An infusion of vocational exploration within the undergraduate science curriculum could provide a path toward more effective healthcare and more significant scientific discoveries. students who pursue these careers often do so because they have a strong desire to help others; yet undergraduate science programs do not typically provide extensive training in communicating with others and learning how to better understand another individual. This essay employs a lens offered by Willie James Jennings (focusing on needed changes in theological education), applying it to undergraduate science education that prepares future physicians and scientists. Given the tendency toward “othering” in our culture, vocational exploration could help our science undergraduates to shift toward embracing others rather than excluding them. This shift will require the development of habitual practices throughout the undergraduate years—beginning with the cultivation of attentiveness, proceeding toward a focus on cultural humility, and finally developing a culture of belonging.
The United states has been a world leader in scientific discoveries and health-care advances1 and would, no doubt, prefer to maintain that status. But the scientific problems of today are ill-defined and multi-faceted; they therefore require interdisciplinary solutions, which in turn will require communication and collaboration among experts in science. Moreover, merely to identify and define the problems that we face, we need to probe the knowledge that can be provided by patients and other research subjects—knowledge that is often of equal importance to the communication and collaboration needed among experts. scientists and physicians need to communicate with, listen to, and come to know the “others” with whom they engage in their research. What foundational training is being offered to students of science, such that they can collectively answer this call?
To answer this question, one would need to examine the primary pedagogical goals for training undergraduates who plan to become research scientists or health-care professionals. I expect that most faculty members at undergraduate institutions would assume that the primary focus of such training should be on learning scientific concepts and developing excellent critical thinking skills. similarly, undergraduates interested in a career in medicine or biomedical research are typically expected to study a minimum of two semesters each of general biology, chemistry, and physics—as well as multiple advanced courses in biology and two semesters of the infamous organic chemistry. Through this coursework, students certainly gain a strong background in multiple scientific disciplines. But does this prepare them to learn from the “other”—that is, from the patient or the research subject?
Knowing the science, and knowing how to apply this knowledge to specific scientific problems, is not sufficient to ensure continued biomedical discoveries and advances. Knowledge alone—even if it is obtained through a decade of in- tensive scientific education—has its limits. Wisdom requires more than learning additional facts. As Adele Calhoun, a pastor and spiritual director, observes, “Knowledge is a powerful thing. The irony is that we become skilled in information acquisition and become no wiser for it. Information doesn’t necessarily transform or shape us. Learning something new doesn’t mean we are teachable. We can always use information to simply reinforce our own opinions or biases.”2 This is precisely the danger to which students are exposed by the current curriculum for most undergraduate science degrees; it can inadvertently allow learners to perpetuate their own biases and may lead to unintentional discriminatory thoughts and actions. Fortunately, however, this is a result that higher education can mitigate, if its leaders are committed to doing so. Curricular and co-curricular supplements to the undergraduate science curriculum could guide students to become more aware of their biases and to pay more attention to the “others” in their work. This increased awareness could lead to a more inclusive approach to scientific discovery and medical interventions.
Among the many adjustments that could be made, the regular practice of vocational reflection in undergraduate science courses is particularly worthy of consideration. I want to suggest that intentional, reflective vocational exploration can have three important effects, which will be explored throughout this essay. Each of these effects represents a shift away from a common tendency in scientific research and medical practice, and a shift toward an approach that can help our students—at least in the short run—and might also lead to more effective and efficient medical care and scientific discovery in the long run. I will describe these three shifts as, first, the shift from otherness to embrace; second, the shift from scientific mastery to cultural humility; and third, the shift from individualism to belonging.
The Shift from Otherness to Embrace
Effective medical care and scientific discovery both rely on physicians and researchers who are willing to understand others as fully as possible. While gaining foundational scientific knowledge is imperative, so is gaining an understanding of the variety of people who make up the human race. Undergraduates need to become adept at learning about, and learning from, the others they encounter.
In its simplest definition, the “other” is someone or something that is not you. simeone de Beauvoir explored the concept of the other in her essay, Le Deuxième Sexe (The second sex). While her focus was on the injustices perpetuated against the female other, her work helps us think more broadly about our relationship to all those who are “other” to us. “The category of the Other is as primordial as consciousness itself. In the most primitive societies, in the most ancient mythologies, one finds the expression of a duality—that of the self and the Other. Otherness is a fundamental category of human thought.”3
We know that individuals exist who are different from us, but otherness is not merely a recognition of difference. A clearer distinction between these two terms is offered by research in the field of human geography, which shines a spotlight on the practice of “othering: transforming a difference into otherness so as to create an in-group and an out-group.”4 This process may begin when we simply try to avoid individuals who are different from us, or different from those with whom we regularly interact. This can lead to treating those people as abstract entities; they become less-than-human, and we do not invest much of ourselves in understanding or being curious about these others.
In order to understand ourselves, it is only natural that we simultaneously recognize the ways in which we are different from others. Moreover, it is natural that we tend to associate with those with whom we identify. Our connections with others, our bonds and friendships, often develop from a recognition of similarity in the way we experience and respond to the world—a moment in which we respond, “you, too?” And yet, differences among people can also create the potential for a process of othering, leading to an “us vs. them” mentality. We see this instantiated in the ways that our culture is polarized over many issues: politics, medical treatments, gun laws, and so much more. Polarization leads us to focus on the differences between ourselves and others, creating a tension between our understanding of our own identity and emphasizing the “otherness” of others. This in turn can lead to hatred and exclusion of others—perhaps the dominant sin of our current historical moment.
This notion has been extensively explored by Christian theologians such as Miroslav Volf, who experienced the physical and mental ramifications of polarization in his war-torn homeland, Croatia. In his book Exclusion and Embrace, Volf explores “what kind of selves we need to be in order to live in harmony with others.” He points to the example of Jesus, who did not shy away from those who were deemed different by society, but rather embraced them. Volf calls on his readers to embrace those who are different—even those whom we label as enemies—as a means of combating injustice and giving breath to a world where all are truly seen, are embraced, and fully belong.5 This is a significant challenge in a polarized society; achieving it will require us to engage in creative encounters with others—which means seeing, appreciating, and eventually embracing difference. We need to practice this activity often enough, and consistently enough, that it becomes a habit.
Educationism as an Instance of Othering
Social psychology research has observed instances of “educationism,” in which those with a higher level of education tend to discriminate against those who have less education. One group of researchers has observed that “those with few educational qualifications have become one of the last bastions of ‘acceptable’ prejudice, to the extent that it may not be seen by many as prejudice at all, and that these views are shared in important respects by the target group itself.”6 This is an obvious danger for those of us in higher education, since one of our stated goals is to increase the educational level of our students; and yet, few of us would want to suggest that this result should lead to discrimination and injustice. Unfortunately, it often has.
One frequently cited example of this injustice is that of the experience of Henrietta Lacks—the unconsenting donor of the first cells that were grown in a laboratory. The physicians who led this research were snared in the trap of ed- ucationism; they did not interact with Henrietta Lacks with the goal of learning from what she had to offer. Perhaps they considered it a waste of time to invest in trying to explain the complexity of their work to an impoverished Black woman who had only a sixth-grade education.7
Even if the injustices that take place in such circumstances are unintentional, they can do genuine damage; they are also often rationalized as creating progress toward some greater good. When Henrietta Lacks had surgery to remove her cervical cancer, neither the physicians nor the researchers felt the need to gain her consent to use this tissue for research. Indeed, it had simply become common practice for physicians to provide collected tissue to researchers, so that they could attempt to develop methods for growing cells; at the time, it seemed that such a process was highly unlikely to succeed.8 If the physicians and the researchers had paused to consider the possibility that they had something to learn from the patient, they might have made more progress. For example, they might have realized that Henrietta Lacks needed to receive antibiotics at her first visit, since a return visit for her was improbable at best. If they had brought their patient into the decision about the use of her excised tissue, they could have lessened the fear that she and her family had about biomedical research. This alternate approach could have been an invitation to be part of the discovery process, allowing for a shared pride in the work and recognition of the combined investment of doctor, researcher, and patient in the process of scientific discovery and help for future generations. This in turn might have offered a gift of hope, providing much-needed comfort when Henrietta Lacks and her grieving family needed it most.
Shifting from Otherness to Embrace
How might we help our students begin to shift their focus away from “othering” those who are different, and toward an ethic of embrace? While this is a question that needs to be answered in specific educational settings, two examples may be useful at this point.
The doctor becomes the patient. We are often told that, if we hope to understand others, we need to be willing to walk a day in their shoes. It is not surprising that opinions may change once the physician or scientist becomes the patient. Paul Kalathini was an up-and-coming neurologist; he had the finest training, and this—combined with his physical and intellectual talent—set him up to be recruited for the most prestigious positions. Yet his vantage point changed dramatically when he fell ill with cancer and became an oncology patient. He realized that he could be a better practitioner if he further considered the perspective of the patient. For example, he found himself changing the way he used and communicated statistics regarding a patient’s disorder. “It occurred to me,” he notes, “that my relationship with statistics changed as soon as I became one.”9
Through his experience as a patient, he shifted away from the tendency to see the patient as an “other” and toward an ethic of embrace.
The call to protect life—and not merely life but another’s identity; it is perhaps not too much to say another’s soul—was obvious in its sacredness. Before operating on a patient’s brain, I realized, I must first understand his mind: his identity, his values, what makes his life worth living, and what devastation makes it reasonable to let that life end.10
Kalanithi realized how much knowledge he could gain by engaging more thoroughly with patients he was serving. “Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete.”11 An openness to experiencing and embracing the “other” can lead a person on a journey of life-long learning.
The ethical value of the other. Many religious and ethical systems commend knowing the other and treating the other as one would wish to be treated. In the Christian tradition, for example, Jesus calls on others to “love your neighbor as yourself” (Matt. 22:39), quoting the words of the Jewish scriptures (Lev. 19:18). While Paul Kalanithi’s experience of cancer forced him to see the relationship between himself and his patients, it would (of course) not be good for every physician or scientist to be afflicted with the disease they are studying. Rather, through shifts in our approach to education in the sciences, we can offer the opportunity for regular and repeated vocational exploration practices, encouraging our students to work against certain societal norms. The challenge is to help students see that the less educated “other” might have greater value than is typically offered in our society, and that the observations of their patients and their research subjects might have a genuine role alongside that of more highly trained experts.
In contrast to the educationism that marks contemporary practice, consider the very different approach in the ethics of Jesus. Even though many of his disciples came from the less well educated strata of society, they further discounted the importance of those with even less education and experience—namely, children. “But when Jesus saw it, he was indignant and said to them, ‘Let the children come to me; do not hinder them, for to such belongs the kingdom of God. Truly, I say to you, whoever does not receive the kingdom of God like a child shall not enter it’” (Mark 10:14–15). The disciples were likely not conscious of the ways that they were marginalizing a group of individuals based on their immaturity; this was a natural assumption in their world, as it often is in ours. But Jesus pointed to a way of being that was represented by the lives of children—a way that the disciples were yet to learn. In fact, the scriptures of many faith traditions are replete with examples of an unlikely vessel being used to teach an important lesson or to demonstrate a valuable practice. Our classrooms and our approaches to undergraduate education can similarly engage students in the practice of recognizing that they may have something to learn from the least likely vessels—including their patients and research subjects, who in most cases will have had much less exposure to higher education.
Attentiveness as an educational practice
Treating patients and research subjects as others, as less-than, can become a subconscious practice and can be easily rationalized. Physicians and researchers have to engage in a balancing act; if they become overly emotionally involved in the lives of their patients, they may fail to make adequate use of their own expertise and their critical reasoning skills to provide the best care for patients and to carry out the best research.12 And yet, if physicians and researchers find themselves needing to toggle between empathy and rational thought, it becomes easy to see the patient as the “other.” How can we help students avoid this trap? As a first step, practicing attentiveness toward others can lead to better care and research.
The work of the philosopher Emmanuel Levinas points to a path away from othering and toward attentiveness. He stressed the need for us to interact intentionally with individuals who are different from ourselves, so that we can form more fruitful ideas about what to do and how to live. He encouraged interest and curiosity in the “otherness” of others—an idea which he labels alterity. He recommended that we celebrate our differences from others; indeed, we should train ourselves to be in awe of others, and therefore to provide them with care and concern.13
Researchers and health care workers could move the needle of discovery and care by embracing Levinas’s approach. We could better understand our- selves through practices of attentiveness and curiosity toward others—celebrating alterity—as a means of embracing those with whom we are different. Practicing Levinas’s approach to others in undergraduate science education could help physicians and researchers retain their posture of curiosity and openness toward others, while avoiding the “compassion fatigue” that can result from an excess of emotional involvement. By asking students to develop a regular practice of knowing and learning from others—in their undergraduate training and beyond—we could avoid the tendency, felt by many physicians and researchers, to toggle between emotional and rational responses (making room for one response by temporarily excluding the other). Levinas’s perspective raises the possibility of a singular approach that could integrate both responses.
A similar approach is advocated by systematic theologian Willie James Jennings. Although his focus is on theological education rather than scientific education, he can help us see how our educational processes could be redesigned to help students avoid “othering” in their day-to-day interactions. “We should work toward a design that aims at an attention that forms deeper habits of attending to one another and to the world around us. Paying attention also requires a commitment to be patient in weaving deep lines of connection between what we teach, whom we teach, and the world we inhabit together with them.”14
The learning journey should include knowledge from teachers and students
that is woven together. It should be a practice of learning from one another— course concepts, yes, but also ways of being in the world (and the integration of these two realms of thought). This work begins with education that helps students develop an awareness of the tensions and problems that exist, but it must also include engaging these future healthcare practitioners and researchers in the practices of attentiveness and curiosity. Within undergraduate education, we can begin to map out an altered journey that opens each of us to attentiveness to each person we encounter—a person from whom we can learn, if only we are attentive, open, and willing to listen. There is room for us to develop practices of attentiveness throughout the curricular and co-curricular undergraduate science major experience. Indeed, efforts are already underway to support a shift toward attentiveness within the sciences.
Muskingum University. At my own institution, I developed vocational exploration exercises aimed at guiding science students to consider their callings. In particular, my efforts were aimed at helping my students develop an increased awareness of others. In my sections of two 300-level biology courses, I have incorporated weekly vocational exploration exercises. I provide a reflection prompt, and students are given in-class time to write. One of my primary goals in this exercise is to encourage students to develop habits of thinking about others and learning from them. Allow me to offer two examples of the weekly reflection prompts that students are given.
- Because the prompts are offered in courses that have a three-hour lab as well as lecture meetings, one of the prompts focuses on the lab experience. It charges students to describe some of the strengths they have observed in their partner—not only over the course of that particular week, but also throughout the semester thus far.
- Students are also asked to explore their experiences and describe a time and an individual from whom they have learned. In particular, they are asked to consider an unexpected person from whom they have learned—and what it is that they learned.
Class time is precious, but the work is important; I signal this by giving the students the gift of time to promote their sincere engagement in this reflection. I am concerned that, without carving out time in class, the potential richness of reflection will be lost; it will become just one more assignment to complete.
Calvin University. science professors at Calvin University have studied the key elements that are present in well-functioning teams. Their work arose from the realization that science is practiced by teams, yet our curricula often fail to focus on developing team skills in ways that are specifically relevant to the scientific disciplines. To that end, faculty members at Calvin have developed and incorporated Team science exercises and reflections, both in undergraduate science courses and in the co-curricular summer research experience. The focus of this programming is to educate students about the good habits—what the classical tradition would call virtues—that have supported success in team-based projects. Their efforts also seek to provide opportunities for students to practice these virtues so as to develop a thriving team, whether members of a course or of a research group.
Students engage in multiple exercises, including reflective writing, focusing on one or two virtues each week. In addition, the professors have designed practices that help to habituate the students in these virtues. One practice that particularly emphasizes attentiveness toward others is that of silence. The practice of silence focuses on countering the addiction of distraction and noise to allow the student to be completely present to others and to hear, in active ways, what others are trying to offer them.
While these are only two examples of what it might mean to put vocational exploration in the service of science courses, they both offer the possibility that students will learn to shift their focus away from the “otherness” of the patient or research subject, and toward an ethic of attentiveness and embrace.
Trading mastery for cultural humility
Closely related to attentiveness and embrace is the practice of cultural humility. We might define this as the “ability to maintain an interpersonal stance that is other-oriented (or open to the other) in relation to aspects of cultural identity.”15 Cultural humility is of critical importance in practicing healthcare and in making impactful scientific discoveries. It is difficult to achieve, however, because science is so heavily focused on the mastery of concepts. The purpose of this section is to consider how we might encourage our students to shift their focus from scientific mastery to cultural humility.
Mastery of scientific concepts
I have often equated biology to a foreign language; it is critical for students to learn the terminology in order to explain the concepts. students encounter a large number of terms that are new to them; this requires significant memorization before they can study the relevant processes. Unsurprisingly, undergraduate science students tend to focus on memorizing terms and concepts, which leads them to be frustrated by test questions that require application of these concepts. In the sciences, the need for memorization and mastery tends to obscure the importance of observation, uncertainty, and inquisitive exploration. As a result, when students become practitioners, it is easy for them to diagnose disease and treat patients while wielding an excessive confidence, developed solely through the analysis of patient data—often with unfortunate results.
This focus on mastery appears frequently within the Western educational tradition. Willie James Jennings explains how this tradition historically promotes the formation of a self-sufficient master. specifically, he identifies two elements of this distortion. First, the image of an educated person “is of a white self- sufficient man, his self-sufficiency defined by possession, control, and mastery. On the other side, many people respond to that image by promoting homogeneity that aims toward a cultural nationalism.”16 This distorted education embraces “control and sameness, a control that aims for sameness and a sameness that imagines control.”17 Jennings describes the historical framework for this way of thinking:
The finished man was always the image held up and held out to colonized peoples in the processes of Western education. The first work of that image is to create inadequacies. This is the energy inside the master/slave dialectic within the legacies of plantation and colonial education. The first word of self-justification that masters told themselves was that the slaves had deficiencies that needed to be addressed. slavery and colonialism always carried a therapeutic wish bound up in a soteriological illusion: they were addressing the deficiencies of the natives. For hundreds of years, generations of indigenous scholars and colonialized subjects have written powerfully and eloquently about the creation of the image and the inadequacies. Everyone must aim toward the finished man, toward a self-sufficiency that overcomes their inadequacies.18
This mastery and possession are evident throughout life science education and subsequent careers of the physician and scientist. The standard image is of the attending physician quizzing the residents, with the master pointing out morsels of knowledge that were missed. This is a mirror image of the graduate student presenting to the principal investigator, with all eyes on this person, waiting for corrections to be pointed out. This may be an efficient way to educate, but it does perpetuate the image of the Western educated person defined by “possession, control, and mastery.”19 sadly, these negative practices have parallels in certain strands of theological education—and, more broadly, in academic practice in general (including that of the natural sciences).
Fortunately, however, there is an alternative. Jennings counsels what he calls a “fragment” approach—one in which all of our fragments are joined to other fragments, renouncing the discourse of mastery. “This fragment work is a deeply Christian calling, born of the tragic history of Christians who came not to learn anything from indigenous peoples but only to instruct them, and to exorcise and eradicate anything and everything that seemed strange and therefore anti-Christian. We Christians created a problem that we are obligated to address.”20 This point has implications for disciplines other than theology. The first step is to realize that we—faculty members, students, and higher education as a whole— are all too ready to “look and listen to those voices most similar and familiar to [our] own.”21 In so doing, we create sameness among self-sufficient masters.
We have been tricked into believing that we are not victim to this ideology—that our behaviors do not perpetuate this disease—yet they do. We blindly follow the one in front of us. As faculty members, we experience this in practically every faculty meeting, with each of us jockeying for position to be the most knowledgeable person in the room. We provide quotations, mention literary works, and appeal to scientific findings to make others aware of the knowledge that we possess. Every time we do so, we are falling into the pattern of the self-sufficient white master. It is our own internal version of educationism.
This approach litters academia, robbing it from embarking on a true journey of learning. We miss out on the integration of our various fragments—the bits and pieces that we all know as individuals—into a synthesis that marks something more profound than what we could have known apart from others. We miss out on important aspects of our collective knowledge because we are all trying to be individuals who are self-sufficient, who are battling to be the master—the headmaster—who knows more and will force that singular knowledge on others. This all-knowing headmaster believes in charting a path that is best for all—without a need to hear the voice of others.
Moving Away from Mastery: Serious Efforts that Fall Short
The injustices that result from the focus on mastery have been felt throughout our society, but it is so powerfully prevalent that it is difficult for us to consider any alternative. One well-intentioned approach has been to focus on the need for cultural competence—i.e., recognizing that there are other approaches that may not align with our own. This is a step in the right direction, but—as we will see—is an incomplete approach. still, it seems wise to review some efforts to help our students achieve a certain level of cultural competency.
The MCAT. The entrance exam taken as part of medical school applications, known as the Medical College Admissions Test or MCAT, now requires testing of knowledge in sociology and psychology. In 2015, this change was developed as a step towards promoting an understanding of others among medical students.22 Careful work was done by the Association of American Medical Colleges to identify needed foundations of knowledge of psychological, social, and biological behaviors and competencies.23 They noted that these “factors influence the way we think about ourselves and others, as well as how we interact with others.” The goal was to lay the foundation essential to develop communication and collaboration with patients in their medical school years.
These MCAT changes are a step in the right direction, but they are not sufficient. In the end, their focus is on knowledge or awareness of cultural difference, but these factors alone cannot address the larger issue of a focus on scientific mastery.24 In fact, it is all too easy for these new requirements to become just one more concept that students need to master in order to show that their undergraduate education was complete. A cautionary note is in order:
In the laudable urgency to implement and evaluate programs that aim to produce cultural competence, one dimension to be avoided is the pitfall of narrowly defining competence in medical training and practice in its traditional sense: an easily demonstratable mastery of a finite body of knowledge, an endpoint evidenced largely by comparative quantitative assessments (i.e., MCAT, pre- and post-exams, board certification exams).25
Notably, medical schools have not adopted a requirement or recommendation for students to practice interactions with others, or to put into practice the concepts of cultural awareness realized from their coursework.26
One could argue that, even within their first year, medical students are taught how to interact with patients and put this knowledge into practice straightaway. Beyond this, competitive medical and physician assistant school applications boast a minimum of 1,000 hours of patient care experience—this is in addition to shadowing practitioners. Given the number of health care hours these individuals have experienced, one might expect them to have become adept to listening to others—and learning from them. But again, if the goal is simply to understand and recognize the cultural assumptions of others, there is little to prevent these experiences from reinforcing the same kind of “othering” that I have described above. The undergraduate experience provides many opportunities to move in a different direction—through internships, shadowing, and teamwork in laboratories. I will return below to the question of how we might pursue such changes.
Efforts to transform Life Science Education. Prior to these updates to the MCAT, changes within life science undergraduate education had already been underway. In 2011, the National science Foundation supported a formal call to action titled Vision and Change. Multiple voices convened to identify issues and needs; this resulted in multiple recommendations for the evolution of biology and life science education at the undergraduate level. Depth was preferred to breadth, and the collaborative nature of science was seen as central. Memorization was to be given less emphasis; the focus should be on the practice of science.
This was a needed change. Five life science concepts were identified that all students needed to know, and six competencies were listed that students should put into practice.27 Of interest is that three of the six competencies required some level of interaction with others—experts in other disciplines or others in society.28 This approach to undergraduate biology courses highlights collaboration and teamwork; the resources provided focus on integration of knowledge and doing scientific research.
Unfortunately, however, although team-based learning and collaboration has been given more attention, the new curriculum did not break this down into simple steps. students were not required to practice elements of teamwork as central learning objectives; rather, most exercises tend to treat team formation as a benefit that inevitably results from required group work.29 (That is to say: it is thought that, if students are required to work as a team, they will figure it out on their own.) However, much like any area of science, fundamental concepts need to be described, recognized, and intentionally practiced and reviewed.30 Team science concepts and exercises need to be more deeply woven into our undergraduate life science curriculum if we are committed to developing undergraduates who collaborate with others and who understand society and its interface with science.
Cultural Competence at First Hand. Over the last several years, a great deal of attention has been given to J. D. Vance’s book Hillbilly Elegy. This book is of special interest to those at my own institution, since we are located in the heart of Appalachia; the book aims to share and to educate about the pervasive culture of this region. In that sense, Vance seeks to expand the cultural competence of his readers; yet this work, too, falls short.
Vance shares that he is proud of his roots; he highlights the good within this culture. Yet, many of his descriptions make use of stereotypes, condescension, and sweeping generalizations of this region’s complex cultural heritage. For example, when referring to his grandmother (Mamaw), Vance refers to what he observes as her conscious and subconscious thoughts; but it seems reasonable to ask whether these are actually her own thoughts about the hillbilly community, or whether the views of the author that are simply being assigned to her. While we are told that “Mamaw felt, whether she knew it consciously, that she wasn’t good enough,”31 the author describes his own life as “genuinely incredible,” leading him to feel “overwhelming appreciation for these United states.”32 Interestingly, none of this self-assessment points back to his home community, his family, or his culture. Instead, we see that the author has actually escaped from the hillbilly culture that he supposedly appreciates so much (and that his life is “incredible” because of that exit).
As noted above, Muskingum University is located in Appalachian Ohio. My own conversations with several individuals who identify as Appalachian pointed to extreme frustration with Vance’s portrayal. His intent was to highlight this crisis being faced by his family and their culture;33 yet in the end, the moral of the story seemed to be about the importance of bettering oneself and getting out of that culture. This involved making it big—and then assigning some residual value to visits back home, expressing an appreciation for certain elements of that culture. Vance does a good job of pointing out what is different about the culture in which he grew up; but he does not focus on what we have to learn from it. The focus is on cultural awareness, but not on cultural humility.
Moving Away from Mastery: Cultural Humility
In contrast to efforts to achieve mere cultural competence, I want to commend efforts to achieve cultural humility. This requires not only an awareness of other cultures, but also an appreciation for the fact that one’s own culture will always tend to seem superior, and that one must be intentional about lowering that expectation in order to be able to truly hear the voice of the other.
Cultural humility has been embraced as extremely important by some physicians and medical educators. They describe it this way:
It is a process that requires humility in how physicians bring into check the power imbalances that exist in the dynamics of physician-patient communication by using patient-focused interviewing and care. And it is a process that requires humility to develop and maintain mutually respectful and dynamic partnerships with communities on behalf of individual patients and communities in the context of community-based clinical and advocacy training models.34
Although this description focuses on the medical profession, a similar pos- ture could be described for the researcher. Embracing learning as a journey and viewing others as sources of knowledge (rather than mere subjects to be investigated) would lead us to an authentic place of cultural humility. Indeed, some physicians and scientists choose a journey of collaborative learning—they avoid the draw of becoming a headmaster. Our goal should be to train our science undergraduates to engage in such a journey of learning; doing so would require us to help them develop good habits that might change their way of thinking and being in the world.
Christians have a model of cultural humility in the ministry of Jesus. During a time when Jewish people viewed the samaritans as an inferior people, he turned it all upside down. He preached that the Jewish lineage and our background was not what he cared about, but rather how we loved the Lord and how we treat our neighbor. He stressed this in the parable of the good samaritan and showed his followers how to put this into practice in his interactions with the woman at the well (Luke 10:25–37; John 4:1–42).
In a fictional encounter with faculty, Willie James Jennings guides professors toward a posture of attentiveness to their students—to model a journey of learning from and with others. Too often, this guidance is interpreted merely as learning enough about one’s audience to communicate one’s own perspective persuasively. But Jennings is after something more:
These seasoned professors misunderstood my invitation to assimilate as meaning learning more things about their new students, coming to know their worlds, and aligning that knowledge with their knowledge. In such a frame of thinking and knowing, education is a calculation of exchange. How much do I need to know in order to give the student what I know? But if assimilation means lifeworlds brought inside lifeworlds, then something historically urgent and spiritually crucial is at stake in this moment. I was after something else with them—a deeper reality of entanglement. An entanglement in which they might give up attaining mastery, or possession, or control, and turn their entire school toward deeper involvement with the lifeworlds of their students whose communities surrounded and extended beyond the institution.35
Jennings does not call us to simply memorize facts about the generation we are educating. He calls us to learn about our students’ life journey. If faculty model a self-sufficient master, how can we expect students to follow a path of attentiveness and embrace the other? Yet if we engage in curiosity and learning about our students, we can then model a state of attentiveness infused with cultural humility for our students. First, we must model a journey of learning in which the professor and the student both participate; we must then provide the time and space for this to happen among peers (with students learning from students, along with coaching from the professor). Providing time and space is an important first step; the next goal should be to cultivate a journey of attentiveness in which concepts are taught and straightforward forms of practice are offered and modeled.
Vocational Exploration as a Path toward Cultural Humility
Vocational exploration exercises and reflections can provide opportunities for students to embody true cultural humility, inculcate it, and form our students in it with the hope that we will habituate them (and ourselves) in this practice. The key element of this vocational exploration is to get students into relatively safe spaces where they intentionally learn more about others and the context of others’ lives. Community-engaged learning experiences are prime loci to learn and practice cultural humility. Yet for this to ensue, a focus on cultural humility as a primary learning objective is necessary. Discussions should move away from “service” and “needs” and focus rather on “collaboration” and “assets.” Darby Ray, director of the Haward Center for Community Partnerships at Bates College, has been refining this craft for twenty years. she summarizes it as follows: “The journey I and many other civic engagement professionals have taken is the same one we wish for our students and our colleges or universities—a journey from paternalism to partnership.”36 The long-term goal would be treatment and research from a more pervasive place of understanding and empathy.
These practices can be ongoing, semester long, or even a single event. I have mentored students in an experience of vocational exploration experience that was part of the National Day of service honoring Martin Luther King, Jr. At Muskingum University, faculty and staff lead a small team of four to nine students in volunteer work at an organization that fosters positive community development. The goal was to avoid a drop-in, one-and-done form of community service, and to aim at establishing a partnership relationship over the long term. To that end, this experience always includes small group and large group reflection exercises. In the most recent round of these activities, I was impressed with the increase in cultural humility among my team. In our van ride, the reflection discussion revealed the students’ newfound awareness of the level of poverty in our region. Their interactions with the people they were helping allowed our team to understand them as individuals. The desire to help more, and to learn more, was present in all members of the group.
Vocational exploration exercises that focus on cultural humility can be embedded in curricular and co-curricular on-campus events as well. Individuals can be invited to a class or club meeting where they give a short presentation, followed by an opportunity to ask questions in a safe space. This on-campus experience could be used to guide students to practice cultural humility—to better appreciate those who are different, and to come to understand some of the context of their lives. This in turn can lead to a recognition and appreciation for the differences within the student body itself; hence, in addition, peer-to-peer interactions could be organized to give students additional opportunities to practice cultural humility.
From Individualism to Belonging
As Willie James Jennings observes, our education system “has yielded tremendous knowledge of a vast number of things, but it has also formed isolating life through isolating ways of looking at life.”37 The solitary lens of the white self- sufficient master leads us to miss out on the cultural fragments throughout our universities, communities, and the world; we practice an educational system that focuses on the individual. That practice seeks to “make us safe from seeing our fragment work and conceal what the fragment aims toward: communion, the working and weaving together of fragments in the forming of life together.”38
We can witness this “concealment of the fragments” in the ways that our approach to pedagogy in science focuses on the knowledge that is appropriated by individuals—undergraduates, graduate and professional students, health professionals, and research scientists. They accumulate a vast amount of scientific knowledge, but they often do so as isolated individuals—remaining limited in their ability to collaborate, communicate, and supplement their knowledge with details that are only known to others. In Jennings’s terms, they may be tempted to see their own scientific expertise as complete in itself—not recognizing that it is indeed a fragment that needs to be completed by other fragments. They may be limited in their ability to conduct the best research and/or provide the best care for patients. We are often limited by our lack of understanding of the real experiences of others.
If we do not listen to and understand others, medicine and research will frequently fail many—as Jennifer Brea eloquently explained in her 2016 TedTalk about the experience of being diagnosed with chronic fatigue syndrome (CFs). Prior to that diagnosis, her affliction was labeled as conversion disorder—what was previously called hysteria. Her neurologist observed that her symptoms were real, but that they had no biological cause. Her disorder was considered psychosomatic; it was “in her head.” And yet, her psychiatrist said, “It’s clear you’re really sick, but not with anything psychiatric. I hope they can find out what’s wrong with you.”39 Every expert was operating inside a closed, individualist conversation, rather than collaborating in community. The problem was exacerbated by insufficient funding for research and study of the disease;40 no individual specialist, working alone, had the knowledge or the tools needed to define what was wrong with Jennifer’s body. More importantly, these communities did not have the commitment of time and resources to work together to understand an affliction that did not fit into the current knowledge and diagnostics in any one of their specialties.
As this example indicates, individualistic approaches in medicine and research are closely related to the aforementioned problems of othering and mastery. I have suggested the need to transcend othering by focusing on acknowledging others and embracing them, and to transcend scientific mastery through the practice of cultural humility. In a similar vein, moving beyond individualism requires us to form a culture of belonging, which naturally includes a desire to know the other and to meet the needs of the other. This again is an ethical injunction that is emphasized in a variety of religious traditions and philosophical perspectives: a recognition that we are not isolated individuals, but that we belong to one another. Jesus makes this point in his description of the last judgment (sometimes known as the parable of the sheep and the goats). When he tells his followers that they have (or have not) provided him food when hungry and drink when thirsty, they are confused; they don’t recall seeing him hungry or thirsty. But he emphasizes that we are all connected: the ways that we have reacted to the needs of others (“the least of these”) is a manifestation of the ways we have reacted to those to whom we consider most important (Matt. 25:34–46).
I would argue that the majority of physicians and the scientific funding community have seen CFs patients as pure individuals—as isolated cases, rather than people whose lives are deeply interwoven with others. The boxes on their charts could be checked; due diligence had been carried out. There is an alternative: working to create a space where those who are “other” to us are seen as part of the whole, as people who belong. As Jennings suggests,
the deepest struggle for us all is a struggle for communion. . . . We belong to each other, we belong together. Belonging must become the hermeneutic starting point from which we think the social, the political, the individual, the ecclesial, and most crucial for this work, the educational. Western education (and theological education) as it now exists works against a pedagogy of belonging.41
The same is true, I believe, in scientific education. At its fundamental level, facilitating belonging requires a willingness to be attentive to others, a willingness to embrace them, and an abundance of cultural humility in the midst of these interactions.
Cultivating Ubiquitous Belonging
The potential for the development of belonging has been influenced by the impact of the combination of our current technology age and the COVID-19 pandemic. These realities have led to fewer interactions among students. some suggest that our current undergraduates are living in a two-dimensional world. Through social media, they experience a highly manipulated view of the world, shaped by individuals who may have little interest in the common good. This leads students to develop unrealistic expectations about their appearance, their performance, and their achievements; the examples they see are only at the extremes (either perfection or total failure). These unrealistic expectations have led many students to experience increased anxiety and depression, exacerbated by our societal desire for immediate gratification. What students do not see, through the tiny social-media windows into the lives of others, are the factors that actually make for a good and successful life—including the many, many hours of study, practice, and hard work exerted over years. Undergraduate education should require students to experience a three-dimensional world; it should allow students to connect to other actual human beings, and not just to their highly curated social media personas. In this regard, peer-to-peer interactions can be of integral importance and can even aid in students’ appropriation of critical course concepts. This, coupled with the fundamentals of a “team science” approach in both theory and practice, could lead to a healthier student population and more effective collaboration among these future professionals.
Paths can be generated in undergraduate education to nurture movement away from pervasive individualism in our society toward a place of belonging. In Jennings’s words, we need to dispense with the assumption that “to know a thing is to possess a thing,” and instead embrace a “journey to know.” Through this journey we can recognize the fragmentary nature of our individual knowledge and draw these strands together as we learn from others. A life marked by the regular practice of gathering these fragments will lead us through what Jennings calls “steps toward a formation of belonging.”42 Such formation would promote deeper understanding in scientific research and greater care within our health-care settings. This journey to know requires that our students embrace the importance of extending a sense of belonging to others (communion), and that they recognize this to be of equal value with mastering scientific concepts and content. Through regular practice of attentiveness and cultural humility, our undergraduates can collect these fragments. We can begin to weave a new way of knowing that leads us toward the “elusive goal—life in a place of communion.”43
Vocational Exploration and Belonging
A wide variety of vocational exploration exercises already exist that are primed to cultivate belonging within the undergraduate experience. I will highlight a few such exercises that have been incorporated into science courses. It is important to scaffold experiences and practices as students develop throughout their undergraduate years. The goal of these practices is to lead students through a progression from attentiveness toward cultural humility and eventually toward the formation of belonging.
Communication. In the digital age, face-to-face communication is less prevalent, especially among undergraduates. In order to mentor students in experiencing others, we must first help them practice face-to-face communication with their peers. I use a “speed dating” exercise, in which students form two lines, with each person facing one person in the other line. students say their name and describe a restaurant they enjoy. After about 30 seconds, one line moves down so they are facing a different classmate; the person on the end moves to the opposite end of the line. This process continues until they return to their starting position. I continue to use this practice throughout the semester, changing the question to something more challenging, such as explaining a difficult concept that we had just covered.
Additional experiences for first-year students could include simply meeting with others outside of class, focusing on the ways that others experience life differently than they do. Mentorship is critical to ensure that the experience does not replicate pre-existing hierarchies. In addition, students need to be asked to reflect on their experiences in this practice, whether through a spoken description of what they learned from a classmate, or a written response guided by a reflection prompt.
Studying in Communion. scientists at Calvin University have spearheaded an approach to integrate such practices into science courses and research curricula. I have adopted these practices within some of my biology courses; one such practice is the communal practice of study. This practice is designed to develop a posture of curiosity about others. In contrast to the typical approach of studying alone, this communal practice “requires an orientation to the other and a desire to hear what the other has to say.”44 The aim is to learn from others, without heavy restrictions on what is being learned. This practice of study can be extended beyond the university setting; for example, students can be asked to interview others about a disease or disorder from which they suffer. The goal would be for the students to better understand the person and their realities. This exercise is especially productive when students interview individuals who suffer from diseases or disorders for which the patient is often blamed, such as addiction or self-harm. These experiences and subsequent reflections may allow the trainees to develop empathy and/or a better appreciation for the perspective, concerns, and experiences of those whom they will study or for whom they will provide care.
Appreciation and Hospitality. In an exercise that I use in an upper-level biology course, students are asked to identify a lesser-known “hero” whom they admire and to prepare a short video describing the hero’s strengths and values. As the students consider this person, they are asked to consider whether they would incorporate some of the hero’s values and passions into their own lives. This exercise exposes students to a variety of other human beings, many of whom they would not have otherwise considered. It also leads them to develop an awareness of the challenges faced by others, kindling a desire to know others and foster their imagination as to how they might better address the needs of others. students are encouraged to create a space of belonging, in which the other is not merely an individual but a part of the whole.
The vocational exploration practices developed by Calvin University science faculty create a space of belonging through the communal practice of hospitality. They define this communal practice as “the act of generously welcoming guests or strangers to our homes or communities and to our tables.45 In a scaffolded experience, students are first made more aware of others, so that they can learn to practice hospitality to these others. This practice can begin in spaces with which students are more familiar, perhaps practicing hospitality with their peers on campus, before extending this experience to those beyond the campus community.
A myriad of stories—from fiction and from real life, in religious and secular settings—provide examples of people who love one another. If they are positive examples, they do not describe love offered conditionally, love that requires others to adapt to the specific form of love on offer. The best examples are those in which love for others is offered without judgment about the other person’s social status, daily practices, level of education, or sickness or health. Love offered in this way encapsulates this essay’s focus on embrace, humility, and belonging.
An attitude of love can help us create a space for belonging in our classrooms. Doing so will require regular practice, in which we develop the habitual desire to know others truly. If we introduce undergraduates to genuine practices of vocational exploration, and if we help them to see that this work is of equal importance to the mastery of scientific concepts, the payoff can be considerable: a doctor’s office or a research lab in which patients and research subjects are not mere statistics, in which they do not need to conform to societal norms in order to be understood and to receive the best care. In that setting, physicians and scientists will have practiced the work of knowing others and loving others; they will have developed a desire for communion with others. They will hunger to discover, unearth, and hold close the cultural fragments that they can contribute, and to connect their own fragments with the fragments of others.
Other benefits might accrue as well. Physicians and researchers might develop greater curiosity about, and empathy toward, those who feel overwhelmed by the world around them. Patients and research subjects might experience lower stress and a greater desire to collaborate. Physicians and researchers might be less likely to become disillusioned, to suffer fatigue, or to burn out. Through an embrace of the other, the development of cultural humility, and the development of true belonging, science students can help us move toward the elusive goal of research discovery and patient care as spaces of communion.46 Not only should undergraduate science education encourage these goals in theory; it needs to develop these elements as an ongoing practice. Only then will we be able to imagine a future where standard medical care and research practices are pervaded by embrace, humility, and belonging.
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