Keeping It Real

In July 2013, I (BL) took part in a week-long Convivium on the Orkney island of Papa Westray. This was a meeting of law lecturers, medical educators, philosophers and theologians, plus a dramatist and an anthropologist, to discuss ethics in professional education, with particular reference to law and medicine. I came away deeply impressed at the systematic efforts in legal and medical education to inculcate a professional ethos in their students. One of the liveliest discussions between the doctors and lawyers was on the topic of how to assess students’ diagnostic interviewing skills. Is it best to use members of the public as subjects in the interviewing examination? This has the advantage of coming closest to reality, but it means that the exam is not standard—the students are not all assessed on the same task, because some subjects will present far more difficult problems, and personalities, than others. This is not fair and not acceptable in a high-stakes assessment. An alternative is to use actors, who can present the same scenario for each student—but this has its own drawbacks (not least the cost; it takes three days to train a ‘standard patient’). The chief risk with a standardised interview examination is that you train doctors or lawyers to interview the standard patient or client as designed for the test, but of course no such person exists in nature.

Listening to this, I became jealous of these clinical subjects that can give their students real things to do, advising real legal clients, prodding real patients, cutting up real dead bodies.  The surgeon trainer, Roger Kneebone, remarked that sending students to draw real blood from real arms is important because in addition to the bare skill of blood-drawing, they tacitly learn a lot of other, hard-to-articulate doctorly stuff (about how, in a professional manner, to touch and manipulate the limbs of strangers in ways that break normal social taboos, for example). He explained that medical students used to learn how to stitch wounds by practicing on pieces of pig skin. This has the drawback that stitching a piece of material that you can turn around and over to get the best angle and light is not like stitching skin on a live body (for a comparison of medical stitching and tailoring, see this film featuring Prof Kneebone visiting Savile Row). So now, some medical students get some practice on fake wounds mounted on real limbs (with theatrical make-up to hide the join).

What part of this could we carry over to philosophy? We know that it is possible to do real philosophy with students.  After all, they are real people with real thoughts and real feelings.  Moreover, an argument really is valid or invalid, even if no-one in the room makes it in earnest.  Nevertheless, these realities do not always lead to authentic philosophy in the classroom.  I was once teaching a module on Hegel and moderating the marking of modules on Kant and Kierkegaard.  Some of the students who wrote essays for the Kant lecturer explaining that Kant’s project succeeds, also wrote essays for me explaining how Hegel’s criticisms of Kant were wholly successful and essays for the Kierkegaard lecturer (JL) on how Kierkegaard revealed Hegel’s philosophy to be a sham.  It is easy to see how they might imagine this to be a rational grade-maximising strategy. Longer experience in philosophy teaches that gaming approaches like this lead to shallow learning and thence to mediocre grades. Grade-maximising is a reliable recipe for not gaining the more valuable gifts that philosophy has to offer, even if it does raise the grades of a student who has decided in advance not to do any deep learning.

One response to this inauthenticity would be to change the curriculum so that it demanded more self-examination from the students.  This is a legitimate angle, especially if it challenges the students’ self-understandings as well as developing and extending them.  “Know thyself” is an ancient imperative and we could do more of it in our curricula.  However, focusing on the self would lack one of the advantages of clinical work: it’s not about me.  One of the deep differences between the workplace and most other institutions that students encounter is that in school, organised extra-curricular activities and university are for the benefit of the student.  Even if you commit a crime and are arrested and imprisoned, the prison is there to punish and reform you, and has people talking to you about your criminality, your anger issues and your drug and alcohol use.  We should not be surprised if some young people are self-absorbed and have a powerful sense of entitlement. What else should we expect when all the institutions they encounter are directed for their benefit?  Work is not like that; the employee, qua employee, is not an end but is rather a means.  This is why going to work for the first time can be a shock, and why work with real clients and patients is educationally valuable in a way that simulations cannot be.  At it happens, many university students now have part-time jobs so they already know that they are not the centre of the world. Indeed, many of them work in retail, so they know plenty about interacting with clients and customers. One of the law lecturers at the convivium observed that, “Professionalism means caring for someone else.” Many students already know this from their paid work. But this experience is disjoint from their philosophical studies.

Ideally, I’d like to find a philosophical task to give to students such that they would harm someone other than themselves if they fluffed it.  Then, their grades would not be the highest stakes in the activity. I conjecture that many students feel no compunction about grade-chasing because there are no serious rival interests—they believe that they don’t seriously hurt anyone else if they pursue their studies cynically. Even if they acknowledge that their grade-chasing may damage the educational experiences of classmates and hurt the lecturer’s feelings, this is unlikely to be decisive because these stakes seem low compared to the importance of their grades. Attitudes might change if we could find a philosophical activity that, like blood-drawing, wound-stitching or clinical legal work, had high stakes for someone else.

So far, the nearest I’ve got is:

• Group presentations where the group gets the same grade (so free-loading may reduce the grades of other students in the group)
• taking students to teach in secondary schools and
• (as part of a module assessment) editing each other’s essays.

None of these raises stakes for others high enough to challenge the students’ own grades for supremacy.  Another possibility might be to have final-year students mark the work of first-years.  Marking a philosophy essay involves philosophical reflection if you do it properly; it’s not checking the essay against some model answer.  This, though, has obvious quality-assurance obstacles. Requiring students to mentor or tutor other, less advanced students is another option, but all of these would be difficult to assess—we would be in the same spot as the doctors and the lawyers, trying to design a clinical practice assessment that is both realistic and fair.

There is another aspect to clinical practice that throws up a direct challenge to philosophical ethics. Part of the value of law-clinics, as the law lecturers at the Papa Westray convivium explained, is that they are diagnostic of selfishness and other character flaws that can lead to professional misconduct. They presented a four-part model (due to James Rest and Muriel Bebeau) of how professional judgments can fail ethically:

1. Moral blindness (this is usually the case where conflicts of interest lead to malpractice, or where the client wants something that may harm someone else)
2. Faulty moral reasoning (compatible with moral awareness, this is a failure to think through situations where there are rival interests in play)
3. Lack of moral motivation (failure to make give ethics its proper importance in competition with other proper professional interests)
4. Ineffectiveness in  implementing ethical judgments, due to lack of interpersonal skills.

According to the Carnegie Report, the moral sensitivity, moral reasoning ability, moral motivation and implementation skills can be developed in law students. However, this is only possible ‘in role’, either through law clinics or classroom role-play, so that the student moves from observer to actor. These experiences can then provide material for reflection. Thus, this four-part model can be the frame for an effective curriculum in professional legal ethics. (Here I follow Clark Cunningham.)  As I understand it, this approach is not standard in the US or the UK but the studies undertaken so far seem to be promising.

Classroom philosophy, as we currently practice it, rarely works on the fourth item in this list.  Much philosophical ethics is content to work out what the right answers are (and think about the logic of the working out and what rightness means, etc.). Insofar as this is true, this too is a failure to keep it real. We philosophers might profitably look at education in client-oriented professions such as law and medicine to see how we might repair this. Taking responsibility for other people seems to be the surest route to diagnosing and building resistance to the four moral weaknesses listed here.  If this isn’t feasible, it may be possible to use imaginative classroom work, that might include reading fiction, watching films, creative writing and role-play as well as critical examination of the works of philosophers, to work on all four elements.

This question of reality, of having stakes in the room higher than the students’ grades, has a bearing on our base question about the modelling of philosophical virtues. There may be some virtues and vices that are only apparent when dealing with people outside the profession. Attending research seminars and conferences may reveal to students how professional philosophers deal with each other—but what about contact between philosophers and everyone else? In any case, it may be that, in the presence of someone else’s interests and vulnerabilities, some of the characteristics prized by philosophers (such as conceptual precision or speed of thought) may not seem so important after all.

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John Lippitt and Nigel Duncan suggested improvements to the text.

Matthew Inglis and Nigel Duncan suggested these options for further reading:

Bebeau, M, ‘Influencing the Moral Dimensions of Dental Practice’ in Rest and Narvaez, (eds), Moral Development in the Professions: Psychology and Applied Ethics, (1994, Hillsdale: Ehrlbaum)

Jones, Ian & Inglis, Matthew (2015) ‘The problem of assessing problem solving: can comparative judgement help?’ Educational Studies in Mathematics July 2015, Volume 89, Issue 3, pp 337-355

Jones, Ian &  Alcock, Lara (2014) Peer assessment without assessment criteria  Studies in Higher Education  Vol. 39, Iss. 10

Donald Nicolson (2008) ‘Education, education, education’: Legal, moral and
clinical, The Law Teacher, 42:2, 145-172,

Donald Nicolson (2013) Calling, Character and Clinical Legal Education: A Cradle to Grave Approach to Inculcating a Love for Justice Legal Ethics
Vol. 16, Iss. 1