Developing clinical wisdom: a phenomenographic analysis of Merleau-Ponty's theories of embodied perception
McNaughton, Susan Maree
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This thesis arose from an individual directed study which showed a lack of psychomotor and affective alignment between secondary school science assessments and four different first year clinical assessments. A model for wise clinical education leadership, developed from discourse analysis of educational public health, social justice, clinical wisdom, and ecological paradigm literature, highlighted the necessity for integrated cognitive, psychomotor and affective learning. This has led to a phenomenographic study of Maurice Merleau-Ponty’s work to identify categories of meaning and/or themes related to embodied perception, as possible explanations of the holistic integrated nature of the development of clinical wisdom. Eidetic reduction of the various works of Merleau-Ponty led to the identification of four main themes relevant to the development of clinical wisdom: the body and perception as self-limiting vehicles of engagement with experience and learning; simultaneous past, present and future existence expressed in a personally and collectively constructed language, history and knowledge; irreducible being-in-the-world, interpersonal relations and the soul as the foundations of self and other understanding; socio-political relationships and Merleau-Ponty’s engagement with these as a model for wise practice. Each of these themes provided a number of insights into the nature of integrated learning and the development of clinical wisdom in the health disciplines. Further insights into the life and work of Merleau-Ponty himself were drawn from writings by two editors and by his colleague Jean-Paul Sartre. Of particular note was Merleau-Ponty’s commitment to authentic pursuit of his calling, to self-criticism and to prudence in public debate. The conclusions drawn from this study are: that clinical wisdom should be redefined to reflect its nature as a form of conceptual expansion and of unique moments of emergent relational knowledge, rather than as a characteristic or attribute; that psychomotor learning, as a function of primary shared sensory capacity, should be considered the gateway to integrated interpersonal learning; that engaged empathy and a form of syncretic sociability are at the heart of reciprocal relationships; that the simultaneous conceptual expansion of the multiple dimensions of clinical wisdom in integrated learning would increase the likelihood of engaged empathy and of moments of clinical wisdom; that socio-political involvement provides a context in which engaged empathy is likely to develop, and clinical wisdom expansion thus more likely to occur.