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AGEM JAHRESTAGUNG 31 – Preparing for Patients. Learning the skills and values of healing encounters (DE)

Datum
29. Juni – 01. Juli 2018 

31st Annu­al Con­fer­ence of the Arbeits­ge­mein­schaft Eth­nomedi­zin e.V. (AGEM) in Coop­er­a­tion with the Col­lab­o­ra­tive Research Cen­ter Media of Coop­er­a­tion at the Uni­ver­si­ty of Siegen

How physi­cians and oth­er heal­ers con­duct their encoun­ters with clients is an  inte­gral ele­ment of becom­ing heal­ers. Nev­er­the­less, this knowl­edge is only part­ly pro­vid­ed by offi­cial chan­nels or cours­es; rather, it is often learned in a sub­tle and implic­it  man­ner  dur­ing  prac­ti­cal   appren­tice­ship.   Despite   broad   inves­ti­ga­tions of the pro­fes­sion­al encoun­ters between heal­ers and  their  clients,  few  stud­ies  have  addressed  the  ques­tion  how  exact­ly  these  skills  and  atti­tudes are  learned. A main crit­i­cism of the patient-physi­cian rela­tion­ship in bio­med­ical con­texts has  long been its asym­me­try (Pil­nick und Ding­wall 2011), and empir­i­cal stud­ies have time and again reassert­ed fun­da­men­tal dis­par­i­ties between those seek­ing and those pro­vid­ing health ser­vices (Bege­nau et al. 2010). At the same time, these asym­me­tries are con­sti­tu­tive of the heal­ing encounter, because they form a func­tion­al dif­fer­ence between heal­er and client: with­out the attri­bu­tion of spe­cial  knowl­edge and skills to the heal­ing par­ty, the whole encounter would be dis­pens­able. In con­trast to bio­med­ical con­texts, the encounter of non-bio­med­ical heal­ers with their clients is often con­ceived as being less hier­ar­chi­cal. Yet, we would assume a sim­i­lar func­tion­al dif­fer­ence between them. We assume that how these asym­me­tries and dif­fer­ences are man­aged and per­formed in dai­ly prac­tice is large­ly learned in the for­ma­tive years of apprenticeship.
Since the sem­i­nal stud­ies “The Stu­dent Physi­cian” (Mer­ton et al. 1957) and “Boys in White” (Beck­er et al. 1961), there has been lit­tle in-depth research on how stu­dents of heal­ing prac­tices acquire such skills and how they are trans­mit­ted in learn­ing con­texts. These stud­ies have shown how  novice  physi­cians  learn  to  cope  with  the con­tin­gen­cies of dai­ly work and how they learn to bal­ance respon­si­bil­i­ty and expe­ri­ence. Through fine-grained ethno­graph­ic field­work, the researchers were able to show how such skills and atti­tudes are learned in the process­es of becom­ing a com­pe­tent mem­ber, by observ­ing and imi­tat­ing role mod­els and by being sen­si­tive to the norms and val­ues dis­played by sig­nif­i­cant oth­ers. In line with Beck­er et al., we assume that most of these skills are part of the tac­it learn­ing in the “hid­den cur­ricu­lum” (Haf­fer­ty and Franks 1994). The hid­den cur­ricu­lum refers to those aspects of learn­ing con­texts that do not fig­ure promi­nent­ly in offi­cial accounts, but are learned as part of becom­ing a mem­ber of a heal­ing pro­fes­sion. Despite (or because of) their infor­mal char­ac­ter, they serve as pow­er­ful ori­en­ta­tions that slow­ly become tak­en for grant­ed, in many cas­es with­out explic­it recog­ni­tion by those who teach and learn them. In the course of the con­fer­ence, we want to shed light on how appren­tices of heal­ing pro­fes­sions are prepar­ing and are being pre­pared for their encoun­ters with patients or clients. Irre­spec­tive of the giv­en heal­ing cos­mol­o­gy, all heal­ing knowl­edge is ordered in spe­cif­ic sys­tems, orga­nized in rules, schemes, and pro­ce­dures that need to be adapt­ed to the indi­vid­ual heal­ing encounter. There­fore, every heal­ing encounter is laced with fun­da­men­tal uncer­tain­ties – not only with respect to treat­ment but also to inter­ac­tion (cf. Fox 1980; Hen­ry 2006). And all heal­ing appren­tices learn how to cope with these con­tin­gen­cies. The sub­tle trans­mis­sion of a “pater­nal­is­tic” mod­el of physi­cian-patient inter­ac­tion in bio­med­ical edu­ca­tion might account for the long-stand­ing asym­me­try that are part of the offi­cial pro­gram of med­ical edu­ca­tion, despite long­stand­ing calls for “shared deci­sion mak­ing” and “informed con­sent” (Stoll­berg 2008) . Con­se­quent­ly, “pro­fes­sion­al dom­i­nance” (Frei­d­son 1970) is a skill that needs to be learned before it can be practiced.
Thus, we want to com­pare and take a clos­er look at the sub­tle modes of how stu­dents of dif­fer­ent heal­ing  prac­tices  –  bio­med­ical  as  a  well  as  all  oth­er  heal­ing tra­di­tions – are pre­pared and how they pre­pare them­selves for their encoun­ters  with  patients.  We  want  to  ask  ques­tions  along  the  fol­low­ing lines:
•Which atti­tudes are trans­mit­ted for cop­ing with the ten­sion between stan­dard pro­ce­dures and indi­vid­ual cases?
•Which roles do author­i­ty, per­for­mances of author­i­ty, com­pe­tence, empa­thy, uncer­tain­ty, respon­si­bil­i­ty, and expe­ri­ence play?
•What modes of teach­ing and learn­ing the “hid­den cur­ricu­lum” can be observed?
Con­fer­ence Lan­guage: English

CME points for physi­cians and psy­chother­a­pists can be obtained.

Dokumente

Poster
Book of Abstracts
Call for Papers

Kontakt

Cor­nelius Schu­bert:cornelius.schubert@uni-siegen.de
Ehler Voss: ehler.voss@uni-siegen.de


31st Annu­al Con­fer­ence of the Arbeits­ge­mein­schaft Eth­nomedi­zin e.V. (AGEM) in Coop­er­a­tion with the Col­lab­o­ra­tive Research Cen­ter Media of Coop­er­a­tion at the Uni­ver­si­ty of Siegen

How physi­cians and oth­er heal­ers con­duct their encoun­ters with clients is an  inte­gral ele­ment of becom­ing heal­ers. Nev­er­the­less, this knowl­edge is only part­ly pro­vid­ed by offi­cial chan­nels or cours­es; rather, it is often learned in a sub­tle and implic­it  man­ner  dur­ing  prac­ti­cal   appren­tice­ship.   Despite   broad   inves­ti­ga­tions of the pro­fes­sion­al encoun­ters between heal­ers and  their  clients,  few  stud­ies  have  addressed  the  ques­tion  how  exact­ly  these  skills  and  atti­tudes are  learned. A main crit­i­cism of the patient-physi­cian rela­tion­ship in bio­med­ical con­texts has  long been its asym­me­try (Pil­nick und Ding­wall 2011), and empir­i­cal stud­ies have time and again reassert­ed fun­da­men­tal dis­par­i­ties between those seek­ing and those pro­vid­ing health ser­vices (Bege­nau et al. 2010). At the same time, these asym­me­tries are con­sti­tu­tive of the heal­ing encounter, because they form a func­tion­al dif­fer­ence between heal­er and client: with­out the attri­bu­tion of spe­cial  knowl­edge and skills to the heal­ing par­ty, the whole encounter would be dis­pens­able. In con­trast to bio­med­ical con­texts, the encounter of non-bio­med­ical heal­ers with their clients is often con­ceived as being less hier­ar­chi­cal. Yet, we would assume a sim­i­lar func­tion­al dif­fer­ence between them. We assume that how these asym­me­tries and dif­fer­ences are man­aged and per­formed in dai­ly prac­tice is large­ly learned in the for­ma­tive years of apprenticeship.
Since the sem­i­nal stud­ies “The Stu­dent Physi­cian” (Mer­ton et al. 1957) and “Boys in White” (Beck­er et al. 1961), there has been lit­tle in-depth research on how stu­dents of heal­ing prac­tices acquire such skills and how they are trans­mit­ted in learn­ing con­texts. These stud­ies have shown how  novice  physi­cians  learn  to  cope  with  the con­tin­gen­cies of dai­ly work and how they learn to bal­ance respon­si­bil­i­ty and expe­ri­ence. Through fine-grained ethno­graph­ic field­work, the researchers were able to show how such skills and atti­tudes are learned in the process­es of becom­ing a com­pe­tent mem­ber, by observ­ing and imi­tat­ing role mod­els and by being sen­si­tive to the norms and val­ues dis­played by sig­nif­i­cant oth­ers. In line with Beck­er et al., we assume that most of these skills are part of the tac­it learn­ing in the “hid­den cur­ricu­lum” (Haf­fer­ty and Franks 1994). The hid­den cur­ricu­lum refers to those aspects of learn­ing con­texts that do not fig­ure promi­nent­ly in offi­cial accounts, but are learned as part of becom­ing a mem­ber of a heal­ing pro­fes­sion. Despite (or because of) their infor­mal char­ac­ter, they serve as pow­er­ful ori­en­ta­tions that slow­ly become tak­en for grant­ed, in many cas­es with­out explic­it recog­ni­tion by those who teach and learn them. In the course of the con­fer­ence, we want to shed light on how appren­tices of heal­ing pro­fes­sions are prepar­ing and are being pre­pared for their encoun­ters with patients or clients. Irre­spec­tive of the giv­en heal­ing cos­mol­o­gy, all heal­ing knowl­edge is ordered in spe­cif­ic sys­tems, orga­nized in rules, schemes, and pro­ce­dures that need to be adapt­ed to the indi­vid­ual heal­ing encounter. There­fore, every heal­ing encounter is laced with fun­da­men­tal uncer­tain­ties – not only with respect to treat­ment but also to inter­ac­tion (cf. Fox 1980; Hen­ry 2006). And all heal­ing appren­tices learn how to cope with these con­tin­gen­cies. The sub­tle trans­mis­sion of a “pater­nal­is­tic” mod­el of physi­cian-patient inter­ac­tion in bio­med­ical edu­ca­tion might account for the long-stand­ing asym­me­try that are part of the offi­cial pro­gram of med­ical edu­ca­tion, despite long­stand­ing calls for “shared deci­sion mak­ing” and “informed con­sent” (Stoll­berg 2008) . Con­se­quent­ly, “pro­fes­sion­al dom­i­nance” (Frei­d­son 1970) is a skill that needs to be learned before it can be practiced.
Thus, we want to com­pare and take a clos­er look at the sub­tle modes of how stu­dents of dif­fer­ent heal­ing  prac­tices  –  bio­med­ical  as  a  well  as  all  oth­er  heal­ing tra­di­tions – are pre­pared and how they pre­pare them­selves for their encoun­ters  with  patients.  We  want  to  ask  ques­tions  along  the  fol­low­ing lines:
•Which atti­tudes are trans­mit­ted for cop­ing with the ten­sion between stan­dard pro­ce­dures and indi­vid­ual cases?
•Which roles do author­i­ty, per­for­mances of author­i­ty, com­pe­tence, empa­thy, uncer­tain­ty, respon­si­bil­i­ty, and expe­ri­ence play?
•What modes of teach­ing and learn­ing the “hid­den cur­ricu­lum” can be observed?
Con­fer­ence Lan­guage: English

CME points for physi­cians and psy­chother­a­pists can be obtained.

Dokumente

Poster
Book of Abstracts
Call for Papers

Kontakt

Cor­nelius Schu­bert:cornelius.schubert@uni-siegen.de
Ehler Voss: ehler.voss@uni-siegen.de