Design and medical education (part 1)

by reestheskin on 15/01/2014

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I didn’t understand  what the word design meant until I read Herb Simon’s ‘Sciences of the Artificial’. I don’t mean this literally of course. I knew architects designed buildings, and graphic artists coloured the world I lived in. Painters painted. Musicians composed. Quavers got ordered. Colour got rearranged. But mainly I saw the world in terms of taking it apart. I lived in a largely man-made world, but was invisible to how it was done. When my eyes opened in the morning, it was all there,just like the birds. I remember, when I was a student at Newcastle University, a friend from school, who was supposed to be studying fine art, taking advantage of cheap student rates to go to the cinema on a Wednesday afternoon. He would watch the same film again and again. Over and over. I didn’t really understand what was going on. The only film I had watched repeatedly in one sitting was “Let it be’ by the Beatles ( in the Cardiff Odeon I think). Now to anybody of my generation watching the Beatles time and time again, does not appear so strange. But why watch film X again and again? Surely you knew the plot and, unless the film fulfilled some sort of comfort role, what was the point. You knew what was going to happen. (But music?).

This anecdote only resurfaced in my consciousness because I have been grappling with learning the technology of FCP X so that I can make some videos for undergraduate students to watch online. There was the technology, but I also had to work out exactly what I wanted to use the technology for. And there is a space in between. Yes, I have always understood that the way you deliver lectures is important. The content does not organise itself. The relation between the reality of ‘all those facts’ and what you say and include in a talk is not a formal process. People do it differently (‘…we are all bad in our own unique way’). Now, I should quickly say that I am indeed aware that if I see a biopic of Nelson Mandela, the film does not last as long as his lifetime. Selections occur, cuts are made etc. But only since trying to formally string ‘scenes’ together for my humble video offering, have I finally woken up to all these little conventions and tricks that film makers use to make us pretend what we are seeing is like living our real lives in whatever timezone we inhabit. Drawing analogies between reality and what we create—the artificial—is what we call design. My student friend was watching the same film over and over again, so that he could see how the magic was done. Only we don’t call it magic. Some may call it art, but for the purpose of this essay, it is design. Just watch a novice settle in to using an iPad for the first time. Where do all those conventions and representations come from? Swipe this way or that. Or presenting text. Why do we use capitals, why do (some of us) read from the left. What font do we use? Why does Powerpoint suck?

This discovery is important for me because I have lived much of my professional life in two areas where design is critical, but widely ignored: medicine and education. We may discover what gene causes red hair; we may discover how sunlight causes mutation in DNA. But we build health care systems. Biology may be created by God, but health and care is something we build. For education this is ever more so. Learning is not about creating facsimiles of what is in the books, or even of what is in ‘the patients’. When you learn something, you build it anew. When you want others to learn things, you do not link your brain with their brains, with a USB cable. You create structures that allow their self-discovery to occur. This is called design. It has taken me a while.

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