Using critical consciousness to inform health professions education: A literature review

Abstract

PurposeTo explore how, in health professions education (HPE), the concept of critical consciousness has been defined and discussed, and to consider and suggest how critical pedagogy could be applied in practice. This exploration responds to increasing calls in the literature for HPE to foster compassionate care and social consciousness through the social sciences and humanities.MethodThe authors searched Medline/PubMed, ERIC and Web of Science for articles focusing on critical consciousness and/or critical pedagogy involving health professions. A thematic analysis aimed to identify key themes of critical consciousness in HPE literature.ResultsThe authors included 30 papers in their review. Key themes related to defining and discussing core attributes of critical consciousness in HPE were: 1) appreciating context in education and practice; 2) illuminating power structures; 3) moving beyond ‘procedural’; 4) enacting reflection; and 5) promoting equity and social justice.ConclusionsCritical consciousness may inform an appropriate critical pedagogy for fostering compassionate, humanistic, socially conscious health professionals who act as agents of change. While the authors share critical teaching practices for educators, considerable care must be taken in efforts to use critical pedagogy within the current structures of HPE programmes. The authors suggest attending to the philosophical and theoretical origins of critical consciousness and those of the dominant models of contemporary HPE (e. g. competency-based approaches) in order to ensure the tenets of critical pedagogy can be enacted authentically.

Critically reflective practice and its sources: A qualitative exploration

“…Together, these findings highlight the role of personal experience in developing critically reflective ways of seeing. This makes sense given that critical and reflective pedagogies centre upon personal experience in education …”

“…In terms of teaching approaches, humanities education and critical pedagogy offer practical educational approaches that align with critical reflection . However, these approaches tend to be applied to curricula as addenda, which may limit their effectiveness and perceived value by learners and faculty members alike.…”

“…This makes sense given that critical and reflective pedagogies centre upon personal experience in education. 40…”

Generational ‘othering’: The myth of the Millennial learner

“…These authors argue that we must develop a critical consciousness that seeks to understand the social dynamics of power, privilege and inequities in order to provide the best quality care for all members of society. A recent literature review substantiates the importance of fostering critical consciousness within HPE as a whole so that “members of a healthcare culture can contend with unexamined assumptions that foster oppression” . This requires a shift in focus from the teaching of knowledge, skills and attitudes regarding perceived cultural attributes, which can degrade into “dehumanising stereotypes”, towards questioning why these differences may exist and how they influence care …”

“…A recent literature review substantiates the importance of fostering critical consciousness within HPE as a whole so that "members of a healthcare culture can contend with unexamined assumptions that foster oppression". 55 This requires a shift in focus from the teaching of knowledge, skills and attitudes regarding perceived cultural attributes, which can degrade into "dehumanising stereotypes", towards questioning why these differences may exist and how they influence care. 42,43,55 To avoid stereotyping HPE learners based upon their generational cohorts, we propose the adoption of generational humility, an approach in which critical consciousness and humility are used to explore the unique needs, values and motivations of learners.…”