Budapest-BUDAPEST, August 6th 2018 – Simulation, the artificial representation of real-world processes, is arguably the most prominent form of pedagogical innovation to occur within the medical field in the last 15 years. However, its origins within medicine date back to antiquity, when human models were built using clay and stone, for instance, to demonstrate certain techniques, structures, and pathologies (Jones, Passos-Neto, and Braghiroli 2015, 57). Today, simulation continues in the mode of low-tech human body models, drawn upon to illustrate anatomical structures and practice basic manoeuvres and procedures, alongside forms of mid to high-tech simulation including, for example, actors trained to role play as patients, screen-based computer simulators used to train and assess clinical knowledge and decision making, and realistic computer-driven patient model simulators which have the ability to produce complex, high-fidelity clinical situations (Ziv et al. 2003, 784).
Semmelweis Museum of Medical History
Over the weekend I took some time out of my sunny schedule to visit the Semmelweis Museum of Medical History, where I had the pleasure of discovering a collection of historical models used in the translation of previous generations of medical knowledge. Amongst these simulations was the Venus Anatomica, an enchanting (if, eerily positioned) full-scale wax figure demonstrating the female lymphatic system. Alongside the Venus – produced circa 1780 – I learnt that wax models, crafted through the coordinated practices of anatomists and artists, were once essential technologies of anatomical education, distributed throughout the medical universities of Europe. Pieces ranged from specific organs, to full anatomical figures, which were used to depict entire bodily systems.
Department of Anatomy, Histology, and Embryology
Throughout my time within the Department of Anatomy, Histology, and Embryology at Semmelweis University, I have had the opportunity to come into contact with many 21st Century anatomical simulations. Though perhaps not as initially engaging as the Venus Anatomica, these models are exquisite in their own right, retaining the integrity of connection between art and anatomy. Medical students and educators turn to models (now usually made of plastic) as one of many pedagogical technologies available to confer knowledge of the human body. This may occur, for instance, when the makeup of a cadaver obscures, to enlarge or highlight certain structures (for instance, the ear or eye), or to help students orient within “virtual space”, as is the case with the pelvis.
The use of these models is one illustration of the continued importance of low-tech simulation within medical education and, particularly in the case of my ethnography, the translation of embodied knowledge of human anatomy through pedagogical technologies.
Jones, Felipe, Carlos Eduardo Passos-Neto, and Freitas Melro Braghiroli. 2015. “Simulation in Medical Education: Brief history and methodology.” Principles and Practice of Clinical Research 1 (2):56-63.
Ziv, Amitai, Paul Root Wolpe, Stephen D. Small, and Shimon Glick. 2003. “Simulation-Based Medical Education: An Ethical Imperative.” Academic Medicine 78 (8):783-788.
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Let’s briefly ponder Le Guin’s words; the meaning and the beauty. This is, as I see it, a large part of what we all aspire to in our work as academics. Writing – a craft – which can meaningfully communicate the knowledge that we, alongside our interlocutors, produce and share. Writing – a skill – that has the power to engage, move, shape, and transcend time and space when tinkered with enough so as to emerge ‘gorgeous’ (Le Guin 2015).
Writing is, indeed, a learnt technique – a craft, a skill (Le Guin 2015, ix). Alongside finding meaning and shaping beauty, we are, at many temporal junctures, presented with the (sometimes daunting) task of pouring over, and into, our gathered material. Pages upon pages of fieldnotes, a camera full of photographs, a recorder jammed with videos, stacks of archival photocopies, soundbites and soundscapes, the list goes on. One question, which thus presents itself, is, how do we move from material to an academic text – one, which is both meaningful and beautiful?
Having mostly concluded our fieldwork and having worked in the Ghanaian archives, this question is a poignant one for our team. We therefore took the opportunity to, following the larger ‘Teaching/Learning Materials: A Skillshare Workshop’, organise a day-long event entirely devoted to the craft of writing and, specifically, to the initial stage of moving from (mostly) undigested material to a workable text that sits warm and comfortable in the belly.
Working on the craft
The event created was titled, ‘A Skillshare Writing Workshop’ and took place in Maastricht from the 12th-13th of July. We were extraordinarily privileged to have the time and expertise of Professor Rachel Prentice, Professor Janelle Taylor, and Professor Jeremy Greene, who guided the workshop, introducing and concluding the event, leading the smaller group writing sessions, and generously sharing their knowledge, frustrations, and personal metaphors for their processes of writing (beach combing, sculpture, and slalom).
The workshop was shaped by texts from authors Ursula K. Le Guin and John McPhee and was supported by an online resource catalogue complied from a list of suggestions given to us by the participants themselves. Our group comprised 19 persons from varying disciplines and with diverse thematic interests, half of who were senior scholars and half of who were PhD researchers – a combination which lent itself to a fruitful skillshare.
Following a wonderful introductory session led by Janelle Taylor and Jeremy Greene and bearing a set of useful tools – postcards, sticky notes, coloured markers, and index cards – we divided into three smaller groups. One writing exercise explored in the small group guided by Janelle Taylor began with a prompt. Using three index cards, participants were asked to 1) describe, in a sentence, an exchange of dialogue or interaction from the field, 2) to create a “map of your fieldwork”, and 3) to focus on an object from the field and present it through drawing. These were then the foundations of, and instigators for, the group’s free writing time.
Another, more practical suggestion for establishing and sticking to good habits of writing – particularly when perfectionism and procrastination (and perhaps a little fear) set in when properly comprehending the quantity of rich material one has collected – was given to us by Rachel Prentice. One minute of writing every day, no matter what. No excuses, no putting it off until tomorrow, no re-reading articles or pouring over notes, we can all commit to one minute. It may seem a little odd or even unproductive, one minute – what can one accomplish in that time? However, as I see it, the purpose is to make writing friendly and approachable. Sitting down and starting is often the hardest part, one can always fill their day with other productive research tasks. Though, as many of us know, once one begins to write, the joy of the medium – of crafting rhythmic sentences and expressing ideas which we truly care for – takes over and we lose ourselves in the task.
A provocation raised in the closing session led by Rachel Prentice was to not only engage with the content of our own, and others’, work but to attend to the language, the structure, and the rhythm of texts in a caring and radical manner. Here, we find ourselves back in conversation with Le Guin’s meaning and beauty. The necessity of playing with rhythm, sound, alliteration, flow (for instance) – of making our writing ‘gorgeous’.
Moving forward our team will be practicing our craft by working through the exercises presented by Le Guin in her book ‘Steering the Craft‘. If you fancy more deeply attending to the meaning and the beauty of your own work, perhaps you could too.
For now, let’s leave it at that, and with a selection of writing currently being enjoyed by some of the workshop participants;
Katherine Verdery (2018), ‘My life as a spy’.
Sayaka Murata (2016), ‘Convenience Store Woman’.
China Miéville (2009), ‘The City & the City’.
John Seabrook (2018), ‘Black Ice, Near-Death, and Transcendence on I-91’.
Chimamanda Ngozi Adichie (2006), ‘Half of Yellow Sun’.
Yona Wallach (1997), ‘Wild Light: Selected Poems’.
Urusla K. Le Guin (1985), ‘She Unnames Them’.
Thanks to the European Research Council and the Netherlands Graduate School of Science, Technology, and Modern Culture (WTMC) who provided the funding that made this workshop possible.
MAASTRICHT, 25 February 2018 – This July, the Making Clinical Sense (MCS) team will be holding a four-day event, ‘Learning/teaching materials: A skillshare workshop’. The workshop will bring together Dutch and international scholars from across disciplines, exploring, amongst other things, skill, learning/teaching, and expertise, and will be held in the beautiful Teaching Hotel Chateau Bethlehem on the outskirts of Maastricht. We are all very excited about this workshop (the first to come from the MCS project) and will post more details soon.
PhD Day: A Skillshare Writing Workshop
Beyond the four day workshop, Andrea and I (with the help of the rest of the MCS team) are organising a ‘PhD day’. This one-day event – running over Thursday 12 July and Friday 13 July – has the express purpose of being ‘organised by and for PhD students’.
We have designed the day as a ‘Skillshare Writing Workshop’, in this way extending the theme of the overall workshop, whilst specifically focusing on the craft of academic writing. At Maastricht University – particularly within the MUSTS research programme, within which MCS is situated – and also within the WTMC (the national graduate programme that Andrea and I belong to) we have many opportunities to share academic texts ‘in progress.’ This, for instance, can take the form of working dissertation chapters (as happens in WTMC’s ‘write shops’), or articles, conference presentations, etc., which one is stuck on, or fine-tuning, for instance (as is the case at the MUSTS weekly ‘work in progress’ meetings). However, Andrea and I both felt that – though these shared sessions are an invaluable resource in the latter stages of writing – we were in need of some guidance in our initial, sometimes desperate, attempts to move from collected empirical material to academic text. Hence, the thinking behind the ‘Skillshare Writing Workshop’.
This workshop will focus on the stage of writing that comes upon returning from the field or resurfacing from the archive (timely considering our current research trajectories). The very practical question driving the workshop is: How do we move from material – fieldnotes, (sensory) experience, a quote from a transcript, photographs, videos, documents – to academic text?
As hinted at, this is quite an invisible stage of writing, and one that we often struggle through (mostly) alone. Over the course of the writing workshop we will thus take the time to articulate what this stage of the writing process entails as well as develop skills for working through it. To do this, we are posing the following guiding questions: What are the challenges related to beginning to write? How have we learnt to write? How does this relate to the identified challenges? What happens to our subjects and our material as we work towards an academic text?
Beyond working through these questions, the participants of the workshop will be asked to submit a ‘think piece’ – that is, some form of material gathered/generated during research – and will, throughout the course of the workshop, move towards translating this piece into text. The workshop will be composed of both junior and senior scholars, and we expect that this combination will allow for a ‘skill share’ related to the creation of academic text.
Although we will focus on a practical skill during the workshop, the scholars who have been invited share thematic interests with the MCS research team. These include materiality, technology, the senses, skill development, medicine, education, teaching/learning, and embodied knowledge. They are ethnographers and historians who use a variety of methods (e.g. re-enactment, video reflexivity, and participant observation). We are very pleased to announce that Professor Rachel Prentice, Professor Janelle Taylor, and Professor Jeremy Greene will help guide the day, functioning as group leaders and writing advisors.
WTMC Funding and Scholarships
We are also pleased to announce that this workshop has received funding from the Netherlands National Research School of Science, Technology, and Modern Culture (WTMC). We thank the WTMC for this generous assistance. The grant received will go towards facilitating the event at large, and will also fund the attendance of six WTMC Graduate Programme members on full scholarships. A call for WTMC member applications will be circulated in early March, and more information will follow here as well. However, if you have any questions at this time, please do not hesitate to contact us.
The workshop, entitled ‘Ethnographic Experimentation: Fieldwork Devices and Companions,’ centered on novel forms of ethnographic practice and presentation. The event hosted a range of scholars, mostly from within anthropology and its surrounding disciplines, and invited its participants to describe their own ethnographic fieldwork practice and to share their experiences of ethnographic experimentation. The three-day programme was divided into open-format sessions, paper presentation panels, and ethnographic film screenings, and allowed for plenty of time outdoors to enjoy the sun and gardens and, if lucky enough, to make friends with a host of local birdlife.
I attended the workshop on behalf of the Making Clinical Sense team and presented our recent work related to experimental and collaborative methods in a 30-minute open-format session.
Here, with the gracious help of the workshop organisers, I assembled an interactive space for participants to engage in the making of an omelette following a Julia Child video recipe (The French Chef: The Omelette Show). Other participants were then invited to notate the learning and cooking experience using various techniques and instruments, such as cameras, smartphones, and tablets, used for photography, video and sound recording, and sketch pads, pens and pencils, used for drawing and writing.
This format was designed in relation to Making Clinical Sense’s quasi- “proof of concept study” (which took place in June, 2017), in which we experimented with different methods of elicitation and notation – namely drawing, photography, and video – which imaginatively attended to skilled, sensory learning. Here we substituted omelette making – a sensory skill that demands finely tuned technique – for the primary focus of the project, the bodily and sensory clinical skills of physical examination.
I am very grateful to have been involved in the workshop and to have had the opportunity to meet with other ethnographers experimenting with methods and methodology, particularly in relation to sensory and material aspects of the empirical. It was an enjoyable and inspiring three days, filled with imaginative ideas and approaches to ethnographic practice – something to bring forward within Making Clinical Sense’s approach to our own fieldwork practice, and to the collection and sharing of our empirical material.
Many thanks to the event organisers for their vision, time, and effort, and for providing several of the materials used in my omelette making session.
How to cook an omelette: A proof of concept study
Sensory ethnography is becoming an increasingly popular method for exploring taken-for- granted practices that are otherwise difficult to articulate. Sensory ethnographers are asked to attune to their own learning, to learn with, not about, others (Ingold 2013). There is however, limited discussion on how to document not only one’s own learning, but also how others learn sensory skills. In the context of a larger comparative ethnographic study about how doctors learn sensory skills of diagnosis, we set out to experiment with different digital methods of elicitation and notation, which imaginatively attend to sensory learning. In a quasi- “proof of concept study”, we will take another example of a sensory skill that demands finely tuned technique – making omelettes. Because our interest in the medical world is the role of pedagogical technologies we will use various audio-visual notation methods to document how cooking omelettes is taught to a group by different technological arrangements: video (Julia Child’s The French Chef); written recipe (M.F.K Fisher’s How to Cook a Wolf); and apprenticeship (under the guidance of a chef). In doing so, we work in collaboration with media and art historians to understand more about what it means to experimentally re-enact and reconstruct recipes.
With awareness that our methods don’t describe practices but rather help create them, in the workshop we will share our discoveries about documenting sensory learning and discuss collaboration, as an ethnographic team, as well as learning experimental methods from other disciplines such as history. Beyond this, we invite participants to engage with sensory and skill learning as well as notation techniques, in the creation and documentation of their own omelette cooking experience.
As the day began our first speaker, Dear Hunter’s Remy Kroese, informed us that Dear Hunter and the Institute of Calibration ‘approach artistic research practice as a space in which the artist develops a methodology of her own’—that is, the artist acts as the instrument of research. The programme, it was explained, would therefore engage with the following (amongst other) questions: ‘How is an artist-as-instrument made sensitive? What kinds of embodied, aesthetic, intimate, sensory ways of knowing are developed? And, how does the artist-as-instrument become attuned or calibrated?
The event was organised as a ‘hands-on working session’ in which thinking-through-making was paramount (hence the sketch pads and pens!). The central and practical aspect of the day was the creation of our own “instrument”—instrument being a metaphor employed by the Institute of Calibration as a means by which to gain perspective on artistic research practice. We were thus instructed by the facilitators to draw imagined instruments and were provided with only one parameter, namely, that the instrument would be capable of receiving input and producing output. So (and with images of Leonardo da Vinci swirling in my mind) we crafted, through our drawings, tens of imaginary instruments, each unique and all with the ability to receive input and produce output, be it material or sensory.
A “letter sorter” was devised by one participant, alongside an instrument capable of receiving and expelling water, and another which had the ability to intake both mass and noise and subsequently compute these into a visual output map. I, myself—completely out of my comfort zone and not entirely sure what I was doing—created a pseudo stethoscope-type instrument and later, better comprehending the exercise, came up with an instrument capable of receiving positive thoughts and translating these into a syrupy output which I titled “happiness tea.” Throughout the course of the day—a day which was interspersed with presentations on hand drawing, architecture, and DIY oscilloscopes—we continued to come back to these instruments, sketching what their output might look like, thinking about the ways in which they might fail, and further fine-tuning their design and function.
These presentations and exercises, though not directly related to Making Clinical Sense, have, in the weeks since the symposium, provided me with some titbits to ponder over at the outset of our project. Firstly, the process of creating an imagined instrument, crafting its function and, in particular, its input and output, has afforded me space to consider, in a more creative way, potential lines of inquiry within my own research. That is, I ask myself, what are the corresponding input, output, and instrument categories within my project? What input, so to speak, will I be receiving when I arrive at Semmelweis, and what output do I anticipate or am I striving for? Moreover, what instrument(s) will I be using to make this conversion?
For me, drawing an instrument to represent this process can serve as an alternative way to conceptualise of my impending ethnographic practice, particularly when, at times, faced with the stagnation of language. Beyond this, Drawing Instruments has caused me to question and experiment with the utilisation of drawing as an ethnographic method. Here, drawing may be seen as a practice which not only considers the artist as a research instrument, but the anthropologist too—that is, drawing may be a different way to conceive of oneself as a sensitive research instrument. Drawing becomes not only a way to represent observed and interpreted reality, but is understood as an action, a way of working with and learning alongside the interlocutors of one’s research. Toying with these ideas I find myself beginning to delve deeper—that is, engaging with another methodological arena—into what it means to consider myself as a research instrument, a specifically important (and exciting) task at the outset of any ethnographic research project.