Embracing ambiguity: Curriculum design and activity theory

Abstract

A curriculum innovation for a new UK medical school – Peninsula, launched in 2002 – was grounded in a period of radical pedagogical innovation in medical education in the UK during the 1990s. Part of this thinking was to include the medical humanities as a medium for re-thinking medical practice, especially how medical students might better learn to communicate with patients and colleagues, and how they might become agents of change in progressing medicine through innovations. In designing the curriculum, Cultural-historical Activity Theory (CHAT) was used as a model to ‘think’, or reconceptualise, the purposes of a curriculum. The first question asked was: ‘what do patients want?’ Emphasis was placed on resisting a ‘will-to-stability’ in adopting safe curriculum process, in favour of adopting a ‘possibility knowledge’ framework that celebrated dialogue. This operated through three ‘spearheads’, or radical aims: democratic habits, towards the feminine, and tender-mindedness.

Keywords:

• Pedagogical innovation
• curriculum design
• cultural-historical Activity Theory
• patient-centredness
• possibility knowledge

Acknowledgements

Thank you to my educationally savvy ex-colleagues at Peninsula, particularly Professor John Bligh.

Disclosure statement

The author reports no conflicts of interest. The author alone is responsible for the content and writing of this article.

Glossary

Activity Theory: An approach to learning that encompasses a whole activity including persons, artefacts, and communities of practice.

Additional information

Notes on contributors

Alan Bleakley

Alan Bleakley is Emeritus Professor of Medical Education and Medical Humanities at Plymouth University Peninsula Medical School. He is an internationally recognized scholar in medical education and medical humanities and is widely published.