A couple of months ago, Charles Jennings wrote an interesting piece about the way our use of knowledge is changing, and these ideas have some important implications the way next generations of physiotherapists are learn their craft.
Jennings’ piece is titled ‘Learning in the Collaboration Age’ (link), and it focuses on the role collaboration is playing in learning. Jennings contrasts what he calls ‘old’ ways of acquiring knowledge (often characterised as ‘knowing that‘), with what is becoming increasingly common these days (knowing how, knowing why).
Jennings argues that ‘Although experiential and social learning have been around for eons, in the past most structured organisational learning and training has focused on knowledge acquisition and memorising’, and this is certainly the way that a lot of traditional physiotherapy knowledge has been conveyed. Often this is still the way that people expect to learn on weekend courses and, sadly, when they come to postgraduate study.
This kind of learning is based on knowledge transfer, normally ‘dispensed’ by an expert to a novice with the assumption that the information is static, acontextual, and based on the goal of empowering the learner to acquire individual command of the material, to allow them, in turn, to dispense the sanctioned knowledge to others (and thereby confirming them as an expert).
Jennings uses two models to show the difference now being expected of learners. (The first is at the top of the page in blue, the second is below in red)
In the first ‘traditional’ model, core concepts needed for basic operation, contextual information required to implement action, and detailed information needed to complete tasks needed to be learned by students of a discipline. With such an emphasis on learning of ‘stuff’, curricula would be filled with large quantities of information, presented by supposed ‘experts’, using sophisticated systems and learning structures to manage the complexity of information being dispensed.
In their revised Find-Access Approach the emphasis is changed. Here, core concepts are still learned, but students are taught how to familiarise themselves with the ever-changing contextual information around them, and they are shown how to find complex information quickly and effectively. In essence, core concepts are still learned, but the time giving to learning all the other stuff (contextual and detailed information) shifts from learning what to learning how.
Such proposals have profound implications for the way we think and learn in healthcare disciplines that have long believed that ‘information is generally static, can be ‘extracted’ and packaged into content-heavy courses and that memorising – and being tested on – short-term recall of the content constitutes ‘learning’’ … ‘that information or ‘knowledge’ is generally acontextual and can be ‘transferred’ irrespective of specific situations and needs
that we work as individuals, so individual training and development is the best solution.’
However, as Jennings argues;
‘[W]e are all aware that the majority people work in teams and that these teams are sometimes fluid and changing, and that ‘organisational learning’ (the learning that organisations undertake) is all about developing the ability to be agile, responsive, reflective and to change rapidly when needed. Organisational learning is not about trying to static build knowledge and skills in some form of ‘competency framework’.’
An interesting first step for physiotherapists might be to decide what constitutes ‘core knowledge’. Would it be the anatomy of adductor longus, or an empathic attitude towards others? Would it be knowledge of the Krebs cycle, or would it be the ability to perform a Thomas Test? And in an age in which information is increasingly ready-to-hand via digital devices connected to the Internet, is it even necessary now to commit this core knowledge to memory? Or is everything, ultimately, contextual?