“The University in Ruins”

Constructing the Paraversity using the web.

 

Introduction

Higher Education institutions across the globe are changing and changing fast. Several writers have expressed dismay, as well as seeing opportunities to move in different directions, in response to what has been called the ‘University in Ruins’ (Readings 1996).

 

Gary Rolfe (2013), picking up on Reading’s work addressed ‘scholarship in the corporate university’ and suggested that academics must ‘dwell in the ruins’ in an authentic and productive way through the development of a community of philosophers who will dissent, subvert and challenge the ‘corporate university’ from within. Tools for subversion are at hand. Social media, blogging, open access journals and the development of new academic websites such as Researchgate and academia.edu, give academics new ways to reach students, and indeed anybody, way beyond the physical confines of their campus. Accepting that there are issues of peer review and hence quality, these tools allow free access and may facilitate dialogue in ways unheard of just few years ago. This paper explores the ruins, argues for critical dissensus, and shares one experience of using such tools and suggests that this might then assist in building Rolfe’s ‘community of philosophers’ or what Slavoj Žižek has called ‘liberated territories’ (Žižek 2008).

 

Following a note on pedagogy and addressing what the purpose of education  might be,  the idea of the Paraversity will be outlined, and importantly a central notion of dissensus highlighted. Why nurse educators and student nurses should engage in dissensus, as well as professional training, is a point to be debated. To do so, I will refer to the work of C Wright Mills’ on ‘intellectual craftsmanship’. Secondly, an example of constructing this Paraversity will be shared, not that this is a paradigm case, but as only one way to do so, a way that of course may prove fruitless as we acknowledge the variety of approaches and uncertainty of any outcomes. Indeed ‘outcomes’ themselves may be part of the language of a certain mindset that is antithetical to the Paraversity.

So, what follows is a thesis, which may draw forth an antithesis resulting in a new synthesis, which in turn can be challenged. Consensus and agreement is not the point; dialogue is. This paper is overtly political; drawing upon Freire’s ‘pedagogy of the oppressed’, Marx and the heirs of Marx, to argue that nursing is locked into a matrix of social systems that are oppressive and marginalising, and that Higher Education itself, in the guise of the ‘University of Excellence’ is increasingly commodified, and losing its way as it tries to meet the needs of the ‘Knowledge Economy’ in the production of ‘Cognitive Capitalism’.  I argue we need to revisit the question ‘what is education for’?

 


 

A note on Pedagogy

 

Paulo Friere’s first premise concerns a humanistic value base, upon which a pedagogy should be constructed. The human being is a ‘subject’, rather than an ‘object’ ready for construction by oppressive forces. Our ‘ontological vocation’ is towards ‘humanization’; to be able to engage in ‘conscientização’   which is learning to perceive social, political and economic contradictions and to take action against the oppressive elements of reality.

Stephen Sterling (2001) later argued that we need a paradigm shift away from transmissive forms of education towards transformative forms of education. Transmitting an education that ensures graduates are better equipped to perform clinical skills is first order learning.  However it is a partial education at best. First order learning takes place within current educational boundaries and philosophies. It is adaptivelearning, e.g. the acquisition of skills and knowledge to assist in adapting to new roles as registered nurses.

 

Education ought to be a process of transforming individuals so that base values, assumptions and paradigms are taken into account and challenged  – this is what Sterling calls second and third order learning.

 

Second order learning involves critically reflective learning. This is about examining the assumptions that underpin first order learning.

Third order learning is transformative learning and allows us to change perspectives and paradigms. It is creative, is a ‘shift in consciousness’, and involves a ‘deep awareness of alternative world views’ (Sterling 2001 p15).

 

Education in this sense is for humanity rather than just the transmission of knowledge, skills and values for the corporate, or employment, sphere. The Paraversity could be such a space in which this pedagogy operates. Thus, the process of education is as important, if not more important, than the end product. However, this is an issue for nurse education – to what degree is the product more important than the process? Do certain professional values, regulation and the needs for an NHS workforce outweigh the experience of a critical pedagogy? If so, are we constructing the student as passive object, who also self governs, rendering them unable to engage with countervailing voices against a one dimensional political hegemony in which the ‘market is king’?

We need to challenge pedagogical assumptions because, contrary to what many would have us believe, history has not ended, business can’t be ‘as usual’ and this is not ‘the best of all possible worlds’:

“The truth is that many things on which our future health and prosperity depend are in dire jeopardy….this is not the work of ignorant people. Rather it is largely the results of work by people with BAs, BScs, LLBs, MBAs and PhDs.” (Orr 2004 p.7)

The global financial crisis of 2007-8 was not caused by blue collar workers, nurses or teachers, but arose out of the activities of very clever people recruited from so called elite universities, many of whom studied economics mired in orthodoxy, rendering it unable to foresee the systemic risk building up within finance capital.

Jihadist social movements have gained ground in part to the ideologically based bumblings of Yale, Harvard and Oxbridge Educated elites, who with characteristic hubris and with appalling lack of insight, declared ‘mission accomplished’, and are now fretting about ‘radicalisation’ while doing little to address the socio-political causes of jihadist ideological narratives that drive young men and women into armed conflict.

Older people, their families, and those with mental health problems, in contemporary capitalist societies are experiencing crises in health and social care provision as successive governments have failed to put the interests of people before profits and capital accumulation.

With a few exceptions, for example Michael Burawoy’s (2004) notion of ‘public sociology’ or Paul Hawken’s notion of the ‘Blessed Unrest’, we have largely failed to produce enough countervailing voices, or a new vision of care that is fit for the 21st century. There is little in the way of critical guiding philosophies in operation for nursing beyond individualised biomedically dominated notions of ‘care and compassion’ in the context of instrumentally orientated curricula obsessed with competence – ‘doing rather than thinking’. This is not to deny the existence of critical voices in the literature, just to acknowledge the often ahistorical, apolitical and anti theoretical nature of what passes for scholarship in and for clinical practice.

This might seem irrelevant, idealistic, utopian and antithetical to professional nursing practice. Nonetheless, it is a notion that can be discussed within the paraversity as an element of dissensus.


 

What is the ‘paraversity’? (Rolfe 2013).

Gary Rolfe  suggest that the ‘paraversity’ runs alongside the visible University, going unnoticed or unseen. The paraversity is a ‘mental space’ of dissensus, seeking no unity of thought or acceptance of any grand narrative. As such, the Paraversity may well throw up an antithesis to this thesis. It is invisible, subversive and a virtual institution. It is not owned by corporate interests, it is not influenced directly by research bodies, funding streams or research programmes or corporate management strategies. The national student survey is irrelevant to its continuance. There will be no physically identified building or faculty – it exists in the form of a community of philosopher scholars exploring and deconstructing and reconstructing ideas.

In the paraversity there is no need to arrive at consensus or agreement or a system of unified thought. It does not exist to fulfil the corporate university’s aims and objectives, it is the ‘pursuit of difference’ to keep open debate and discussion and not to shut it down. It also operates to call the corporate university to intellectual account.

In this aim, it fosters countervailing voices to critique one dimensional thought and implicitly evokes the critical theory of Herbert Marcuse, Theodore Adorno and Louis Althusser, but is of course not merely the intellectual heir to such thought as if the matters regarding ontology, epistemology and philosophy were settled. This uncertainty of certainty could be potentially unsettling for nursing thought and practice which seeks certainty and truth in professional practice.

 

What are Universities for?

“In a world characterised by complexity and uncertainty, our long term survival lies…..in our willingness to bend the rules in unforeseen circumstances and even operate beyond our level of knowledge as we make our world view” (Paul Vare p2).

Vare acknowledges that the problems besetting the world require thinking differently, acting differently and challenging many long held assumptions. Academic disciplines which cannot evolve their thinking will produce graduates who will engage in ‘business as usual’ chasing fewer and fewer ‘plum’ jobs as they join the precariat (Standing 2011) as ‘graduates with no future’ (Mason 2012) .

 

The ‘University of Excellence’.

It might be argued that within the ‘Enlightenment’, the historic missions of Universities focused on ‘truth’ and ‘emancipation’. Docherty (2014) writes

“In 1946, the political theorist Hannah Arendt received a copy of The Idea of the University, which was written by her mentor, Karl Jaspers. Jaspers had revised the book, originally published in 1923, for the post-war context, when German universities needed to recover from explicit institutional and ideological conformism to Nazism. He advances a reconfiguration of academic freedom that, today, is everywhere threatened again, thanks to a failure of political will – and of leadership – that allows intellectual freedoms to be sacrificed to financial priorities. Writing to Jaspers on receipt of the book, Arendt firmly expressed the view that, given the cost of the higher education system, it must be state-funded. But it was vital that the professoriate should not thereby become tacitly politicised “civil servants”. Academic freedom meant that universities should be governed by intellectual demands, without improper political interference”.

Now, this narrative has been replaced with that of the neoliberal capitalist narrative of efficiency and profitability, i.e. the narrative of the market. Readings (1996) argued that the ‘pursuit of excellence’ within this narrative is a legitimising idea. However, ‘excellence’ refers more to administrative processes in which ‘excellence’ is a unit of measurement, devoid of qualitative content, which we now measure through such metrics as attrition, the number of firsts, impact factors, the number of research grants awarded and student perception questionnaires. An excellent nursing degree is one with low attrition, satisfied students, high employability and high numbers of firsts. Who would disagree with that?  Rolfe (2013) suggests this view of excellence is one of quantity rather than quality and brings us into the realms of ‘efficiency, profitability and administration’ (p9). He goes on to argue

“The vision and mission of the University has shifted from the production and dissemination of thought and ideas to the generation and sale of facts and data” (Rolfe 2013 p 81).

This suggests that the role of Universities now is often that of contributing to the local and national economy and to train graduates for the job market, and I would suggest that in many nursing departments that is the sole ‘raison d’etre’.

This instrumental orientation to nursing education (Goodman 2012) is evidenced by the dominance of competency based education, fit for practice, fit for purpose curricula, based on the NMC’s educational standards. The student nurse or graduate registrant who questions and critiques the ontological, political, ideological and epistemological assumptions upon which care is designed, delivered and evaluated would not be that welcome in clinical practice and perhaps only marginally tolerated in many nursing modules based on the transmission of facts and theories for clinical practice, grounded as many are in the assumptions of positivist and empiricist science. Nursing theory, let alone feminist or critical theory, may have disappeared from nurse education.  We may now be less able within nursing curricula to question the basis of social knowledge and care practices from critical perspectives that seeks to illuminate the subject positioning of women and the marginalisation of older people as unproductive burdens on society.

What is being lost is the notion of ‘intellectual craftmanship’ in favour of the search for empirical certainty, data and hard facts to guide practice. Indeed, evidence based practice education can be reduced to issues of methodology rather than issues of epistemology, philosophy and ontology. Perhaps many nurse scholars themselves have lost the ability to engage in this activity, and thus to be role models, buckling under the pressure to deliver clinical skills and other diverse teaching while also delivering empirically based research which provides facts and answers to practical questions. Many of course will have been schooled in the biomedical sciences and thus would not have had the critical epistemological enquiries and paradigms of social science. What we end up with is the pressure to produce ‘denotative’ writing – the telling and informing process through powerpoints and scientific reports as the dominant discourse of knowledge production and dissemination.  This is the ‘University of Excellence’.

 

What are academics for in the ‘University of Excellence’?

 

Brock (2014) asked “what is the function of the social movement academic’? However I would rephrase this and ask “what is one of the functions of the nurse academic? I would respond, as Brock does, with the suggestion that it is partly “to debunk the knowledge on which the powerful rest”.  One of those notions being peddled currently is that the NHS and society will not be able to afford care for older people,  that free at the point of delivery will no longer be possible, and that expensive external monitoring and inspections are worth the money spent on them. All the while corporates lobby behind the scenes for bits of the profitable NHS pie; see this list by Andrew Robertson on his site ‘social investigations’.

To engage in debunking requires ‘intellectual craftsmanship’ and is important for critical enquiry in the paraversity. What might that look like?

 

On Intellectual Craftsmanship  (C Wright Mills 1959).

 

In the appendix to ‘The Sociological Imagination’ Wright Mills outlined his view on ‘doing’ social science in which he suggested that ‘Scholarship’ is more important than empirical research for the social scientist. He considered that Empiricism was the ‘mere sorting out of facts and disagreements about facts’. Wright Mills’ critique of abstract empiricism contained in ‘The Sociological Imagination’ is that argument made manifest. Rules of method and arguments on methodological procedures and validity are just so much navel gazing which Wright Mills wished to avoid if he could possibly do so:

 

“Now I do not like to do empirical work if I can possibly avoid it” (p205) and “there is no more worth in empirical enquiry as such than in reading as such” (p 226).

 

The task of social science is thus to critically engage in the real world, joining personal experience and intellectual life through critical reflective reason as the

 

“advance guard in any field of learning” (p205).

He argued:

“It is the political task of the social scientist — as of any liberal educator — continually to translate personal troubles into public issues, and public issues into the terms of their human meaning for a variety of individuals. It is his task to display in his work — and, as an educator, in his life as well — this kind of sociological imagination. And it is his purpose to cultivate such habits of mind among the men and women who are publicly exposed to him. To secure these ends is to secure reason and individuality, and to make these the predominant values of a democratic society” (p187).

The personal trouble of obesity is a public issue not a personal moral failing of weak willed individuals. We must look to the role of fossil fuels instead of food, in providing energy; we must look at the marketing and distribution activities of the food industry; we must look to portrayals of the body in the media;  we must look to the structures od sedentary employment…..

Nurse educators might read this and think, actually, no it is not my political task at all!  Nurse students do not need to think about their personal lives and the lives of others as they relate to wider social and political issues…they need to be able to deliver care – to provide pain relief, comfort and explanations to vulnerable people, to interpret cardiac rhythms and administer medications, to assess wounds and decide upon management plans….that is the stuff of nursing and the rest of this is mere frippery. This is a view I have heard expressed by students as they cry “when are we going to learn proper nursing?”

In this they might be supported by the Corporate University which, in response to the demands of its customers, industry, commerce and the economy, has shifted the emphasis of the role of the academic from raising questions to providing answers, from problematizing to problem solving. Many nursing students want answers, not to raise questions. Thus empiricism and the tenets of positivistic science have been dragooned to support this mission. This is in opposition to many notions regarding personal and social transformation.

 

Michael Burawoy argued:

“The original passion for social justice, economic equality, human rights, sustainable environment, political freedom or simply a better world, that drew so many of us to sociology, is channeled into the pursuit of academic credentials. Progress becomes a battery of disciplinary techniques—standardized courses, validated reading lists, bureaucratic ranking intensive examinations, literature reviews, tailored dissertations, refereed publications, the all-mighty CV, the job search, the tenure file, and then policing one’s colleagues and successors to make sure we all march in step. Still, despite the normalizing pressures of careers, the originating moral impetus is rarely vanquished, the sociological spirit cannot be extinguished so easily”.

Can we replace sociology with nursing in this paragraph? Can we say our original passions have been channeled into pointless mindnumbing bureaucratically led education programmes that do nothing to challenge or change the context of care in which currently we are facing major issues in mental health and the care of older people with long term conditions?

Antonio Gramsci’s (1971) archetypal theory of the intellectual may also be illuminative and raises questions about what we are here for. Gramsci described two types of intellectual: the ‘traditional’ and the ‘organic’. The traditional is the academic who secures the status quo and the organic as the activist whose function it was to ‘construct a transformative historical bloc’, an alternative basis of consent for social order (Cresswell and Spandler 2012 p4). Although written many decades ago, this archetype may well be seen within the corporate university which supports and encourages the traditional and ignores the activist.

Nursing, and nurse academics, have a question to address. Are we engaged in the development of a practice based discipline interested only in the ‘sorting out of facts and the disagreements of facts?’ Are we traditional and/or organic academics? Is there room for both, either as separate individuals or as two roles within the same person? Justification for the ‘discovery of facts’ may be founded on its usefulness for policy and clinical practice and of course should be foundational knowledge for clinical nursing practice, after all we do not want the wrong drug to be administered because we have not sorted out the ‘facts’.

However, empirical research does not take place within a political vacuum and it would be a mistake to see the relationship of research to policy and practice as a simple linear relationship. The purist model of ‘research-policy relationships’ which takes for granted that research informs policy action by generating knowledge, or the problem solving model whereby research is driven by the need for a policy answer, do not adequately describe the process and is a far too narrow a focus for scholarship. It just does not address some of the fundamental questions underpinning human health and well-being which are as much to do with human agency and social structures within certain political economies, as to do with biomedical processes.

Research and policy then is a political activity. Wright Mills in arguing for craftsmanship in intellectual life implicitly acknowledges in the Sociological Imagination the need to go beyond simple empirical knowledge in forming policy action when he enjoins social scientists in a political and intellectual task to clarify the contemporary causes of “uneasiness and indifference to personal troubles and public issues” (p13). The social scientist is not to merely describe the contemporary elements of social life, but to engage in it.

The use of the word ‘craft’, undefined by Mills, appears here to differentiate the activity from that of (mere?) mastery of elaborate discussions of research method and ‘theory-in-general’, which would quickly make one “impatient and weary” (p195). A craft suggests development of skill by diligent constant practice, honing one’s technique by reference to finished products and products in the process of being to evaluate their flaws and strengths and then adjust accordingly. This is reflexive practice in that the work as it continues is being constantly worked and reworked as required. It suggests leaps of imagination and intuitive thinking and practice in the creation of a project. It calls for a departure from strict adherence to a rigid structure of routines, methods and frameworks. It also suggests a measure of artistry in thinking.

The scholarly craftsman is his work as his craft develops alongside who he is. Scholarly craftsmanship then is a state of being not only doing:

When Wright Mills argued that:

“admirable thinkers…do not split their work from their lives” (p195), he also argued

“Scholarship is a choice of how to live as well as a choice of career” (p196).

And:

“Scholarship is writing”.

To undertake this craft he asked students and social scientists to keep a journal to enable the development of the intellectual life, of the craftsmanship of social science. This should consist of ideas, personal notes, excerpts from books, bibliographical items and outlines of projects. He suggests that journals should record ‘fringe thoughts’, snatches of conversation and even dreams. This will also include the taking of copious notes from books and this needs developing into a habit.

Since Wright Mills outlined notes on journal keeping there has been the explosion onto the scene of information technologies, elearning and web 2.0. These are now new tools that were unavailable to Wright Mills. However the essential nature of scholarly activity should not be lost in any infatuation with new technologies, rather these gateway technologies could facilitate critical enquiry, journal keeping and the connection of a community of philosopher scholars engaged in dissensus and critique through a process of what Paolo Freire called dialogics.

To assist in this process, scholars need to write, and to write essays or blogs and not just research reports; to engage in discussion and not just to tell; write to invite commentary, to clarify one’s thoughts, to learn about oneself as well as to explore ideas and investigate one’s area of interest. Nursing is a socio-political activity and not just an applied set of techniques; and as such requires critique, understanding, discussion, reflexivity and transformation. The corporate university may not be interested in these ‘outcomes’, fixated as it may be on contracted commissioning targets, workforce development, league tables, SPQ results, attrition rates and ill defined notions of the ‘student experience’. The early career nursing academic will be faced by a host of external constraints on their intellectual development and their ‘success’ or performance development reviews may rest on targets and values not of their own making. What may be ignored by ‘impact metrics’ is any of their writing, which is createdover and above the research ‘write up’ focused on answering an empirical question according to a matrix of methodological imperatives. Graham Scambler (2014), as a now retired academic,  makes the point that he benefitted from the freedom to engage in intellectual activity unchained from the demand s of the Corporate University chasing its position in league tables:

“I was rarely during my career forced onto the back-foot, obliged to define achievement in terms of research revenue generated or publications in high-impact journals.”

And…

“I have encountered several ‘young’ sociologists whose expertise by far exceeds mine and who have played significant roles in facilitating as well as contributing to virtual networking and innovation but whose pioneering expertise in social media remain institutionally unrecognized and unrewarded” (my emphasis).

 

Karl Marx, C Wright Mills, Antonio Gramsci, Paulo Freire, Pierre Bourdieu, Michael Burawoy,  recognized that intellectuals can play a crucial role in ideological warfare against the dominant classes. The Paraversity may assist in this by creating

 

“havens of thinking into which thinkers can migrate and from which thoughts can proliferate and social change can reify” (Žižek 2008).

 


 

What might the Paraversity begin to look like?

 

The examples below are not definitive, it is up to the community of scholars to construct the Paraversity and if it is based on dissensus, it may look very different and take on a dynamic nature. If the idea is to create dialogue, to share ideas, to critique, to go beyond the physical confines of the Corporate University, the web 2.0 technologies might assist in this process.

 

1. Social Science and Nursing

2. Graham Scambler

4. Benny Goodman’s blog

5. Researchgate

6. Academia.edu

7. Facebook

8. Twitter

 

The links above will provide examples of critical thought and the sharing of ideas accessible by anyone anywhere and at anytime. They provide platforms for commentary and feedback, both synchronously and asynchronously. Their credibility may be built upon already established reputations and research outputs and/or by the clarity and force of the arguments. They will stand or fall by the readership wanting to engage and share and the commitment and enthusiasm by the creator.

 

Conclusion

 

Human health and wellbeing depend on many things. Critical education and challenging taken for granted assumptions are part of the foundations for human progress, if we still believe in progress. Universities may not provide the fertile soil for critical enquiry and discourse, but we do not have to wait for this to occur. We can right now live in the ruins of the University and engage in scholarship that is subversive, critical and potentially engaging and do so in the full knowledge that traditional rewards and recognition may not be forthcoming. That makes it risky. That also makes it fun.

References

Brock T (2014) What is the function of the Social Movement Academic? The Sociological Imagination. http://sociologicalimagination.org/archives/15545

 

Burawoy, M. (2004) Public Sociologies: Contradictions, Dilemmas and Possibilities. Social Forces, 82(4), 1603-1618.

 

Cresswell M. and Spandler H. (2012) The Engaged Academic: Academic Intellectuals and the Psychiatric Survivor Movement, Social Movement Studies DOI:10.1080/14742837.2012.696821.

 

Docherty T (2014) Austerity canard stymies funding debate. THES. July 7th  http://www.timeshighereducation.co.uk/story.aspx?storyCode=2014367

 

Goodman B (2013) What are nurse academics for? Intellectual craftsmanship in an age of instrumentalism. Nurse Education Today 33: 87-89

 

Gramsci, A. (1971) Selections from the Prison Notebooks. Lawrence and Wishart. London

 

Mason, P. 2012 The graduates of 2012 will survive only in the cracks of our economy. The ‘Graduate without a future’ series. http://www.guardian.co.uk/commentisfree/2012/jul/01/graduates-2012-survive-in-cracks-economy

 

Orr D. (2004) Earth in Mind. On Education, Environment, and the Human Prospect. Island Press, Washington.

 

Rolfe G (2013) The University in Dissent. Routledge. London

 

Readings B (1996) The University in Ruins. Harvard University Press. Cambridge. MA.

 

Scambler, G. (2014) A 100th Blog: A reflexive interlude.http://www.grahamscambler.com/a-100th-blog-a-reflexive-interlude/#respond

 

Standing, G. (2011) The Precariat: the new dangerous class. Bloomsbury. London

 

Sterling S (2001). Sustainable Education – Revisioning Learning and Change, Schumacher Briefings 6. Green Books, Dartington.

 

Vare P (2014) Sustainability Literacy: role or goal? (online) http://arts.brighton.ac.uk/__data/assets/pdf_file/0010/6202/Sustainability-Literacy-Blewitt-and-Vare.pdf in Stibbe A (2014) Handbook of Sustainability Literacy http://arts.brighton.ac.uk/stibbe-handbook-of-sustainability

 

Wright Mills C (1959) The Sociological Imagination. 40th Edition. Oxford University Press  Oxford.

 

Zizek S (2008) Violence. Profile. London.

 

The Corporate University, Health as commodity and the citizen as customer.

 “As universities mirror the increasingly unequal nature of English society … their role in advancing social equality, or minimising embedded disadvantage, will be traduced in a ‘meritocratic’ game of spotting talent and ensuring that it is slotted into the appropriate tier.” So writes Andrew McGettigan on the the discoversociety.org website in 2014. This comment on the ‘corporate university’ indicates that universities have functions that go beyond only meeting the needs of student consumers in their quest for a job, that indeed Universities should address aims beyond producing  ‘cognitive capitalism‘.

Should we care at all about this, or should we encourage even more market discipline?

For some, education is a commodity which should be bought and sold in a free market.  If a student wishes to borrow money to study literature or sociology then that is their choice, the State has no business in supporting study that has little direct economic benefit for individuals or society. So goes the free market apologists who places trust in the individual rational action of the student/consumer when buying the commodity of education. This is not new. Logan et al in 1989 argued in the context of the provision of health care that

“…services should be treated just like any other commodity that can be efficiently produced and consumed under market conditions”.

David  Willetts, Minister for Universities and Science, told a fringe event at the most recent Conservative party conference: unleashing the forces of consumerism is the single best means of improving the quality of undergraduate provision.

Student tuition fees have turned students into customers. This is seen as a ‘good thing’. Students will vote with their money and desert courses and institutions that they feel will not fulfill their hopes and aspirations. Competition for Elite universities will thus increase and only the best survive – a bit like the Premier League. Since its inception we have seen the loss of 50 football clubs as well as a sense of the club representing the local community values. Does that matter? Not if you are the winner – a Manchester City/Utd or a Chelsea – or a winner’s fans.

A clearer statement of the ideology of free market capitalism you will find hard to beat. Consider that this thinking has, not as yet, boldly reared its head for health. How would you feel upon hearing:

“unleashing the forces of consumerism is the single best means of improving the quality of health care provision”.

What do you think about  this:  Individuals should pay for their own health and social care needs at the point of delivery, as they are best placed to know what their needs are and how much they value health and social care. If they value beer and fags more, then that is their choice and the state should not intervene in that decision.  Individuals and families could pay for insurance for that ‘rainy day’ of dementia, cataracts or a broken leg. Hospitals and GP practices would be forced to compete for customers and those with poor reputations would have to close. Public Health England could be disbanded as a wasteful state cost base and instead individuals could be nudged to take responsibility for their health.

Well, if you have swallowed market ideology wholesale, that might sound like nirvana.

If universities are turning into warehouses for the production of cognitive capitalism in which education is a commodity to be bought and sold for instrumental purposes (“its the economy, stupid”), then their social role diminishes. Likewise, is health care a commodity to be bought and sold or does society also need a health sector that addresses the social and political determinants of health as well?

Individual rights and liberties balanced with social solidarity?

At root this is the difference between a social democratic political philosophy and a market driven neoliberal agenda. Its your choice, but remember ‘some animals are more equal than others‘ and they have the clout to ensure they stay ‘more equal’.

Funding cuts to nurse education – austerity hits students

“Universities say nursing education has reached a “tipping point”, with proposed funding cuts putting the quality of courses and ultimately the quality of nursing care at risk”

The funding cuts and increase in student numbers may well have a detrimental affect on the learning experience. To address it we have to adopt new methods – some of which we need to do anyway – such as increasing use of web 2.0 technology for example ‘webinar’ presentations and discussions. Simulations are expensive and time consuming and allied to pressures on mentors, we have an overall picture of stress on the system. This will increase the call to take education back into the NHS, to see students as part of the workforce and not supernumerary, and the adoption of training rather than education. The wider context is the increasing control of nursing for managerial reasons within the contested economic policy of austerity. The country largely believes there is no money for education, health or welfare. In addition the policy is one of creating a market for those public goods based on the idea of a ‘consumer’ exercising rational choices. That is why the student pays fees so that through a market mechanism they will drive up quality by only buying education from quality providers. That is the theory. There is money – its just that it is in the hands of the few that gov’t dare not touch.

In a report, a Tale of Two Britains, Oxfam said the poorest 20% in the UK had wealth totalling £28.1bn – an average of £2,230 each. The latest rich list from Forbes magazine showed that the five top UK entries – the family of the Duke of Westminster, David and Simon Reuben, the Hinduja brothers, the Cadogan family, and Sports Direct retail boss Mike Ashley – between them had property, savings and other assets worth £28.2bn.

The UK study follows an Oxfam report earlier this year which found that the wealth of 85 global billionaires is equivalent to that of half the world’s population – or 3.5 billion people. The pope and Barack Obama have made tackling inequality a top priority for 2014, while the International Monetary Fund has warned that the growing divide between the haves and have-nots is leading to slower global growth.

This is the real issue – inequality politics resulting in an impoverished public sector. JK Galbraith way back in 1958 argued that a feature of advanced capitalism was that public (sector) squalor went alongside private affluence. Quite.

The medics get it – sustainable literacy in education

Sustainability, health and education – Priority Learning Outcomes for health professionals.

 

 

Although some scientists and commentators such as Indur Goklany, have disputed claims about the precise impacts of climate change and human health, it is nonetheless accepted that wider environmental factors can and do impact severely upon health. Climate change, as has been pointed out before, is only one aspect of the relationship between the environment and health and focusing on it may not always be helpful. Instead, many medical and other organisations in the UK have clearly accepted that our relationship with the environment is a foundation upon which health is based. This relationship is also part of our socio-political relationships and forms the matrix of connections and systems that life on earth depend on. Oil and its production, distribution and exchange is a fact of that socio-political and environmental relationship – what John Urry calls the carbon based economy-society.

 

At this point the connection between health and social analysis might begin to seem tenuous, especially to those steeped in a biomedical frame of reference. However, within health education there are two perspectives that bring issues around sustainability, whether they be political, social and/or environmental, back into focus. The Social Determinants of Health and the Inequalities in Health literature raise issues about our relationship both to the environment and to each other and the impact this has on individual, community and population health. Both of these perspectives on health may well be addressed in undergraduate medical and nursing education, but the extent to which they are, is not currently mapped. Although these two perspective do not always explicitly discuss the environment they do focus attention beyond the individual and biology. A great example is Barton and Grant’s (2006) ‘health map’ which clearly models determinants of health. Their paper, and model for health, would or should be a foundational read in undergraduate health education emphasising as it does biodiversity, climate change and the global ecosystem as key determinants of health.

 

This has now been explicitly accepted by some in the medical profession following the publication of three specific priority learning outcomes for the education of ‘Tomorrow’s Doctors’. This publication follows calls for medical graduates to be sustainability literate and is based on a General Medical Council’s request for learning outcomes for environmental sustainability in medical education. A call for nursing in general, and the Nursing and Midwifery Council (NMC) in particular, for nursing to be more explicit on sustainability and environmental health in its educational standards for undergraduate nursing education has not resulted in a similar request by the NMC for learning outcomes of this nature. The NMC prefer to see this subsumed under general public health.

 

The priority learning outcomes just published on the Sustainable Healthcare Education network are:

 

1. Describe how the environment and human health interact at different levels.

2. Demonstrate the knowledge and skills needed to improve the environmental sustainability of health systems.

3. Discuss how the duty of a doctor to protect and promote health is shaped by the dependence of human health on the local and global environment.

 

The site helpfully expands on these outcomes.

 

An important point is that although sustainability literacy may involve explicit new curricular content for doctors, for example critical reflection on the philosophy of dualism and anthropocentrism, it is also about developing a perspective on health, a lens through which we see anew the relationship between human health and the environment. Medical schools may already address models of healthcare delivery that go beyond the biomedical to embrace and examine biopsychosocial, salutogenic and complementary approaches. The European Centre for Environment and Human Health based in Truro, Cornwall,  is an example of a research centre specifically and explicitly addressing sustainability and environmental issues.

 

Thus we have the medical profession very clearly stating that sustainability and environmental health should be explicit in the education of our doctors of the future. This of course follows on from other clear statements such as the first University College London and the Lancet Commission on managing the health effects of climate change report.

 

These learning outcomes have been called ‘priority’ learning outcomes and this perhaps reflects the seriousness with which the issues are taken. A counter is that of course Public Health is a core component of both medical and nursing education, so why the need to make sustainability specific? Why indeed have ‘priority’ learning outcomes if this is being covered already within public health education. The answer may be that ‘Public Health’ itself is a multi perspectival subject in which it is possible that biomedical and epidemiological approaches could dominate while downplaying the environmental and social determinants of health. It is certainly possible to address public health without critically examining and understanding sustainability. The General Medical Council seem to have accepted this,  and hence their call for these learning outcomes. The Nursing and Midwifery Council have considered that their own standards that inform education practice are broad enough so that sustainability can be incorporated into undergraduate programmes within Public Health teaching. This might be a mistake, because if educators do not have a sustainability perspective, or lens, then they may well miss a vital aspect of health education.

 

The publication of the medical priority learning outcomes on the other hand gives a very clear message to those developing educational experiences for doctors. The message is that to fully understand human health one has to address environmental, social and political determinants of health. This understanding then feeds into strategies and actions  to address inequities in health and the environmental health crises that may severely impact on individuals, communities and populations. Other health professions might learn from this approach taken by the GMC.

The NHS needs Registered Nurses. Patients need Registered Nurses

 

First let’s deal with the title ‘Nurse’. In the UK it is illegal to call yourself a nurse if you are not on the register, Nurse is a legally protected title…this is a fact which gets lost in media talks about poor ‘nursing’.

Too much ‘nursing’ is in fact done by care assistants.

Too many student nurses are being supervised by care assistants.

Care assistants often are good people trying their best but they are not always supported, trained or supervised enough. They need to support nurses in their roles rather than replace them, which is in fact what is happening.

In ‘Skill mix and the effectiveness of nursing care’ Carr-Hill (1992) argued that ‘grade mix had an effect on the quality of care in so far as the quality of care was better the higher the grade (and skill) of the nurses who provided it’. In other words skilled nurses reduce poor quality care.

In the United States a Philadelphia hospital (2012) adopted an all RN care model, they eliminated the use of care assistants and patient outcomes improved and costs reduced.

This comes on the back of another 2006 in the US  study indicating that increasing the ratio of nursing by RNs reduces stay, adverse outcomes and patient deaths.

Finally as published on the nursingtimes.net a UK study suggests:

“There is a link between higher death rates and the number of healthcare assistants employed in NHS hospitals”.

A study by the University of Southampton found trusts with a higher number of unregulated HCAs also had a higher mortality rate.

A higher HCA-to-bed ratio increased the mortality rate up to a maximum of 5.4% more than would be expected, the new study found.

The study also identified a clear link between the number of registered nurses and mortality. It found there were fewer deaths the more nurses were employed. For every 10% increase in the number of registered nurses the odds of patients dying dropped by almost 7%.

Based on hospital admissions in 2010-11, the study found a 10% increase in the number of nurses would result in 2,600 fewer deaths.

Lead study author Professor Peter Griffiths told Nursing Times the findings on HCAs needed further investigation, but said: “It certainly calls into question a workforce strategy that moves registered nurses further away from the bedside and replaces them with assistants.

“This echoes some of the findings of the [Mid Staffordshire Public Inquiry] report, which expressed concern over the lack of regulation for this workforce.”

Professor Griffiths added: “The fewer registered nurses a hospital has, the more patients die. So the significance of nurse staffing levels seems to be well established both in the research and in the tradition of the profession.”

He added that, while the government appeared “dead set” against introducing mandatory staffing levels, “there is surely a level at which we can be clear it cannot be safe under any circumstances.”

He suggested a ratio of eight patients per nurse, saying in his study 60% of shifts were at this level or better.

“The findings taken as a whole point to the need for more qualified nurses at the bed side,” Professor Griffiths said. “It is hard to conclude from this evidence that the solution lies in downgrading the training of the nursing workforce as a whole and reducing the number of registered nurses.”

On Graduate nursing:  

http://jama.jamanetwork.com/article.aspx?articleid=197345 ?

Reference Aiken et al (2003) Educational Levels of Hospital Nurses and Surgical Patient Mortality. JAMA 290(12):1617-1623

June Girvin argues:  The evidence clearly shows that graduate nurses offer better care than non-graduates and the more highly skilled and educated nurses there are in clinical areas, the better care outcomes are. The tendency to attack the academic elements of nurse education as being at the root of the current perceived crisis in care has no place in modern healthcare environments.

‘Nuff said.

The ‘sustainability literate’ nurse graduate – why do we need one?

“In a world characterised by complexity and uncertainty, our long term survival lies less in our ability to ‘apply the grammar’ (of sustainability literacy) and more in our willingness to bend the rules in unforeseen circumstances and even operate beyond our level of knowledge as we make our world view” (Paul Vare).

 

1. Vare’s point is that the world’s problems requires graduates to have not only an understanding and knowledge of key sustainability concepts but also to be able to act in an emancipatory fashion to engage in critical thought and action beyond merely understanding what sustainability may mean. If indeed ‘climate change is the biggest threat to public health in the 21st century’ (Costello et al 2009) then action is required.

 

2. We argue there is a ‘sustainability-climate change-health’ triad (Goodman and Richardson 2010) which makes it an imperative that we examine notions of sustainability and climate change in the curriculum (Goodman 2011).

 

3. Plymouth University itself recognises the issues, and has identified sustainability as a policy objective (a key performance indicator) at all levels of university life (campus, curriculum, culture and community).  

 

4. The NHS Sustainable Development Unit states on their website that it is working “to help the NHS fulfil its potential as a leading sustainable and low carbon healthcare service…by developing organisations, people, tools, policy and research which will enable the NHS to promote sustainable development and mitigate climate change”. Nursing staff in NHS organisations will be key people helping to achieve carbon reduction targets (NHS SDU 2009) and thus need to have the skills, knowledge and understanding to help their clinical settings achieve this.

 

5. The NMC standards for education (NMC 2010) explicitly outlines that nurses  should engage in promoting the health, not just of individuals, but also of communities and populations. Public Health is also core to the standards. We know that unsustainable lifestyles and practices lead to poorer health outcomes, and we also know that low carbon lifestyles are also healthy lifestyles, i.e. that there are health co-benefits to be had.

 

6. In ‘Securing the Future’ (DEFRA 2005) the UK government published a strategy for sustainable development and encouraged all education sectors to embrace SD. The HEA (2009) has taken this on, to support ESD in the HE sector across 17 subject centres. The HEA has a dedicated Education for Sustainable Development theme aiming to provide strategic leadership for ESD in the HE sector. HEFCE (2009) also support sustainability practices across the sector.

 

7. David Orr (1994) argues that current education practice is not the solution, it is the problem. That is to say graduates who lack an eco-perspective, or who are illiterate in sustainability matters, become part of the problem as they engage in ‘business as usual’ activities. A nurse who cannot make the links between clinical waste, resource use, carbon reduction and health inequalities will not be able to devise solutions because they are not asking the right questions.

 

8 Nurses are about health (in theory at least), understanding health requires understanding the social determinants of health, which includes the interdependence and interrelatedness of many factors including the physical and social environment. This is core to sustainability thinking.

 

9. There is increasing evidence that students themselves demand their universities encourage and develop sustainability across their programmes. Bone and Agonbar (2011) argue that first-year students believe universities should be responsible for actively incorporating and promoting sustainable development to prepare them for graduate employment.

 

10. The challenges to current and future global health (Rao 2009) that result from high carbon and unsustainable patterns of living require nothing short of mobilising healthcare professionals to not only understand but to act upon the various factors that result in disease and misery for billions on the planet. Not to do so is an abrogation of our ‘moral responsibility’ (Morrall 2009) as healthcare professionals to prevent suffering.

 

 

Finally,

 

As we reflect on the challenges to earth’s natural resources and the planetary boundaries that scientists are now beginning to reveal (Rockstrom et al 2009), we realise that we are running a huge experiment on a global scale. The time scale for evaluating the success or otherwise of this experiment, based on high carbon lifestyles of industrial and post-industrial capitalism, is some time in the future. However we are having measurable adverse effects now on both the planet’s climate and upon the ecosystem services that we all depend on. Nurses, as people, are part of the problem. We need to be part of the solution.

References

Bone, E, and Agonbar, J. (2011)  First-year student attitudes towards, and skills in sustainable development. HEA. York.

 

Costello, A. et al (2009) Managing the effects of Climate change. Available online at http://www.thelancet.com/climate-change

 

DEFRA (2005) Securing the Future. Delivering the UK sustainable development strategy. http://www.defra.gov.uk/publications/2011/03/25/securing-the-future-pb10589/

 

Goodman B., Richardson J. Climate Change, Sustainability and Health in United Kingdom Higher Education: The Challenges for Nursing In: Jones P., Selby D., Sterling S.(2010) Sustainability Education: Perspectives and Practice Across Higher Education. London, Earthscan.

 

Goodman, B. (2011) The need for a ‘sustainability curriculum’ in nurse education. Nurse Education Today. Nov  31 (8):733-7

 

HEFCE (2009) Sustainable Development in Higher education [online]

http://www.hefce.ac.uk/susdevresources/ accessed 24th may 2010.

 

Higher Education Academy (2009) HEA Sustainability Project http://www.heacademy.ac.uk/ourwork/learning/sustainability

 

Morrall, P. (2009) Sociology of Health. Routledge London.

 

National Health Service Sustainable Development Unit. (NHSSDU) (2009), Saving Carbon Improving Health. NHS Carbon Reduction Strategy for England. NHSSDU. Cambridge.

Nursing and Midwifery Council (2010) Standards for Pre-Registration nursing education. NMC. London.

Orr, D. (1994) Earth in Mind. On Education, Environment and The Human Prospect. Island press. Washington

 

Rao, M. (2009) Climate change is deadly: The Health Impacts of Climate Change. Chapter 2 in Griffiths, J. et al (2009) The Health Practitioners Guide to Climate change. Earthscan  London

 

Vare P. (no date) Sustainable Literacy: role or goal [online] http://arts.brighton.ac.uk/__data/assets/pdf_file/0010/6202/Sustainability-Literacy-Blewitt-and-Vare.pdf

 

“What are nurse academics for?”

 

“What are nurse academics for?”

Having pondered on the future of nursing education given various issues (see *), it occurs to me that we could do with some coordinated critical thinking and action in response.

The literature suggests that some (nurse) academics are very uneasy about the direction that education practice is taking (Thompson 2009, Walker, 2009, Morrall 2010, Shields et al 2011). Darbyshire (2011) suggests that many colleagues say they are too busy to research, publish, present or otherwise engage in scholarship, I have suggested similar (Goodman 2011). The main reason put forward (he writes) is that they see their job is primarily to teach and support students. However, I would add to that growing managerialism and bureaucracy of modern university life (and not just in the UK) allied to the overemphasis on reproducing ‘cognitive capitalism’ in which universities are becoming factory like, (Roggero 2011) turning out fodder for the ‘knowledge economy’ which undervalues critical thinking (Morrall, 2010).

*Issues:

Public concerns about poor quality care, NHS restructuring, funding cuts to humanities, challenges to public sector funding, global health issues linked to sustainability and the challenges of climate change, the commodification of education and its concomitant challenge to critical thinking, the triumph of neoliberal ideology in all areas of social, health and education policy, and an instrumental/vocationally oriented educational philosophy.

 

 

 

 

 

 

For nursing, our partners in the NHS are so stretched in many clinical areas that student support is at breaking point in terms of their educational development in practice. Clinical practice for too many resembles nothing more than old style apprenticeship experiences where intellect withers, let alone flowers, and the tension between getting the work done and education that Kath Melia identified in the 70’s is as strong as ever.  

In this context, Gary Rolfe (2010 p 703) recently noted:

“If the discipline of nursing is to survive and flourish as anything more than a provider of vocational training, it is imperative that we make connections and find our place in the wider community of academics and scholars in what remains of the modern University”.

Darbyshire (2011) goes further:

“nurse educators need to do what they should have been doing the moment nursing moved from the old ‘college of nursing’ world into the university sector and that is connecting with and embracing the world of scholarship that did, and hopefully still does, characterise university life”…..“As a nurse educator, you are not in the business of ‘giving lectures’, ‘marking papers’, ‘supporting students’. ‘facilitating tutorials’, ‘designing curricula’ or the like. You are in the transformation business” (Darbyshire 2011 p 723). I think this is deliberately provocative and needs to be read in its context. My personal feeling is that we are ‘in the business’ as described but without the transformation bit and struggling to juggle the competing demands placed upon us. However, I also think that some demands maybe self-inflicted, and result from acquiescence, tiredness and apathy which result from disempowerment flowing from treadmill like educational processes.

He then goes on to describe what transformation might mean. While I think his points have merit, there is just a tad too much emphasis on the utility of academic work as a criterion for assigning value, thus omitting the liberal humanistic approach to education which sees it as a ‘good in itself’.  That being said the challenge is then put:

“if you are not actively engaged in the research and scholarship of nursing education then be prepared to face the question, “what business do you have being part of a University?” (Darbyshire 2011 p 723).

Good question.

What to do?

I think there is a debate to be had here about the meaning and value and purpose of nursing education. I mean a real debate informed by philosophies, reason and evidence that informs and creates the cultural edifice in which we work. We need to examine the organisational culture which forms the scaffold for our educational values and priorities. There may be taken for granted assumptions which upon examination do not hold water. For example, that we have to account for every hour a student spends in theory and that this is achieved through attendance registers. Another assumption may be about research being too time consuming or too constrained by faculty priorities, there may be assumptions about scholarly activity v teaching or what ‘teaching’ actually means. We may consider whether (Nursing?) Theory informed education as well as research informed education itself may have disappeared from curricula replaced by narrowly defined epistemologies that close down evidence based practice into the confines of ‘empiricalitis’ and the tenets of positivistic science. There may be some bureaucratic processes that actually do not enhance the quality of the student experience at all (the standard module evaluation forms?) either because they do not have robust evaluation or because they are gathering the wrong data. This matters because every minute spent on administrative action is a minute not spent on intellectual sharing and development. The next generation of nurse educators needs mentoring, but they need the intellectual freedom to challenge orthodoxy which requires intellectual spaces or ‘liberated territories’ (Zizek 2008) which are havens of thinking into which all thinkers can migrate and from which thoughts can proliferate and social change can reify.

The reason not to discuss this will of course be time, the treadmill can’t be switched off, can it?

Benny Goodman

(refs available on demand)

Communicating health messages in contemporary culture.

Jon Snow, the channel 4 journalist, chaired the morning’s panel discussions at the BMJ’s ‘Climate Change, health and security’ conference held at the BMA in London on Monday 17th October. In addition to his skills and experience based on years of writing and presenting, he brought interesting insights into how the media works, insights which healthcare professionals could learn from.

One message was that the media had lost interest in climate change, partly due to the hard lobbying by climate sceptics, partly due the East Anglia ‘climategate’ emails but also due to the financial crash of 2008. This illustrates Roger Pielke’s ‘iron law of climate policy’: “when policies to curb emissions come up against policies for economic growth, economic growth wins every time”. The lesson? Messages compete on an ideological stage for their performance time.

The medium of communication is important. The panel of 9 on the stage were asked whether they use twitter. One person affirmed this to be the case. Snow pointed out that those working in the media use twitter and other social networks as core tools in their armoury. Snow argued that he gets a great deal of useful information from twitter and suggested that the doctors ought to seriously consider it as a medium of communication.

This illustrates another issue. Healthcare professionals work in a particular communication bubble, as do academics. Those who we need to communicate with (the public, journalists) live in another communication bubble. There is some crossover between the two but the implication is that healthcare professionals (clinicians and academics) are out of the communication loop, that the overlap between the two worlds is not large enough.

At root is a misunderstanding of the link between knowledge and policy decisions/public understanding. Healthcare knowledge is often  science based and rooted in medical understanding. There were suggestions from the floor that the science needs to be simplified and clarified in order to transmit the correct messages. This will not work in the way we think it ought to.

Firstly, policy and understanding is not based on medicine and science, it is based on what the popular culture tells us, which in turn is shaped by various vested interests, ideology, misconceptions, advertising, public relations and dominant cultural paradigms (e.g. the ‘economic growth’ paradigm, the tenets of consumer capitalism, anthropocentrism and philosophical ‘dualism’ i.e. the ‘objective-subjective’ , ‘nature-man’ divide).

Secondly we are using the wrong tools. Those who need the messages do not attend conferences, read academic journals or are linked into professional networks. They use facebook, twitter, radio, television and popular magazines. These media are not often used enough by academics, doctors and nurses.

Therefore the worlds are apart, divided by the understanding how the world works and by different tools of communication. The growing interest in ehealth and web based methods is an attempt to bridge that divide, but to date is still in its infancy. This is not to say these attempts are entirely absent, see for example the facebook group ‘Nursing Sustainability and Climate Change’, or the ‘Climate and Health Council’ website, but that there is a long way to go to understand what our story is and how to best connect with a wider audience. Healthcare professionals need to learn from media studies, social marketing and cognitive psychology on how to reach those who matter if we are interested in promulgating our messages.

 

Pielke, R. (2010) The Climate Fix. Basic Books. New York.

Nursing Sustainability and Climate Change https://www.facebook.com/groups/NursingSCC/

Climate and Health Council  http://www.climateandhealth.org/

Are we losing our minds to the cloud?

A key aspect of learning is memory and the recall of facts. Certain clinical situations make it critical that certain facts are brought to mind quickly and then acted upon. Knowing the facts of the clinical signs of hypovolaemic shock will save someone’s life. Knowing where those facts are that outline the clinical signs of shock is not good enough if that ‘where’ is not in your head, you may not have the time to check them out. So, when I read about what the use of computers may be doing for our memories I think about how we are going about learning facts. 

Betsy Sparrow and colleagues have studied the effects of Google on memory. They argue that when we are faced with complex problems we now begin to think about computers. This is because we know we can ‘google’ anything we want. The further effect this is having is that we have lower rates of recall. We don’t remember the information itself, we remember where it is. The internet acts then as “transactive memory’, i.e. memory that is stored externally to ourselves. This relates to the idea of the ‘group mind’, whereby knowledge is shared among a group of individuals in an interdependent cognitive (knowledge) relationship. This may be seen in long term relationships between two people who then rely on each other for memory. 

Marshall McLuhan argued  “The medium is the message. This is merely to say that the personal and social consequences of any medium – that is, of any extension of ourselves – result from the new scale that is introduced into our affairs…by any new technology” and “We shape our tools and afterwards our tools shape us”. 

By that he means that to understand new technologies, it is not the content that is so interesting it is the effects that the technology has on thoughts, feelings, behaviours, cognitive and socio-cultural practices. If Sparrow is correct than the internet is shaping they way we store and retrieve and share memory beyond the obvious use of memory sticks and hard drives. 

Does this mean that the internet is now creating group memory and diminishing individual memory? Will the need to have individual facts in our own heads in the future diminish as the technologies develop? In addition are students subconsciously not committing facts to memory because they know that the vast majority of what they require is available in ‘the cloud’. Tablet computers and smart phones are now bringing literally to your hand, a store of knowledge that was just not available only a few years ago. The sheer weight of knowledge required for modern clinical practice may align with technological developments so that in future the key skill will be not what you know but where you know it?

Sparrow, B., Liu, J., and Wegner, D. (2011) Google effects on memory: Cognitive consequences of having information at our fingertips. Science. [online] 14th July DOI: 10.1126/science.1207745

McLuhan, M, (1964) Understanding Media, The Extensions of Man. McGraw Hill. New York.

Alternative to the White Paper – Putting the Vision Back into Higher Education by John Holmwood

I cant really better this so in full:

? British Sociological Association: Response to White Paper
Alternative to the White Paper – Putting the Vision Back into Higher Education by John Holmwood

Academic staff and students from across the sector and in a variety of campaigning groups – Campaign for the Public University, Oxford University Campaign for Higher Education, Sussex University Defends Higher Education, Warwick University Campaign for Higher Education, Humanities Matter, No Confidence Campaign, Cambridge Academic Campaign for Higher Education – have written a trenchant response to the Government’s White Paper.

This document – Putting the Vision Back into Higher Education is a call  to colleagues and their subject associations and other groups to contribute to an Alternative White Paper to be published at the end of the Government’s consultation period in September. This will be presented to the Department of Business, Innovation and Skills, together with the weight of opinion in its support.

The response to the White Paper argues that:

It threatens the excellence of higher education in England. It does not put the student at the ‘heart of the system’, but the market.

It cuts direct public support for undergraduate degrees by 80%, and by transferring costs to students via higher fees it succeeds in providing fewer resources for most degrees while requiring students to pay more.

It is a reckless gamble, a dangerous experiment in university funding with no precedent in British experience. Its different elements are incoherent.

While the Browne Review advocated a new funding model because of uncertainty over public funding, the present proposals will not produce stability. The uncertainty is switched to the ballooning student support arrangements necessary to maintain a fee-based system of loans and the Government’s overriding interest is now to reduce their cost.

It has parallels to the privatisation wrecking the financial solvency of high-quality public universities in the US (such as the University of California, where net private revenues have not covered the public funding lost through cuts despite upwardly spiralling tuition costs).

It had no vision for higher education, only a narrow emphasis on employment and education as an individual investment in human capital.

It is necessary for higher education to “sustain a culture which demands disciplined thinking, encourages curiosity, challenges existing ideas and generates new ones; [and to] be part of the conscience of a democratic society, founded on respect for the rights of the individual and the responsibilities of the individual to society as a whole” (Dearing Report, 1997).

There is no government mandate for the privatisation of higher education and for the despoiling of the social and cultural value of universities.

John Holmwood University of Nottingham, Chair of Heads and Professors of Sociology Group/Campaign for the Public University