Reflection as transformation Collaboration and reflection across boundaries

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Reflection as transformationCollaboration and
reflectionacross boundaries

• Steen Wackerhausen
• Dept. of Philosophy and the History of Ideas
• Aarhus University, Denmark
• steen_at_wackerhausen.dk

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Content

• Why inter-professional collaboration?
• An ontological perspective
• An epistemological perspective
• Ethical requirements
• Professional identity and boundaries
• The anatomy of professional identity
• Forms of identity possession
• Ways of acquiring professional identity
• Reflection and collaboration
• 1. order reflection
• The immune system or the empire strikes back
• 2. order reflection
• Inter-professional reflection
• A plea for the future

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Why inter-professional collaboration?
(a) Ontological perspectives

• Ontology the study of the basic structures
  and dynamics of existing phenomena
• A solid ontological result
• Every existing phenomenon is the center of a
  highly complex and dynamic field a causal field.
• Nothing comes of nothing (and only nothing
  causes nothing).
• Consequently, every phenomenon owes its
  existence to something else.
• Metaphorical speaking Every phenomenon is a
  child with many parents, grandparents,
  great-great parents, etc.

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Why inter-professional collaboration?
(a) Ontological perspectives (cont.)

• Example A specific persons back pain after a
  football match
• What made this phenomenon come into existence?
• X f (a, b, c, d, e, )

For causes and explanations physiology physics
psychology cultural studies rules of
football etc.
X
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Why inter-professional collaboration?
(a) Ontological perspectives (cont.)

• What can make this phenomenon change or
  disappear?
• (q, z, y, w, etc.) X f (a, b, c, d, e, )

Passive
Active
X
A phenomenons causal field
.. and only nothing causes nothing
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Why inter-professional collaboration?
(b) An epistemological perspective

• The size and complexity of a causal field
• outside the epistemic reach of any given
  scientific discipline
• The truth, nothing but the truth, but not the
  whole truth
• epistemic humility far more to be know
• And ..
• No profession knows all what are relevant to know
• A professional humility is warranted

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Why inter-professional collaboration?
(C) The ethical demand

• The goal
• Doing what is best for the patient
• The means
• Relevant knowledge, skills, and competence
• The ontological condition
• The complexity and size of a causal field are
  infinite
• The epistemic limitations of any profession
• No profession has all the knowledge and skills
  to do what is best for the patient. Collectively,
  the professions know and can do more.
• The ethical demand
• For the purpose of the patients well-being,
  inter-professional collaboration is a
  requirement.

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Professional identity and boundaries

• Inter-professional agreement (in a philosophical
  moment) ..
• on the ontological conditions, the epistemic
• limitations, and the ethical demands
• but often no genuine collaboration!
• Why?
• Some of the reasons are to be found in the
  constitution and roles of the identity of
  professions (professional identity)

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Professional identity and boundaries

• Macro level of professional identity
• not the professions decision alone
• acknowledgement and negotiations
• other factors history, economy, political
  factors, prestige,
• technology, scientific progress, etc.
• Micro level of professional level
• practitioners, communities of practice, etc.
• to be one of our kind
• formal qualifications
• explicit knowledge, tacit knowledge, skills, etc.
• But more is needed to be a fully acknowledge
  member
• of a profession ..

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Professional identity and boundaries
(a) The anatomy of a profession

• A way of speaking (terms, concepts, etc.)
• A way of questioning (relevance)
• A way of understanding and explaining
• A way of seeing
• A way of doing
• And acknowledgement of the professions..
• symbolic capital, status, metaphors, narratives,
  conceptions of other professions, etc.
• To become, to be, and to stay one of our kind
• Habitual approach perspectives and dispositions

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Professional identity and boundaries
(b) Forms of identity possession

• Explicit levels of possession
• Embodied levels possession
• Embodiment, habituation, and habits
• Everyday habits and professional blindness
• excursion A cow named Maren
• The habitual/the usual does not thematize itself

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Professional identity and boundaries

• Scholastic learning (secondary)
• Informal and tacit learning in communities of
  practice (primary)
• informal learning of
• a way of talking
• a way of questioning
• a way of explaining
• etc.

(c) Ways of acquiring professional identity
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Professional identity and boundaries

• On the micro level of professional identity
  habitual ways of talking, questioning,
  explaining, doing, assuming, etc. often embody
  unwanted boundaries constraining genuinely
  inter-professional collaboration
• On the macro level of professional identity we
  often witness embodied boundaries of and barriers
  to inter-professional collaboration too.
  Survival, symbolic capital, higher salary, etc.
  plays significant roles.
• Often too many unexamined background (embodied)
  concepts and assumptions are serious obstacles to
  collaboration. Concepts and assumptions in
  disharmony with the ontological, epistemic, and
  ethical arguments for collaboration.
• It seems reflection is needed

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Reflection and collaboration

• Is reflection a solution? It depends!
• Reflecting on (theme, topic, etc.)
• Reflecting with (concepts, beliefs, etc.
• Reflecting from (perspective, interest, etc.)
• Reflecting in (context, surroundings, etc.)

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Reflection and collaboration
1. Order reflection

• Reflection as usual habitual reflection?
• 1. order reflection
• Effective? Maybe! Transformative? Probably not!
• Many topics, concepts, perspectives,
• contexts, etc.
• Background concepts and dogmas of a profession
• are often undisturbed

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2. order reflection

• Becoming a stranger to oneself
• Making the invisible visible
• Reflection on our habitual way of reflecting
• Reflecting on our 1. order reflections
• on something (what and why we thematize)
• with something (basic concepts, beliefs, etc.)
• from a perspective (tacit interests, values,
  etc.)
• in a context (the motivating/constraining
  surroundings)
• Destabilizing the stabilized
• Enough?

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The immune system - The Empire strikes back!

• One of our kind rules of conduct and
• membership
• Attacking the destabilizer
• Ignoring
• Re-education (rehabilitation)
• Marginalization
• Isolation or exclusion
• Courage and the willingness to be proven wrong
• Minimizing the immune system
• Changing conditions, diversity, and fit

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Inter-professional reflection

• A shared set of goals
• Professional humility
• Acknowledgment of the ontological, epistemic, and
  ethical conditions and requirements
• Critical and constructive
• Non-fundamentalist attitude
• A way of being professional
• Transformative
• Surely, not all reflective activities
  (reflection) fulfill the normative
  characterizations.

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A plea for the future

• Reflection as a transformative and collaborative
  quest
• The requirements
• 1. and 2. order reflection
• A quest for what is right and what is true
• A willingness to be proven wrong
• An epistemic awareness
• Intuition, habits and consensus are no guarantee
• Humanism (renaissance)
• Fighting self-deception
• Raw realism
• Human flourishing (is and ought)

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A plea for the future

• Reflection in a humanistic perspective
• Reflection as a human obligation
• Reflection as a critical and constructive
  activity
• Reflection as an unending journey
• Reflection as a productive disharmony
• Reflection as a way of being
• That is, reflection as a transformative and
  collaborative quest