Using critical consciousness to inform health professions education : Aliterature review.

Mark Halman,Lindsay Baker,Stella Ng

doi:10.1007/s40037-016-0324-y

Abstract

PurposeTo explore how, in health professions education (HPE), the concept of critical consciousness has been defined and discussed, and to consider and suggest how critical pedagogy could be applied in practice. This exploration responds to increasing calls in the literature for HPE to foster compassionate care and social consciousness through the social sciences and humanities.MethodThe authors searched Medline/PubMed, ERIC and Web of Science for articles focusing on critical consciousness and/or critical pedagogy involving health professions. A thematic analysis aimed to identify key themes of critical consciousness in HPE literature.ResultsThe authors included 30 papers in their review. Key themes related to defining and discussing core attributes of critical consciousness in HPE were: 1) appreciating context in education and practice; 2) illuminating power structures; 3) moving beyond ‘procedural’; 4) enacting reflection; and 5) promoting equity and social justice.ConclusionsCritical consciousness may inform an appropriate critical pedagogy for fostering compassionate, humanistic, socially conscious health professionals who act as agents of change. While the authors share critical teaching practices for educators, considerable care must be taken in efforts to use critical pedagogy within the current structures of HPE programmes. The authors suggest attending to the philosophical and theoretical origins of critical consciousness and those of the dominant models of contemporary HPE (e. g. competency-based approaches) in order to ensure the tenets of critical pedagogy can be enacted authentically.

Highlights

Fostering compassionate, socially responsible health professionals is an imperative of health professions education (HPE)
An education concept originating from emancipatory work with marginalized and disadvantaged populations, holds promise if health professions education (HPE) aims to foster compassionate and socially responsible providers
We conducted a literature review to summarize and present ways in which critical consciousness has been explored in HPE

Summary

Introduction

Socially responsible health professionals is an imperative of health professions education (HPE). Competency-based medical education runs the risk of reducing learning to a series of measurable skills and behaviours This narrow focus potentially obscures professional identity development [6] and the place of personhood and values in becoming a physician [7]. Critical approaches explore unexamined assumptions that are held at individual, institutional, and cultural levels of healthcare and aim to raise awareness of the conditions of the people and communities served They question the power relations inherent in health and healthcare, and how individuals, groups, and systems may be (unintentionally or intentionally) complicit in perpetuating and reproducing the current, at times inequitable, state of social conditions [8, 9]. A gap remains: what would critical approaches look like in actual HPE practice and how could they be applied within the current structures of HPE?

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Conclusion