Drawing meanings from drawings

Drawing meanings from drawings

The potential for using drawings to interrogate practices in medical education is becoming more and more appealing as I delve into this modality. While images in terms of diagrams and imaging are integral components to medical training, asking individuals to draw on their experiences, thoughts and feelings through drawings is not common.

In our Faculty we have used drawings in a limited way with first year students. For several years I was asked to instruct my small group of students to draw their personal development illustrating their learning in a semester course. These images were interesting with frequent reference to metaphors such as growing beans, meandering rivers and flowers opening up. Thick wax crayons were used as cost was always a big concern.  I began to question how authentic such evaluations were, and whether we were actually rather facilitating students’ strategic actions to complete a desired task to please their teacher. As the facilitator of student learning, I grew to dislike the materiality of the crayons as it placed a childish perspective to the many course tasks that had potential. Later I introduced alternative stationery to offer more choice to the students.

In 2013 I used the title of this blog for a presentation at the Higher Education Learning and Teaching in South Africa (HELTASA) conference in Pretoria. It was a small part of a collaborative group project organized by our course facilitators from a professional development course run by the Cape Consortium for Higher Education (CHEC). This presentation is on Slideshare at http://www.slideshare.net/VeronicaMitchell/drawing-meanings-from-drawings

Through recent involvement in two collaborative research projects where drawings are integral to the processes, my interest has been reignited. When we can better integrate personal insights and experiences into the drawings, they can become exceptionally meaningful with useful sense-making of situations. Last week I had the opportunity to ask 13 educators in the Faculty to create their individual drawings responding to a video clip from our Head of Department, now on YouTube at  http://youtu.be/kwBDT1JElWY 

Above is my simple and quick drawing indicating the ladder of 6 years of study that comprises the medical curriculum.  The majority of students enter the Faculty with great ambitions to be caring and to make a positive impact on health, yet along the climb and after graduation, there are many uncertainties and huge challenges that they face in our public health system that frequently leave them floundering sometimes resulting in them climbing off the ladder or at times falling.

My personal observations from these recent drawing projects:

Ø    Engagement with the task of drawing varies: some people dive in with great enthusiasm and others are frozen with uncertainty

Ø    Paper size: some use the large A2 option while others fold up the sheet to work on a smaller, more defined surface

Ø    Types of images: people, nature and conceptual representations indicate the varying connections made by individuals

Ø    Focus: Some avoid the real issues such as prevailing tensions using alternative images while others dig deeply into interrogating issues through their images

Ø    Colours: The choice of colour seems to be significant. For instance, monochromatic may indicate a single perspective as opposed to multiple colours and textures reflecting the complexities

Ø    Emotion: sometimes clearly evident, sometimes emerging through the oral description of the image, and other times missing

It feels like drawings can offer deeper insights than photos but are more challenging to elicit.

Reflective diffractions

       

An introduction to the methodological theory of diffraction in Karen Barad’s book, Meeting the universe halfway (2007) is shifting my gaze. These photos were taken on different days this week in our Faculty computer lab. They indicate the complexity of relationships and the intra-actions between myself (reflected in the first photo) and the material objects around me. The glass, the light and the position of the vertical blinds illuminate different stances as I stand in the same position on both days.

At our recent research project retreat in the beautiful Stellenbosch area, we grappled with ideas and concepts and alternative points of view. The space facilitated such interactions – while uncomfortable, they were meaningful. I came away with personal experience of how we can gain deeper insights through disruption of the status quo yet in many instances it is not allowed. Although resilience and agency are perceived as important characteristics to enhance our pedagogical interactions, care and compassion with creativity to engage in uncertainty seem paramount.

Student saturation

Recently I sent out my research survey questions to a selected group of students. The Google form was accessible through a tinyurl mailed to the students. It was created attractively to add appeal by using relevant images and colour, and asked for 10 minutes of the students’ time. Like my pilot survey only 2 students responded. However unlike previously, a follow-up note using the mail merge add-on did not elicit more responses. While the subject of my research is related to students’ experiences and many have indicated a keenness to bring change, I'm wondering why the response rate was so poor.

Are senior students saturated by the numerous requests for evaluation, feedback and research participation? Involvement in research is voluntary so they have every right to refrain from participation yet this does have serious implication for a PhD project that hinges on the students' experiences in engaging with the curriculum. 

Perhaps students have become emotionally detached.  Individual achievement and motivation to succeed in the course can override broader concerns such as becoming part of a community of inquiry for change. Timing is a factor that I now recognize as crucial. Final year-end exams and the beginning of a short summer vacation are not conducive to responding to extra requests. I will retry the survey at the start of 2015 when students are refreshed and inspired to face new challenges.

As the link between emotions and affect becomes clearer, I consider alternative strategies to encourage students to feel empowered to act beyond the confines of the designed curriculum.

A thorny issue

A thorn bush in the northern areas of South Africa seems to be a significant symbol for the problem of disrespect in Obstetrics, which is not straight forward, rather complex with multiple prongs. There is a need to draw on the different perspectives, from different angles in terms of the behavior and attitudes of the many actors, as well as engaging with emotions. 

Stepping into one of these thorn bushes is extremely painful, initiating a sharp reaction. A prick, a jab or a deep gash may result in lasting pain and discomfort. Similarly negative experiences of birthing can have detrimental consequences for mums, students, midwives and others involved.

The silencing of these practices seems to demonstrate an unwillingness to engage in difficult issues, perhaps the emotional labour is too unsettling. It feels like we are conditioned to keep our distance from the thorns, to stay away, which appears to exacerbate the “othering” of relationships.

Is the medical curriculum providing the space and opportunity for students to develop the muscle to recognize the thorns and bounce off them, or teaching and building resilience to insulate future doctors from harm, or shifting away from discomfort to accomplish the requisite knowledge and skills at the expense of other competencies?

A vertical gaze

An African safari is a greatly sought after experience by many people around the globe. Beyond taking time out away from home, it also offers an opportunity to connect with wildlife and learn from other species.

The height reached by a giraffe particularly while stretching to nibble leafy nutrients gives a very different perspective to the life world of the dung beetle shifting its way along the road. It reminds me of standing in a lift next to a very young child whose perspective is restricted by height. 

Considering the labour facilities where women are told to lie on a bed with health care providers and others attending to them, and looking down, it could be different. Doulas tend to sit beside a woman at the same level to offer support and compassion.  Perhaps we ought to give more consideration to these connections.

Horizontally speaking through the passage in Obs and Gynae

When I first became aware of the hidden curriculum, it was described as the informal learning that takes place outside the classrooms, such as in the passageways and refreshment areas. A new awareness was awakened to become conscious of these occurrences and opportunities which most frequently occur without planning. At the time I was participating in a health and human rights workshop and recognized the unmet needs of some of the participants who were keen to share their stories from the Apartheid years of discrimination.

Recently and unexpectedly I engaged in a brief conversation in the corridor with our departmental head, the importance of this interaction led me to again reflect on the unexpected opportunities arising from these open spaces. Our mutual concern was about the normalization of disrespectful practices in labour wards. What about those who are unaware of the inappropriateness of their habitual poor and abusive practices?

A recent reading from Lenz Taguchi's book, Going Beyond the Theory/Practice Divide in Early Childhood Education, draws on Deleuze and Guattari's concept of striated and smooth spaces demonstrating the differences between organized, controlled, ordered and safe learning as opposed to that which is uncertain, with multiple opportunities and avenues, yet both are generally intertwined. Do the passageways provide us with an agentic force and materiality that inspire deeper insights and conversations?

Google chain

Google Drive has become part of me and my work. 

Am I chained to it, amidst the roughness of my teaching and research? Perhaps I am, as it provides a firm hold with an organized structure that assists my progress. I like the ever-increasing affordances, shifting my practices into new and uncertain spaces.  

Since discovering Google Drive through a course on Emerging Technologies in Higher Education (run by the Cape Higher Education Consortium), I’ve shared it with colleagues, and introduced it to students enabling them to use it through authentic learning, as their comrade. It offers a user-friendly avenue for reflective practice from where students’ voices and experiences can be amplified through online collaborative engagement.

  

An explanation of my use of Google Drive with medical students is now published in a Routledge book edited by Vivienne Bozalek, Dick Ng’ambi. Denise Wood, Jan Herrington, Joanne Hardman and Alan Amory.

Starting up

Since ethics clearance from 2 universities, my PhD journey has become more real. 

Because reflection is a crucial aspect of my research project, I have been grappling with ideas of how I can share my thoughts and feelings in an authentic and critical manner without using too much text as in the traditional formats. Visual teaching and learning is my preference.

A recent introduction to photovoice methodology gave me new insights and inspiration to try this route with myself and to even offer it to my students. Below is an image (taken in a sauna) depicting the apparent murkiness at the start of a big research project. Looking into the picture are the lines and blocks symbolizing the numerous steps and stages that will mark the progress of this project.