31 September 2011
I called into a health conference to make a contribution and once I was struck by the extent to which the two areas – health and education – were similar in all but two respects.
They are both similarly based on a fundamental value of service to people, we both do what we do because someone else has a need and when that need is met we leave the world a better place, well at least for them.
Both our groups work in teams, each health or education professional is necessary to the process but never in themselves sufficient. Managing this relationship between the members of the team and recognising the value of what each contributes to the team’s mission and to its outputs is the mark of a professional. But the success of our contribution also requires us to act with high levels of autonomy.
Health and education call for practitioners who are committed to reflective practice. Being able to reflect on what is happening or has happened and to adjust practice to take account of that reflection requires high level understanding of a number of things – the needs of others, the appropriate range of interventions to take, the signs of progress (or lack of progress perhaps), the willingness to consider the contribution made to the work of the team, an awareness of the strengths and limitations of oneself and so on.
A further clear similarity is the institutional nature of the place in which the arts of healing and teaching are practiced – hierarchical, predominantly public service in origins, current focus on managerialism, and so on. Being big ticket budget items for any government, they are also very political.
Finally there is the impact of the success of what is done – both affect lives. In health unsuccessful interventions could result in death or prolonged suffering. Issues in education, while not life threatening in the dramatic sense, are at least critical to the quality of life, the capacity to earn and the ability to provide for others. Both are central to happiness and peace in our lives.
But there are two critical differences – response to research and the uptake of technology.
Medicine is essentially highly responsive to research and indeed is research driven. New techniques of treatment, new drugs and their use and new regimes for recovery come directly from research to shape new practices among health professionals. Those working at the patient or community front are well-informed by research and are diligent about their continuing professional development.
On the other hand, education is sluggish in its response to research. The vast industry of educational research has always found it hard to make connection with and to inform classroom teaching – we continue practices long past the point when we know that they are not working, that there are better ways of working.
I speculate that the big difference has two explanations.
The first might be that health researchers work more closely with those who practice whereas in education the gap between research and practice seems never to close.
The second might be more critical. The health sector is largely self-monitoring. It disciplines its members who transgress, it admits into membership those who meet criteria of both qualifications and competence and they lead the public discussion. The government health agencies don’t control the participants but are left to manage the delivery vehicles – hospitals, Pharmac and so on. By comparison education, the school sector especially, is centrally controlled and managed with less devolution to the professionals in the schools than might be suggested by the model of governance that we use. Tertiary institutions are closer to the health model.
A self-monitoring and self-managing sector is much more likely to also accept the additional responses of continued development professionally.
And lastly, there is the matter of the uptake of technology. Both at the conference I attended and whenever I visit someone in hospital I am amazed at the uptake of technology and the specialist and advanced applications of it to the practice of administering and delivering health interventions. Hospitals are changed places in appearances, applications of technology and subsequently practice.
By contrast, schools are very much slower to change and new technologies find a place largely to replicate and reflect old pedagogies. Compare, for instance the way in which technologies allow for asynchronous teaching delivered flexibly over distance with the requirement that the greater part of instruction in schools and institutions takes place with designated groups who must assemble in a particular room at a certain time who must progress through a programme in a lockstep manner! This might be a result of having to work with groups.
I enjoyed my day amongst the neonatal nurses at their conference – we don’t spend enough time with other professions.