hospital for angioplasty (stretching up a narrowed coronary artery) and then being followed up by their family doctor a few weeks later. This gives a vivid sense of what it’s like to be a patient, as well as showing what goes on in the closed world of the medical specialist.
This theatrical approach – using minimal props to establish a clinical setting - proved highly effective. So I’ve been exploring how simulation can recreate the uncertainties and ambiguities of clinical practice, and how professionals and patients can learn from one another by sharing their experiences and expertise. And now I’m moving beyond the world of medicine to look at engagement more widely.
You have been involved in many outreach and public engagement projects. How does being involved in this kind of work shape or impact on your learning and teaching practice?
I see engagement as an instance of education, where people with different perspectives come together with the intention of learning something new about one another’s worlds. In recent years this has become the main focus of my work, and I’ve been using simulation to open up the world of surgery to outsiders – adults, young people, patients and other publics.
Traditional approaches to public engagement think in terms of transmission of information from ‘experts’ to ‘non-experts’. My colleagues and I have been developing a different model which assumes that everyone who takes part has expertise, though of different kinds. The expertise of being a surgeon may be very different from the expertise of being a patient – but effective engagement can result in ‘reciprocal illumination’ for all who take part.
I’ve been very fortunate in being awarded a two year Wellcome Trust Engagement Fellowship, which has allowed me to explore these ideas in many different venues. These range from large scale set-piece events at the Science Museum, Big Bang Fair and Cheltenham Festivals to experimental work with artists and performers at music festivals like the Green Man. All of these experiences feed into my own teaching practice at the university where I work.
You end your TedMed talk with a quote from TS Eliot. Could you give an example when an insight offered by ‘know[ing] the place for the first time’ has impacted on your approach to teaching and learning?
I’ve been exploring the idea that surgery is a practice which depends upon craft and performance as much as upon science. So I’ve been working with expert craftsmen – a jeweller, a bespoke tailor, stone carvers, a hat maker and many others – to look at how we gain the skills we depend on. I’ve also been working with experts in music, drama, dance, magic and puppetry to explore how we can learn from performance across domains.
These conversations have powerfully influenced my own teaching on the Masters programme (M Ed in Surgical Education) which I lead at Imperial. For example, through an ongoing sequence of encounters between surgeons and craftsmen at the Art Workers Guild in London we are developing what the sociologist Richard Sennett describes as ‘open-ended collaboration - where you want to find out what another person is about without knowing where it will lead. Put another way, you want to avoid the iron rule of utility that establishes a fixed goal - a product, a policy objective - in advance’.
I think this is becoming increasing rare in education, where ‘open-ended collaboration’ is being eclipsed by intrusive systems of regulation and assessment. There is something liberating about starting a project that has no prescribed outcome, and where success is measured by how much people enjoy the experience rather than what is produced at the end.
What advice would you give to a colleague who is about engage in trans/interdisciplinary work?
Transdisciplinary work can be extremely rewarding but takes time to develop. My advice would be to give rein to your curiosity, connect widely and develop a network of people whose work interests you and with whom you would like to collaborate. Don’t be dispirited when people don’t want to collaborate but persevere in finding the right partners.
My work around simulation has allowed me to invite non-clinicians to take part in surgical teamwork and experience medicine from the inside. This has been the start of many interesting collaborations. If possible, find ways of demonstrating what you do – that will encourage people to join you.
Future-gazing – where next in terms of developing your own practice? Is there an emerging practice/technology that is grabbing your interest?
I’m fascinated by the challenges of bringing clinicians, scientists, patients and publics together to share insights and perspectives. My colleagues and I have recently established a Centre for Engagement and Simulation Science at Imperial College, to develop a theory and practice of engagement through simulation. My next priority is to research the impact of engagement on researchers themselves, mapping how their thinking changes as they explain their work to others.
What does the word ‘engagement’ mean to you?
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