The proof is in the pudding: Putting Actor-Network-Theory to work in medical education
Abstract
What constitutes valid evidence from medical education research is typically grounded in the scientific paradigm of proof through experiment. Here, explanation through single meaning is privileged over exploration of multiple presentations of phenomena--short, interpretation eclipses appreciation. This approach is challenged as reductive by naturalistic qualitative methods such as rich ethnographic field reports, presented as narratives. Contemporary ethnographic approaches have entered medical education by a back door--disguised as a stable of 'social learning theories'. Communities of Practice theory, Activity Theory and Actor-Network-Theory (ANT) all serve as research practices forming identifiable contemporary ethnographies. 'Evidence' is conceived as exploratory rather than explanatory, through baroque descriptions of innovations in learning organizations, including medicine. ANT is then both a theory of innovation in organizations and an ethnographic method, where practice and theory coincide. ANT is interested primarily not in epistemologies, but in how a phenomenon such as an 'illness' is conceived across differing practices as multiple ontologies (experienced meanings), each meaning generated and suspended within a particular network of effects. How such networks are initiated and developed has significance for rethinking the nature of 'evidence', restoring faith in the value of a good story.
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Neglecting materials may put patient safety at risk.
“This is relevant to medical practice where a variety of tools inform medical practice and design23 and neglecting materials may put patient safety at risk.24”
From Cultural Historical Activity Theory for Studying Practice-Based Learning and Change in Medical Education (2021) · cites this paper as [24]
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- Authors
- Bleakley, A.
- Affiliations
- Royal Cornwall Hospital (GB)
- Corresponding author
- Bleakley, Alan
- ORCID
- Bleakley, Alan
- Venue
- Medical Teacher
- Publisher
- Informa UK Limited
- Published
- 2012-04-10
- Volume
- 34
- Issue
- 6
- Pages
- 462-467
- ISSN
- 0142-159X (ISSN-L)
- 1466-187X
- OpenAlex
- W2156391211
- Cited by
- 66
- References
- 19
- Citations by year
- 2026: 1 · 2023: 4 · 2022: 4 · 2021: 4 · 2020: 4 · 2019: 3 · 2018: 7 · 2017: 9 · 2016: 6 · 2015: 10 · 2014: 4 · 2013: 8 · 2012: 2
- FWCI
- 7.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Teacher (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Education › Qualitative Research Methods and Applications
- Social Sciences › Human Factors and Ergonomics › Innovative Education and Learning Practices
- Keywords
- actor-network theory, medical education research, ethnography, qualitative research, communities of practice, activity theory, social learning theory, learning organization, organizational innovation, multiple ontologies, epistemology of evidence
- MeSH terms
- Anthropology, Cultural, Communication, Education, Professional, Health Personnel, Humans, Learning
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