Month: November 2024

Navigating complexity: The art of becoming in health education

_{By Joost van Wijchen & Paul Beenen}

In a world where healthcare systems are shaped by constant change and uncertainty, traditional approaches to education are no longer sufficient. Learning today moves beyond acquiring skills or absorbing knowledge; it’s about becoming—an ongoing, adaptive process that equips us to navigate the complexities of the real world.

But what does it mean to “become” in the context of health education? At ECOLAH, we see embracing complexity and ambiguity as a challenge and an opportunity. By reframing education as a process of continuous growth, we can empower learners to thrive in unpredictable environments.

FROM PASSIVE LEARNING TO ACTIVE TRANSFORMATION

In complexity, learners cannot afford to remain passive recipients of information. Becoming demands active engagement with the environment, intentional choices, and transformation through the learning process.

LEARNING AS PARTICIPATION: Education in complexity moves beyond following a script. Learners co-create their journey, interpret challenges, and intentionally shape their growth. This engagement nurtures critical thinking and problem-solving skills that extend far beyond the classroom (Freire, 1970; Mezirow, 1991).

TRANSFORMATIVE EXPERIENCES: Real-world scenarios provide opportunities for learners to expand their professional identity and sense of purpose (Dall’Alba, 2009). Each challenge reshapes not only what learners know but who they are, fostering resilience and adaptability.

AGENCY IN ACTION: Empowering learners to direct their development fosters ownership and accountability. By aligning personal aspirations with societal needs, learners become active contributors to the evolving practice of healthcare (Barnett, 2009).

When education centres on active and transformative learning, it equips learners to adapt to the dynamic realities of healthcare.

THE POWER OF RELATIONAL LEARNING

In complexity, the connections we form with others are as essential as the knowledge we acquire. Learning is a relational act, emerging through collaboration, dialogue, and shared understanding (Wenger, 1998).

COMMUNITIES OF PRACTICE: Structured spaces where learners at different stages work together create invaluable opportunities for mutual growth. Novices gain insights from experienced peers, while seasoned professionals benefit from fresh perspectives, forming a symbiotic learning ecosystem (Lave & Wenger, 1991).

CO-CREATING KNOWLEDGE: In a complexity-oriented framework, knowledge isn’t static—it’s co-constructed. Through meaningful interactions with peers, mentors, patients, and communities, learners develop a richer, more contextually relevant understanding of their practice (Braidotti, 2013).

EXPANDING EMPATHY AND PERSPECTIVE: Collaborative learning fosters relational competencies essential to healthcare, preparing learners to thoughtfully engage with diverse individuals and systems (Minkler, 2012).

Relational learning strengthens the social fabric of education, transforming knowledge into a dynamic, shared experience.

EMBRACING AMBIGUITY AS OPPORTUNITY

In healthcare, uncertainty is inevitable. Rather than resisting ambiguity, learners can learn to navigate it with curiosity and creativity.

TOLERATING UNCERTAINTY: Developing comfort with not knowing all the answers fosters the flexibility needed to address complex problems. Learners who embrace uncertainty cultivate a mindset that seeks possibilities rather than definitive solutions (Morin, 2008).

GROWTH IN DISCONFORT: Complexity-oriented education encourages learners to step into challenging scenarios, expanding their capacity for critical thinking and adaptive action. Growth often emerges from discomfort—the space we instinctively avoid (Barnett, 2009).

CREATIVE PROBLEM-SOLVING: When ambiguity is seen as a space for exploration, learners develop innovative approaches to care, moving beyond rigid protocols to meet the unique needs of patients and communities (Nicholls, 2018).

Ambiguity isn’t a limitation—it’s an invitation to reimagine what’s possible.

Relational learning strengthens the social fabric of education, transforming knowledge into a dynamic, shared experience.

LIFELONG LEARNING IN COMPLEXITY

Becoming is not an endpoint; it’s a lifelong journey. In a world evolving faster than we can predict, health professionals must commit to continuous reflection, adaptation, and growth.

ITERATIVE DEVELOPMENT: Growth in complexity is cyclic. Reflection transforms experiences into lessons, which inform future actions (Schon, 1983). This iterative process builds a resilient foundation for lifelong learning.

ADAPTING TO CHANGE: The healthcare landscape is constantly shifting. Professionals who embrace lifelong learning remain agile, integrating new insights and technologies without losing sight of their values (Barnett, 2009).

NO FIXED ENDPOINTS: In complexity, there’s no “final stage” of learning. Instead, education becomes an evolving process that mirrors the dynamic nature of healthcare itself (Braidotti, 2013).

By cultivating a mindset of ongoing growth, learners remain prepared to meet the demands of an uncertain future.

SHAPING LEARNING ENVIRONMENTS FOR COMPLEXITY

The environments we create for learning are as important as the content we teach. To nurture becoming, educational spaces must balance support and autonomy.

PSYCHOLOGICAL SAFETY: Learners need spaces where they can take risks, make mistakes, and experiment without fear of judgment. A safe environment encourages exploration and deep engagement (Halbe & Pahl-Wostl, 2019).

DYNAMIC SUPPORT SYSTEMS: Personalized feedback, peer mentorship, and scaffolded challenges help learners navigate the complexities of growth at their own pace.

FACILITATORS AS GUIDES: In complexity, educators are not authority figures but guides who support learners as they chart their paths. This balance between structure and freedom fosters autonomy and confidence (Freire, 1970).

A thoughtfully shaped learning environment transforms challenges into opportunities for meaningful growth.

LOOKING AHEAD: ANOTHER PARADIGM FOR HEALTH EDUCATION

“Becoming in Complexity” reimagines education for health professionals. It shifts the focus from static competencies to dynamic growth, from rigid structures to adaptive processes, and from individual achievement to relational and collaborative practice.

At ECOLAH, we see this approach as a path toward creating professionals who are not just technically skilled but ethically grounded, resilient, and prepared to engage with the complexities of modern healthcare.

How can you bring the principles of “Becoming in Complexity” into your own learning or teaching practices? Join the conversation in the comments or explore more at ECOLAH.eu!

REFERENCES

Barnett, R. (2009). Knowing and becoming in the higher education curriculum. Studies in Higher Education, 34(4), 429–440. https://doi.org/10.1080/03075070902771978
Braidotti, R. (2013). The Posthuman. Polity Press.
Freire, P. (1970). Pedagogy of the Oppressed. Seabury Press.
Halbe, J., & Pahl-Wostl, C. (2019). A methodological framework to initiate and design transition governance processes. Sustainability, 11(844), 1–14. https://doi.org/10.3390/su11030844
Lave, J., & Wenger, E. (1991). Situated Learning: Legitimate Peripheral Participation. Cambridge University Press.
Mezirow, J. (1991). Transformative Dimensions of Adult Learning. Jossey-Bass.
Minkler, M. (2012). Community Organizing and Community Building for Health and Welfare. Rutgers University Press.
Morin, E. (2008). On Complexity. Hampton Press.
Nicholls, D. A. (2018). The End of Physiotherapy. Routledge.
Schon, D. A. (1983). The Reflective Practitioner: How Professionals Think in Action. Basic Books.
Wenger, E. (1998). Communities of Practice: Learning, Meaning, and Identity. Cambridge University Press.

Insights from recent studies

_{By Petra Cremers, Centre for Teaching & Learning, Hanze UAS Groningen}

In the last few years, a fast-growing body of research has emerged about education for sustainable development (ESD). To underpin the design of our badges within EduSTA, we studied some of these publications around the aims and ambitions of ESD. This blog highlights a particular theme from this research that is often not acknowledged but can be troublesome: the framing of sustainability challenges as problems to be solved.

This frame is found in many publications and competence frameworks for ESD: students should develop skills to be able to solve sustainability problems in the real world. And, of course, solving problems is important. But when faced with the uncertainty, complexity and emergent character of sustainability challenges, the frame falls short. When transitioning towards a more sustainable world, our actions can have unexpected consequences; what seems a good path to follow today, might cause problems tomorrow. Sustainability challenges, due to their uncertain nature, resist solving in the linear way we are used to. Often, due to their complexity, these challenges even resist definition. Therefore, it is not possible to foresee or figure out a solution or a linear path to achieve it.

When we teach our students to be goal-oriented and to work towards solutions, we prepare them for complicated problems. ‘Complicated’ implies that the result can be predicted or calculated and that the circumstances are relatively stable. However, complex or ‘wicked’ challenges require a different approach and skillset. Instead of taking steps along a path towards the solution, it is necessary to deal with and even embrace unexpected, emerging events. The way forward is then one of probing, experimenting and responding to what happens. So, when educators and students approach problems as if they are complicated but in fact they are dealing with wicked problems, they don’t learn to acknowledge and deal with uncertainty and emergence and run the risk of becoming frustrated and overwhelmed.

So, how can ESD address complexity? Here are some insights on education, pedagogy, and educational design.

EDUCATION AS SUSTAINABILITY

According to Stephen Sterling, a renowned researcher of environmental and sustainability education, the ambitions of ESD are to foster an open mind, a willingness to shift one’s mindset, to be curious and question assumptions and values to find new ways to move towards a more sustainable world. However, because of our default in wanting to solve problems, Sterling identifies three narratives in talking about sustainability education. First, education about sustainable development, where we teach and learn about SD issues. Second, education for sustainable development, which focuses on problem solving. Yet the closest to the aims of ESD is a third narrative – education as sustainable development, calling for transformative learning and holistic thinking in connection with the world and all its inhabitants.

This implies that education should be connected to the world and take place in the world, rather than exclusively at school. It also means that there is not such a thing as ‘being ready for the world’ after completion of the study programme. For students and teachers alike, dealing with challenges in the world is ongoing, and education should stress the ability to engage with the world in a creative way, to embrace uncertainty and to reflect on and learn from what happens when trying to bring about change. Arjen Wals calls this the ‘capacity to disrupt’ and ‘learning from resistance to disruption’.

PEDAGOGY OF DISRUPTION

When students and teachers are both learners trying to understand a complex challenge, and it is not possible to know in advance what will happen when we work on sustainability challenges, what does this mean for the pedagogical role of the teacher? Research suggests that pedagogical approaches should facilitate exploration of alternative ways of acting and thinking and thereby questioning values and assumptions underlying current systems, strategies and decisions.

This also implies that teachers are willing to get uncomfortable together with students. Keri Facer expresses it beautifully when she states: “ESD is about opening educators’ and students’ hearts so that they can know beyond the boundaries of what is acceptable, so that they can think and rethink, can create new visions”. Another implication of embracing complexity is that there are no fixed learning outcomes in the sense of competences that can be ‘measured’ in terms of the classical grade. Outcomes are more likely process-oriented, assessing a shift in coping strategies or a shift in mindset, rather than indicating a specific competence level that is the same for every student.

EDUCATIONAL DESIGN

There is not one way to design education as sustainable development. But several studies provide perspectives, principles or practices that can guide the development of learning environments for ESD. Bringing diversity and multiplicity into the learning environment is an important guideline, as well as embeddedness in real-world communities. The need to bring dissonance and an openness to emergence is complemented by what Bas van den Berg calls “an ethic of care”, which means that there is always consideration for emotional wellbeing, safety and community building, inside as well as outside the classroom.

The last important feature of ESD is its cyclical nature: education as an iterative or spiralling and emergent process, that is monitored continually. In his research into regenerative education, Thomas McIntyre characterizes the ESD-teacher as the “transgressive gardener”: like the gardener, who knows what each flowerbed, shrub or tree needs, the teacher tends to (designs and enacts) the conditions for each learner to flourish so that learning-based change can emerge.

Designing education as sustainable development requires a shift in perspective regarding the role of the teacher, where education takes place (inside or outside the classroom), what it is students are working towards, and to capture it all together, the frame we use to look at problems. Distilling this into a badge challenged the EduSTA consortium to think about what the essence of this perspective shift might be and translate these to very concrete ‘measurable’ outcomes. The badges are a snapshot of what it can mean to be a sustainability educator, in a format that is familiar to us in the world of education that revolves around measuring outcomes and certifying our learning.

The proof of the pudding is of course in how the badges can activate a shift in the mindset in sustainability educators to facilitate the transformative and emergent learning that ESD calls for.

READING TIPS

On complicated/complex:

The Cynefin framework. Snowden & Boone 2007. A Leader’s Framework for Decision Making. Harvard Business Review.

On the transgressive gardener and spiralling education:

PhD thesis Thomas Macintyre

On transgressive learning, regenerative education:

Capturing Transgressive Learning in Communities Spiraling towards Sustainability. Thomas Macintyre, Valentina C. Tassone and Arjen E. J. Wals 15 June 2020.

Arjen Wals (2022), Transgressive learning, resistance pedagogy and disruptive capacity building as levers for sustainability.

Bas van den Berg (2022), PhD Thesis. Design Principles for Regenerative Higher Education in Times of Sustainability Transitions. https://edepot.wur.nl/589879

Koen Wessels (2022). PhD Thesis. Pedagogy of Entanglement. A response to the complex societal challenges that permeate our lives.

Keri Facer (2019). Storytelling for troubled times. What is the role for educators in the deep crises of the 21st century? Literacy, 53(1), 3-13.

Thank you, Lauren Verheijen for your valuable feedback on the first version of this blog!

NOTE: This article was originally published on the website of the Academy for Sustainable Future Educators – EduSTA. Many thanks for granting us permission of re-publishing on our blog!