Bodily-awareness-in-reflection: Advancing the epistemological foundation of post-simulation debriefing

Abstract

Reflection is generally considered to be important for learning from simulation-based training in professional and vocational education. The mainstream conceptualization of reflection is argued to rest on a dualistic ground separating the mind from the body. Drawing on phenomenological analyses of bodily awareness and an ethnographic case study of maritime safety training we show how and why students’ embodied experiences and subjectivity play a foundational role in reflection. We develop and illustrate the notion of bodily-awareness-in-reflection which captures a mode of reflection wherein non-conceptual pre-reflective bodily experiences are integrated with conceptual thought. In this way, we aim to enrich and complement prior work on simulation-based training and embodied professional learning by providing an enactivist epistemological foundation of reflection in debriefing, highlighting awareness of the lived body as a necessary ground of reflective self-knowledge.

Keywords:

• Simulation
• debriefing
• reflection
• phenomenology
• lived body
• embodiment
• subjectivity

Introduction

Human experience is incarnated[…] From the most visceral of cravings to the loftiest of artistic achievement, the body plays its formative role. (Leder, 1990, p. 1)

The field of professional education and training has recently seen rapid growth in research on learner’s embodiment, subjectivity and selfhood (Dall’Alba et al., 2018; Francesconi & Tarozzi, 2012; Green & Hopwood, 2015; Hyland, 2019; Loftus & Kinsella, 2021; Somerville & Lloyd, 2006). The embodiment thesis, as explored primarily in phenomenology and cognitive science, states that our bodies and their embeddedness in a physical and social context shape our minds and interactions (Gallagher, 2005; Gallagher & Zahavi, 2008; Varela et al., 1991). We perceive ourselves and the world through our sensory organs, which in turn shape what we perceive and how we perceive ourselves and the world. As a result, our relations and interactions with others and things are made possible through our bodily existence, and our thinking is deeply structured by our bodily experiences and capacities (Lakoff & Johnson, 1999). This insight has several implications for education and learning, such as the impossibility to ‘separate the unity of the mind and the body from its relationship with the world’ (Stolz, 2015, p. 478). The embodiment thesis is particularly relevant in research on simulation-based professional training and other forms of learning by doing. Highlighting the inherently embodied nature of professional knowing and learning, Hopwood et al. (2016, p. 175) conceptualize simulation as offering:

…opportunities for students to be professionals in a social and material environment that requires and reaffirms them as such, to experience their professional bodies in conscious moments of breakdown (incompetence, struggle etc.) and to use their bodies in performances as future professional selves.

However, few studies have investigated embodiment in simulation-based training and in particular the relation between reflection and embodied experience during debriefing (cf. Hutchins & Nomura, 2011; Roth, 2015). In the debate on the theory and application of simulation-based training, the practice of debriefing after action is frequently emphasized as especially important for learning from experience (Fanning & Gaba, 2007; Lederman, 1992). The debriefing process is often described as a didactic method to enable participants to transfer experiences and outcomes from simulations back into their own context of real-life situations and to ‘create new innovative concepts’ (Kriz, 2010, p. 669). In this process, students’ reflection on their experiences is crucial in order for sense-making and learning to occur (Crookall, 2014; Dreifuerst, 2009).

Although there is an overall agreement in the literature about the importance of reflection on experience, the theoretical underpinnings of the nature of experience and reflection are seldom explicitly articulated, and the meanings of these terms are most often taken for granted (Poikela & Teras, 2015; Rooney et al., 2015)¹. Some have even argued that this conceptual unclarity and wide range of diverging definitions has resulted in reflection becoming a ‘catch-all title for an ill-defined process’ (Bleakley, 1999, p. 317; Leigh & Bailey, 2013). In this paper, we explore the notion of embodied reflection in professional education from both a theoretical and an empirical perspective. We consult recent phenomenological literature to develop a philosophical-empirical account of students’ bodily awareness in post-simulation debriefing, describing the relation between reflection and lived experience. We ground our argument in a case study of maritime safety training in which we interviewed master mariner and ship engineering students about their embodied experiences after having participated in various emergency simulations. This endeavour is supported by what Abrandt Dahlgren et al. (2019, p. 142) argue to be ‘a need to situate simulation-based education as a pedagogical arrangement in accordance with recent theorizations of professional knowledge and learning’. In the conclusion we argue that reflection that does not encompass participants’ embodied awareness of their being-in-the-world—that is, their social, material, emotional and intersubjective entanglements, as experienced from each student’s first-person perspective—misses a crucial dimension of experiential learning and what it means to reflect in simulation-based training.

The concept of reflection in debriefing research

In the literature on simulation-based training, reflection is often used as a synonym for debriefing and is rarely analysed on its own. As such, reflection is often viewed as a ‘chronological review of […] the thinking processes that took place during the events of the simulation’ (Dreifuerst, 2009, p. 111). In their paper discussing reflection after simulations, Husebø et al. (2015) define reflection as ‘an in-depth consideration of events or situations outside of oneself’ (emphasis added). Similarly, Rudolph et al. (2006) consider that the central purpose of debriefing is for participants to identify and analyse their ‘internal cognitive “frames”, internal images of external reality’. Based on a literature review exploring the concept of reflection in debriefing, Nagle and Foli (2020, p. 35) suggest defining student-centred reflection as ‘an intentional meta-cognitive examination of knowledge, skills, and attitudes in which students’ dialogue with peers and an experienced facilitator to make sense of the simulation experience resulting in cognitive adjustments and perspective reframing’.

As revealed by these definitions representing the dominant viewpoint, reflection is often seen as an extraction or detachment of rational knowledge from the ‘mess’ of human experience (Jordi, 2011). That is, reflection is seen as a way of stepping out of one’s subjective experience, with the aim of separating best practices from the participants’ embodied experience. Although emotions are acknowledged as being relevant to address, they are often treated as secondary—or even harmful (Jones, 2004)—to the actual purpose of reflection. While many models of debriefing recommend starting with questions probing how students feel (Sawyer et al., 2016), the purpose of such questions is usually just to release tension or ‘blow off steam’. Questions addressing feelings or other bodily experiences are thus merely used to prepare the students for the intended purpose of the debriefing exercise, which is often seen as being to resolve knowledge gaps or uncertainties and develop critical-thinking or problem-solving abilities (Nagle & Foli, 2020).

However, a few authors have questioned the dominant dualistic view on reflection and its neglect of the embodied and subjective nature of experience and cognition. Jordi argues for a need to ‘re-embody experiential learning’ and states that reflective practices have the potential ‘to integrate a range of cognitive and nonconceptual elements that make up our experience and consciousness’ (2011, p. 2). In their proposal of an alternative to the traditional narrow technical-rational approach to reflection, Leigh and Bailey (2013, p.164) characterize embodied reflection as ‘being aware of what is going on in the physical and physiological self, and how that relates to emotions, feelings and thoughts’ and as an ‘on-going process of bringing conscious self-awareness to and about the body’. Therefore, it appears to be worthwhile to further explore the possibilities of an embodied conceptualization of debriefing in simulation-based training. The question of how we can understand the relation between embodied experience and reflection is addressed in the next section.

Pre-reflective and reflective bodily self-awareness

Phenomenologists distinguish between a range of ways in which our body is presented to us in consciousness, making varying degrees of bodily presence possible (Colombetti, 2011; Gallagher, 1986; Legrand, 2007; Zahavi, 2005). Our subjectively lived body², defined as ‘a dynamic spatio-temporal presence anchored in the tactile-kinesthetic-affective body’ (Sheets-Johnstone, 2019, p. 12), is often thematically absent in conscious reflection (Leder, 1990). Most often, when deeply engaged in actions, we are ‘absorbed in the objective’ and do not pay much attention to our bodies (Petitmengin, 2006). In these situations, the body is, as Legrand (2007, p. 504) characterizes it, ‘transparent in the sense that one looks through it to the world’; that is, our body is normally not presented as an intentional object of reflection as it ‘effaces itself on its way to its intentional goal’ (Zahavi, 2019, p. 83). Moreover, the transparency of our embodied actions is arguably a prerequisite for skilled coping, that is, smooth uninterrupted action (Dreyfus & Dreyfus, 1986; cf., Montero, 2010). Thus, when engaged in an intense simulation, students are unlikely to reflectively think about or consciously objectify themselves, their bodies or the tools they are using as ready-to-hand extensions of their bodies while responding to the situation.

However, the body is never completely invisible or absent from consciousness. We are always, at least, pre-reflectively, that is, nonthematically and pre-cognitively, aware of our embodied experience (Legrand, 2007). Without that we could not be self-conscious in the more explicit sense (see Zahavi, 2005 for an extended argument for this). Pre-reflective bodily awareness is characterized by a phenomenal quality associated with experiencing; a subjective (first-person), immediate and non-observational feel of having a certain experience. This awareness does not depend on full consciousness of the experience. Thus, to be pre-reflectively aware of one’s body does not require any explicit though about it (Gallagher & Zahavi, 2008). When absorbed in an action one may experience ‘different degrees of self-presentation or self-intimation of the lived body’ without directing explicit attention to it (Colombetti, 2011, p. 307). Students might, for instance, experience a simulation as possessing ‘a specific affective quality’ through their body, such as when feeling the tension in the air before a stressful scenario (experiencing their bodies pre-reflectively in the background, as colouring the world). Or, they might suddenly feel themselves to be blushing in front of the participants, yet not think about their embarrassment explicitly (experiencing their bodies pre-reflectively foregrounded in the situation).

In contrast to the transparent or the marginal pre-reflective body, our bodily experience can also become fully present in thought as when we feel a sudden pain or discomfort and is often a necessary step when we try to learn a new skill (Dreyfus & Dreyfus, 1986). Think about the novice golf player learning how to grasp and swing a club for the first time, consciously placing her fingers, arms and legs in the instructed position. A common phenomenological point is that reflection, or observational self-consciousness, is an explicit, conceptual and objectifying process whereby consciousness ‘turns back upon itself to experience itself’ (Crossley, 1995, p. 49). This form of reflection on embodied experience is sometimes characterised as involving a self-distanciation and reification of the body, that is, an objectification and distortion of subjectivity and a turning of the self-as-subject into an opaque self-as-object (Zahavi, 2005).

But does explicit embodied reflection necessarily involve reification of the body and isolation of the ‘experience itself’ from its social and material context? We suggest that, in reflection on embodied action which we call bodily-awareness-in-reflection, we are thematizing and articulating thoughts about our worldly lived interactions without distancing ourselves from or reifying the experience as such (se also Legrand & Ravn, 2009). This is a cognitive process that is grounded in a recollected subjective (embodied) perspective yet aimed at interpreting and evaluating action, know-how, skills and events in a meaningful context. The notion is inspired by the embodied view on cognition known as enactivism which maintains that ‘cognition [or reflection] depends upon the kind of experience that comes from having a body with various sensorimotor capacitates, and second, that these individual sensorimotor capacities are themselves embedded in a more encompassing biological, psychological, and cultural context’ (Varela et al., 1991, 173). This implies that the type of knowledge that can be gained from simulation-based learning and later reflected upon in debriefing does not consist in representing a pre-given outer world but emerge from the enaction of participants’ active sensorimotor-environmental coupling (Thompson, 2007). From this theoretical standpoint, bodily-awareness-in-reflection does not objectify or separate mind (experience, cognition) from body and world (interaction) but discloses their mutual co-dependence. It allows a combination of third-personal conceptual reasoning and first-order subjectivity: ‘a dialogue between our implicit embodied experience and conceptual aspects of our consciousness’, as Jordi (2011) expresses it. Our proposal is thus similar to Varela et al. (1991, p. 27) ‘embodied reflection’, ‘in which body and mind have been brought together’, Laner’s (2021, p. 456) ‘situated reflection’ in which the body is regarded as ‘the instance which reminds the mind that it still has to learn, i.e. be open for change in the light of intelligently responding to new situations’ and Gallagher and Marcel (1999, p. 25) ‘embedded reflection’, which is ‘a first-person reflective consciousness that is embedded in a pragmatically or socially contextualized intentional attitude’ and where ‘[one’s] attention is directed not in a reflective inspection of consciousness as consciousness, but toward [one’s] own activities in the world where [one’s] intentions are already directed’.

Evoking bodily-awareness-in-reflection

How exactly can participants in simulation-based training be encouraged and facilitated to become bodily-aware-in-reflection? Originally used to study the invariant structures of consciousness, the explicitation interview (EI) technique, as developed by Vermersch (2009) and described by Petitmengin (2006), has been shown to ‘bring a person, who may not even have been trained, to become aware of his or her subjective experience, and describe it with great precision’ (Petitmengin, 2006, p. 229). In what follows, we suggest that an adaptation of the EI can be used to provide debriefing participants with access to their pre-reflective lived bodily experiences, making them discursively aware of their embodied experiences in reflection.

The purpose of EI is to facilitate a ‘transition from a pre-reflective consciousness of the lived experience to a reflective consciousness of the same lived experience’ (Vermersch, 2009, p. 13). Our purpose is not, however, to encourage students to engage in psychological introspection; it is merely to prompt them to recollect their pre-reflective bodily awareness and draw on it during reflection on their actions. Taking consciousness seriously does not mean, as pointed out by Merleau-Ponty (1962), that reflection is turned inwards in an introspective or psychologizing way, but merely acknowledges that the way the world (or simulation in our case) is given to the subject (student) cannot be separated from its embodied mode of presentation. To enable the interviewees—or students—to become aware of their subjective experience and describe it, it is crucial for the interviewer/facilitator to continuously try to stabilize the interviewees’ attention on their embodied experience. This can be done by reformulating and commenting on what the interviewees have said regarding their experience (and particular sensory modalities of it), as well as by using ‘direct references’, such as ‘that feeling’, to designate emerging articulations of the embodied experience. When facilitating the interviewee’s/student’s reflection, their attention is guided towards the how of the various dimensions (diachronic, synchronic, visual, auditive, kinaesthetic and emotional) of the experience (‘I felt an incredible heaviness on my shoulders’), rather than the what or why (‘the equipment weighted several kilograms’). Attention is steered away from general descriptions (‘it’s never pleasant to carry heavy equipment’) to articulations of particular experiences (‘I felt very uncomfortable carrying it’). The process can be further triggered by pictures, videos or other stimuli that retrospectively bring the subject back to the situation from which the experience originated, in order to re-enact its ‘carnal and living density’ (Petitmengin & Bitbol, 2009, p. 244). The aim is to bring the subjects into an evocation state in which their experience can be re-constructed and described, in order for the subjects to conceptually reflect on and draw conclusions from the experience that are relevant for learning and professional development.

It is important to emphasize that embodied awareness in reflection involves reflection being directed at one’s being-in-the-world—that is, one’s primordial entanglement with things, people and practices. Thus, as expressed by Heidegger, ‘if we wish to study the self, we should look not inside consciousness in the hope of finding some elusive I, but rather at our worldly experience; therein will we find the situated self’ (Zahavi, 2005, p. 82). It should therefore be noted that, with this method, we do not suggest a separation between the reflective mind, the feeling body and the external world. This is an important deviation from the EI as formulated by Vermersch, who argued that ‘practicing introspection is going into myself to find information which is largely invisible until I have brought it into reflective consciousness’ (2009, p. 17; italics added). Another important deviation is that, although Petitmengin and Bitbol (2009) consider that reflection on embodied experience ‘is not a matter of intellectual, conceptual understanding’, we argue that bodily-awareness-in-reflection is conceptual. The key is for the student to come into contact with the experienced body or the body in reality, rather than to inhibit all thought of the body or the body in idea. A third difference is that, while the explicitation interview and other similar approaches for analysing subjective experiences (Høffding & Martiny, 2016) aim to reveal a general invariant phenomenological structure, we think that EI can be used to elicit students’ situated, idiosyncratic and individual experiences. Below, we present a case study in which we applied EI to a group of students undergoing maritime basic safety training with the purpose of evoking students’ bodily-awareness-in-reflection.

Case study - Pilot-testing the adapted EI for the debriefing of embodied experiences

The empirical exploration of bodily-awareness-in-reflection in debriefing took place as part of a broader ethnographic study on basic safety training (BST) that was conducted during the fall of 2020 at two maritime training centres in Sweden educating future professional seafarers (ship captains, officers and engineers) (Viktorelius & Sellberg, 2022). Some of the goals of BST involve improving seafarers’ ability to survive at sea in the event of ship abandonment, practicing firefighting and preparing for immediate action upon encountering an injury or any other medical emergency. Many of the mandatory exercises included in BST involve demanding physical tasks and bodily challenges such as navigating in dark and hot environments wearing heavy equipment. The fieldwork methods (Table 1) included observations, interviews with instructors and video recordings of the practical exercises (emergency simulations) during two similar BST courses given at the two maritime training centres. The recordings were made with the use of iPhones held by the authors and GoPro cameras attached to students that had agreed to it. In this way naturalistic data could be collected on students’ and instructors’ verbal and bodily interactions from within the simulations where the researchers could not access (e.g. in the compartments with smoke and fire).

Table 1. An overview of the fieldwork settings.

Simulation exercise	Site	Participants	Duration
First Aid	Site 1	13 students, 1 instructor	4 h
Survival techniques	Site 1	15 students, 2 instructors	5 h
Survival techniques	Site 1	11 Professionals, 2 instructors	1 day
Survival techniques	Site 2	15 students, 5 instructors	2 days
Fire fighting	Site 1	19 students, 5 instructors	2 days
Fire fighting	Site 1	20 students, 5 instructors	2 days
Fire fighting	Site 2	18 students, 5 instructors	2 days

For the present study, the collected material (fieldnotes and recordings) was used to construct a debriefing guide, consisting in a set of questions (Table 2) and pictures (Figures 1 and 2) capturing essential moments and actions in the scenarios. The guide was then used during subsequent non-compulsory debriefing interviews aimed at encouraging students to reflect on their embodied experiences from the simulations.

Figure 1. Simulation of firefighting operation.

Figure 2. Simulation of ship abandonment.

Table 2. Interview guide based on the elicitation interview technique.

Guiding questions
Eliciting pre-reflective experience
What experiences did you have during exercise [x*]? Can you describe your experience of doing [x*]? What was your experience of using the equipment during the simulations? Could you describe those experiences further? How did you experience your own actions during the emergency situations? Reflecting on implications What in your experiences during the exercise surprised you? What do you think is the important lesson based on your experiences? What will you change in the future?

* Refers to a particular exercise (prompted by pictures from the exercise).

The debriefing interviews were conducted a few days after the simulations via an online video conference tool and were led by the first author of the paper. The sessions took the form of five focus groups with, altogether, 51 of the students that had participated in BST and agreed to take part in the study (Table 3). In addition to the questions in the debriefing guide, follow-up questions were also spontaneously formulated in response to the participants’ evolving descriptions. As devised by the explicitation method, the interviewer tried to focus the students’ awareness on different embodied dimensions of particular experiences. This involved picking up on what the students were describing and encouraging them to elaborate on utterances that could be interpreted as emergent articulations of the pre-reflective level of experience. Throughout the debriefing the author/facilitator tried to make sure that none of the student participants did feel uncomfortable talking about their own bodies and feelings. Students were thus never pressed to share experiences from the simulations and were informed that they could leave the debriefing whenever they wanted. Only students that had agreed to participate, upon being informed about the research purpose, were included in the study.

Table 3. Focus groups pilot-testing the EI for embodied debriefing.

Focus group	Participants (no. of students)	Duration
1	11	62 min
2	10	46 min
3	8	43 min
4	12	23 min
5	10	26 min

The online debriefing sessions were video recorded and later transcribed in order to be thematically analysed for this paper. The empirical analysis of the material from the focus groups was guided by the conceptual framework presented above and by questions of whether and how the debriefing had facilitated reflections expressing embodied learning, that is, provoked articulations of bodily self-awareness and understanding of emotional and physical reactions in emergency situations.

Illustrating bodily-awareness-in-reflection

After performing a variety of physically and emotionally demanding exercises during a full week of training, few students were left unaffected by their recent experiences. The students’ general impression of the course was that it had given them important first-person insights into the experiential reality of performing different life-saving actions in simulated emergency situations. Most students reasoned that becoming exposed to stressful situations and even negative emotional reactions helped them to prepare for what to expect in real emergencies. They thought that their acquaintance with their own embodied reactions, such as stress and anxiety, gave them important insights into the reality of emergencies at sea:

I learned a lot about myself and how much you can manage in those situations. If you’ve never done it, then you don’t know how your own body works. (Student 3)

You get an opportunity to experience your own reactions in these types of situations, it’s, like, very useful to understand how you react. (Student 4)

I think it helped to get to experience the stress and how scary it was, so that you don’t get the same shock in a real situation. To know how your body reacts to be more prepared. (Student 5)

When describing their own understanding of the objective of the exercises, many students emphasized the difference between learning about and learning how to do firefighting and other rescue operations. Resonating with Ryle’s (1949/2000) analysis of knowing-that and knowing-how, this distinction is further explained by the phenomenological distinction between third personal observational knowledge about the body (self-as-object) and a first personal subjective pre-reflective awareness of one’s lived performing body (self-as-subject), respectively. This was for instance expressed by one student saying that: ‘reading about this in a book, sure you might learn something, but you don’t really know how hard it is to, for example, climb the life raft from the water, until you’ve done it’. Or, as another student expressed it when comparing her embodied experience from the simulation with her previous theoretical lectures on heat exposure in firefighting:

It was cool to first hear the theory and then feel for yourself how big the difference in temperature and endurance was between standing upright near the fire and sitting down; you realized where you should and shouldn’t put your head. (Student 1)

Although the students’ reflections were seldom exclusively focused on their bodily experiences in a reifying way (by reducing their self-as-subject to a self-as-object)—or, for that matter, in an overly subjectifying but equally reductive way (by describing self-absorbingly the experiencing of their experiences)—it was nevertheless apparent that they had conscious access and drew on their recollected pre-reflective bodily experiences in the debriefing. Indeed, students would not be in the position to articulate the judgements they did were it not for their recollected first-person (lived) bodily awareness. Instead of merely talking about their sensations and feelings, students were describing the simulations as experienced through their lived bodies, acknowledging, at the same time, how the physical and social features of the task-environment affected their bodily experiences. The reflections expressed a merging of subjective embodied experiences and third person reasoning about their performances, often by comparing their lived-through experience of having done the exercises with their previous pre-reflective self-understanding:

When you stand with the equipment outside, you think that this, this will be great, that it will go well. But then, as soon as you start crawling in the tunnels, you start to feel how your heart starts racing. My head started spinning out of anxiety. It’s easy to say that you can handle certain situations before you’re in the middle of things. But then, when you’re like, in there, and it’s dark and you see nothing, and it’s hot and it feels strange to breathe, and you have heavy equipment that weighs you down, and it hurts in the knees and so on. Then, it’s, like, very, very different from how you imagined it would be. (Student 2)

As seen in the quote above, the student is sharing a reflection that is permeated by her recollected subjectively lived (first-personal) bodily experience. In referring to the remembered feeling of her racing heart, anxiety, the visual perception of darkness, the heat from the fire, the strangeness of breathing in the mask, the pain in her knees from crawling, her body is everything but absent or transparent in awareness; it is present in reflection. Her pre-reflective embodied experience as lived through in the simulation (a memory thereof) is brought into thematic explicit awareness by directing her reflective consciousness toward it. Her subjectively lived body, as thematized in the narrative, is not separated from the biological body (Merleau-Ponty called this double character of the body the ‘subject-object’, 1962). It is co-experienced both as a thing (e.g. a racing heart) and lived body (her subjective point of view). However, her reflection is not restricted to a reporting of the immediate flow of consciousness as it happened; she is instead juxtaposing different temporal and subjective horizons of self-experience to make a conceptual point: performing an action is very different from imagining it. As described in the theoretical section, pre-reflective embodiment is not restricted to how the body is experienced: how the world is perceived is also shaped, or coloured, by one’s embodiment. As expressed by Merleau-Ponty (1962, p. 430): ‘the world is inseparable from the subject, but from a subject which is nothing but a project of the world, and the subject is inseparable from the world, but from a world which the subject itself projects’. Thus, in the reflection the student expresses how the task-environment shaped her bodily experiences and how her bodily experiences reciprocally shaped her perception of the task-environment.

From an embodied perspective, the environment is defined as a world of affordances which is shaped by the possibilities and limitations that our body enables (Thompson, 2007). This is, for instance, expressed by Husserl’s (1989) analysis of motor intentionality as an implicit and practical ‘I can’ (rather than the Cartesian ‘I think’). In the students’ reflection we could see an expression of a contrasting ‘I cannot’, that is, a pre-reflective sense of the limitations of their bodily capabilities in relation to certain situations and given their current skills and personal physique. This is an experience that they could only acquire and reflect on by living through the simulation scenarios, that is, by being immersed in the simulated world as embodied actors:

You realize your personal weaknesses; for example, that you may not have much, how should I say it, muscle capacity. You notice that you can barely stand with the equipment. Lifting a 40 kg mannequin is hard enough. I wouldn’t want to be the one going in to save someone that weighs 120 kg; I wouldn’t be able to lift him if I had to. (Student 11)

In their reflections students frequently referred to their emotions and sensory perceptions in conjunctions with cognitive and evaluative judgments about actions and equipment, thereby situating their experiences in the context and elucidating the entanglement of pre-reflective bodily awareness, cognition, interaction and environment:

I didn’t like how I experienced the survival suit. I think it went up and covered my nose, so I didn’t get any air. Not getting air and being in something that feels like a plastic bag in water is not a good combination. (Student 8)

In the quote, Student 8 recollects his experience of what the survival suit felt like. Although the quote is linguistically phrased as a memory of the suit, it nevertheless implicitly refers to the student’s pre-reflective bodily awareness. The student is not describing a subject-independent feature of the suit but rather the subjective feeling of jumping into the water while wearing it. The student is revisiting his pre-reflective bodily experience of jumping-in-a-survival-suit-into-water but adding a cognitively derived explanation of the unpleasantness of that experience.

Finally, some students were able to form generalized and proposition-like (know-that) statements or insights about training and performance in emergency situations based on their thematized pre-reflective embodied experiences:

You easily get paralyzed in stressful situations and, if you’ve only done it once, then it’s not certain that you’ll know what to do. These are things you’ll have to do many times for it to sink in and for it to be available in a crisis when you’re stressed, feel anxiety and are afraid. (Student 13)

The student conceptualizes the problem of passivity and indecisiveness in emergency situations in general. In his emphasis on the importance of training he expresses lived through phenomenological insights about the nature of skill, emotion and practice. The subjective perspective of the student is not explicitly attended or taken as the intentional object but is nevertheless present in the background of the reflection, as its primary source. This further demonstrates how conceptual understanding can be integrated with first-person realization (reflected subjective experience) in debriefing.

Conclusions

The aim of this study was to explore the meaning of embodiment in post-simulation debriefing from both a theoretical and an empirical perspective and to explore a non-representational epistemology thereof. Rather than taking the meaning of experience for granted we have offered an account of reflection in debriefing grounded in an analysis of the relation between subjectivity and bodily self-awareness. Responding to the increasing recognition in professional education that learning cannot be properly understood without the inclusion of the body (Barnacle, 2009; Hyland, 2019; Loftus & Kinsella, 2021; O'Loughlin, 1998) we suggest that a phenomenological/enactivist perspective (Gallagher & Zahavi, 2008; Thompson, 2007), which takes students’ first-person perspective as a fundamental constituent of reflection, is a viable alternative to traditional dualistic philosophies of education underlying simulation-based learning. Although the discussion on the need of non-dualistic theories of cognition and embodiment in professional practice and education is not new, especially through notions such as skillful coping (Dreyfus & Dreyfus, 1986), tacit knowledge (Polanyi, 1966), know-how (Ryle, 1949/2000), and reflection-in-action (Schön, 1983), it is often emphasized that the embodied mind is primarily revealed in non-reflective ‘doings’ and is seldom if ever verbally voiced and thematized in conscious thought (Kinsella, 2007). However, the present case study of bodily-awareness-in-reflection illustrates how embodied experience in educational context can be articulated and conceptualized by students for the purpose of learning. It can also be noted that while many non-dualistic notions of cognition intend to disrupt the entrenched gap between the body and mind they sometimes introduce new ontological dualisms between conceptualization and embodied action which we aim to bridge.

The phenomenological/enactivist alternative implied by our notion of bodily-awareness-in-reflection, as demonstrated in the previous section, offers a non-representational understanding of reflection conceived as a subject’s thematization of his or her particular embodiment in the world. We emphasize, in particular, the subjective (phenomenal) and pre-reflective dimension of bodily experience as a pre-requisite for any further act of reflection. As expressed by Sartre (1956, p. Iiii): ‘it is not reflection which reveals the consciousness reflected-on to itself. Quite the contrary, it is the non-reflective consciousness which renders the reflection possible’. Moreover, the meaning of reflection is, from this epistemological perspective, not that of representing a pre-given world which the student just happens to be a part of but rather as something emerging through interaction, as subjectively (reflectively and pre-reflectively) experienced by the student and which can be tied to wider experiential and conceptual horizons involving various (e.g. social, cultural, material, historical) contexts. We conclude that reflection in post simulation debriefing does not have to be conceived as abstraction, separating the lived body from the mind; rather, it can be an act of worldly self-awareness, a conceptualization of one’s own embeddedness in the world as an embodied learner and future professional practitioner. However, neither does reflection, based on our notion, have to be conceived as a psychological construction but as an attempt to actually understand and shape our being-in-the-world.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Stiftelsen Sveriges Sjömanshus.

Notes on contributors

Martin Viktorelius

Martin Viktorelius is assistant professor in learning in a digitalized society at the Department of Education at the School of Education, Humanities and Social Sciences at Halmstad University in Sweden. He has a background in philosophy and cognitive science with an interdisciplinary PhD thesis positioned in the fields of organization theory, information systems and education. His research focuses on practice-based professional learning and knowing in educational and organizational settings.

Charlott Sellberg

Charlott Sellberg is an associate professor in IT and learning at Department of Applied IT, University of Gothenburg. She has a multidisciplinary background in cognitive science and human-computer interaction and a PhD in education. Her research focuses on professional learning in higher education and vocational settings.

Notes

1 Most research on simulation in professional education is grounded in the theoretical frameworks of constructivism, as developed by Dewey, Piaget, Kolb and Gibbs. However, theoretical developments have recently occurred, primarily due to the introduction of practice theory and ethnomethodologically informed interaction analysis (Hindmarsh et al., 2014). Surprisingly, given the experiential and embodied focus of all simulation-based education, few studies are grounded in the phenomenological tradition.

2 The concept of the lived body originated in Husserl’s’ distinction between leib and körper, and was later referred to as corps vivant, or corps proper by Merleau-Ponty and being-for-itself (as opposed to being-for-others) by Sartre (1956). The lived body can be contrasted with how the objective or physiological body is known or presented to us: respectively, as a phenomenal background of any experience or through observation. The lived body is thus constituted in the subjective (first-person perspective) experiencing of one’s own body, including its affective states and emotions.