Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
Med Educ. 2023 Apr;57(4):305-314. doi: 10.1111/medu.14978. Epub 2022 Nov 29.
Health professions education teaches students to notice particular things, but has given little attention to teaching 'noticing' as a form of personal inquiry. The former is self-evidently important, as it develops a way of seeing and behaving that is uniquely relevant to each health profession. Despite this emphasis, health professionals may fail to notice 'warning signs' in patients, be unaware of their own biases or develop unrecognised habits that have moved away from accepted standards. It has been suggested that such 'not noticing' is currently endemic.
We situate our exploration of noticing in the mathematics and science education literature and John Mason's treatise on 'The discipline of noticing', differentiating between the observations that people make as they go about their lives ('ordinary' noticing), the specialised noticing that underpins professional expertise (Professional Noticing) and practices that can enhance the capacity to notice and to learn from experience (Intentional Noticing). We make the case for teaching health professions students about these conceptualisations of noticing, being able to notice with all our senses, and learning about the practices of Intentional Noticing in particular, which we suggest will have utility across health professional careers and personal lives.
We acknowledge the difficulties in transferring heterogenous finding from one field to another but suggest that there are gains to be made in applying these noticing concepts to health professions education. We tentatively propose some strategies and activities for developing Professional Noticing and the practices of Intentional Noticing and link them to a new module that we are piloting with health professions students. As well as aiding health professionals sharpen their noticing abilities, reinvigorate their practice and interrogate assumptions that underpin health care, we suggest that ideas about 'noticing' may also help educators and researchers in the health professions reimagine their work.
健康职业教育教导学生注意某些特定的事物，但很少关注将“注意”作为一种个人探究形式的教学。前者不言而喻很重要，因为它培养了一种独特地适用于每个健康职业的观察和行为方式。尽管如此，卫生专业人员可能会忽略患者的“警示信号”，也可能没有意识到自己的偏见，或者养成了没有被认识到的、偏离公认标准的习惯。有人认为，这种“视而不见”目前普遍存在。
我们将对注意的探索置于数学和科学教育文献以及约翰·梅森（John Mason）关于“注意的学科”的论述中，区分了人们在日常生活中所做的观察（“普通”注意）、支撑专业知识的专门注意（专业注意）以及可以增强注意和从经验中学习的能力的实践（有意注意）。我们主张向卫生专业学生讲授这些关于注意的概念，使他们能够用所有感官进行注意，并了解特别是有意注意的实践，我们认为这些实践将对卫生专业人员的职业生涯和个人生活都具有实用价值。
我们承认将来自一个领域的异质发现转移到另一个领域存在困难，但我们认为，将这些注意概念应用于卫生专业教育可以带来收益。我们试探性地提出了一些发展专业注意和有意注意实践的策略和活动，并将其与我们正在卫生专业学生中试点的一个新模块联系起来。除了帮助卫生专业人员提高他们的注意能力、重振他们的实践以及质疑支撑医疗保健的假设之外，我们还认为关于“注意”的想法也可能帮助卫生专业教育者和研究人员重新想象他们的工作。
