||Liberal Education, Spring 2005
Pedagogies of Uncertainty
By Lee S. Shulman
There are those who believe that professional
education is a corrupting influence that must be kept at bay
in order to preserve the purity of the mission of liberal
education. At the Carnegie Foundation for the Advancement
of Teaching, we disagree. We are engaged in a long-term program
of research on how professionals are educated, even as we
collaborate with the Association of American Colleges and
Universities (AAC&U) and with the Wabash Center for Inquiry
in the Liberal Arts on studies in liberal education. We pursue
these two efforts concurrently and interactively because we
assert that each field has much to learn from the other. Professional
education poses compelling pedagogical challenges that can
and should inform all sectors of education, including undergraduate
liberal education. Of course, studying professional education
is not new to us. We began in 1910 with the Flexner Report,
the first major study done by the foundation, which irreversibly
changed this country's education of physicians.
In professional education, it is insufficient
to learn for the sake of knowledge and understanding alone;
one learns in order to engage in practice. Professional
education involves teaching ideas, facts, and principles so
that they can contribute to skilled professional practice.
Professional pedagogies are continuously attempting to forge
connections between key ideas and effective practice. But
a true professional does not merely practice: he
or she performs with a sense of personal and social responsibility.
In the work of a professional, the performances of practice
must not only be skilled and theoretically grounded; they
must be characterized by integrity, by a commitment to responsible,
That said, it's also insufficient
to claim that a combination of theory, practice, and ethics
defines a professional's work; it is also characterized
by conditions of inherent and unavoidable uncertainty. Professionals
rarely can employ simple algorithms or protocols of practice
in performing their services. How then does a professional
adapt to new and uncertain circumstances? She exercises judgment.
One might therefore say that professional education is about
developing pedagogies to link ideas, practices, and values
under conditions of inherent uncertainty that necessitate
not only judgment in order to act, but also cognizance of
the consequences of one's action. In the presence of
uncertainty, one is obligated to learn from experience.
Are there connections between these ideas
and the goals of liberal education? I would say that learning
ideas, practices, and values, and developing the capacity
to act with integrity on the basis of responsible judgments
under uncertainty, and to learn from experience, is a reasonable
description of what liberal learning should be about, as well.
In January, I conducted a site visit
to the teaching hospital of a major American medical school.
These visits are an integral part of our ten-year program
of research on how lawyers, engineers, clergy, school teachers,
nurses, and physicians are taught and how they learn. At the
teaching hospital, I joined a team of students and faculty
in the daily ritual of clinical rounds. I use the term "ritual"
quite precisely: they follow the same pedagogical pattern
daily as they move from patient to patient and review their
status. The clinical rounds team included a chief resident,
a third-year resident, two first-year residents, two third-year
medical students beginning their internal medicine rotation,
and a pharmacy student on internship. Each of seven patients
comprised a "lesson" within a unit of instruction.
We stopped outside every room. The resident or medical student
responsible for that patient gave a report that followed a
strict outline. We talked about what had changed from the
previous day. Patients ranged from someone who had been in
the intensive care unit for less than twenty-four hours to
one who had been in a coma for thirty days. After thirty days
of clinical investigation, they still didn't know the
causes of this patient's condition.
These were indeed pedagogies of uncertainty;
students at all levels were learning how to act under conditions
where knowledge is limited yet actions must be taken. Patient
after patient, the same routine continued. At some bedsides,
they only discussed; at others, they would listen to an interesting
heart sound or palpate the abdomen. I had come to observe
the learners and their processes of learning, but the longer
I stayed the more it became unclear who the learners were.
The people teaching were also learning, and roles reversed
and shifted constantly.
Next, the chief resident discussed what
had occurred during the rounds with the third-year resident
in a preceptor interaction, essentially like a supervising
teacher with a student teacher. They reviewed how rounds had
gone pedagogically and talked about what other questions one
might have asked, what other aspects of patients' conditions
one might have noted, and how well patients were managed and
whether to do something different. We then moved to teaching
rounds, in which the chief resident presented a didactic seminar
on pulmonary function tests. Finally, we went to M&M,
Morbidity and Mortality, otherwise known as, "Where
Did We Screw Up and What Can We Learn from It." Pretty
much the same group from morning rounds reconvened, joined
by other faculty. They reviewed at an institutional level
one of their most persistent failures, namely the unacceptably
high infection rate associated with running central lines
into arteries. Data indicated that the infection rate is higher
when lines are run from certain locations in the body, and
lower when run from other locations. Everyone in the system
was learning. In fact, an assistant professor ran the session,
with full professors learning alongside third-year clerks.
This communal questioning and learning
is compelling. Where in higher education do we find an institutional
pressure to come together and ask why students are not learning
mathematics or economics well, and what to do institutionally
about that? What I watched at this medical school was an institution
knowing, caring, and operating corporately to improve student
But let's focus on the pedagogy,
one of active student participation. It began with students
reporting and then becoming interactive, pushing one another
to clarify, elaborate, extrapolate, and explain, finally concluding
with plans for what to do next. The "doing" included
not only medical interventions, but also strategies for how
to relate to human beings affected by tragedy, for what to
say to family members, and what to do if the plan doesn't
go well. The pedagogy is one of inherent contingency and uncertainty.
The content of instruction is uncertain. Because the teacher
doesn't always know what the students will report until
she hears them, she has to deal with substantive uncertainty
even though the learning protocol itself is fixed in ritual.
This is an important point: it's routine, yet never
the same; it's habitual, but pervaded by uncertainty.
Three years earlier, I had a parallel
experience. We were studying legal education, which has the
distinctive pedagogy of the case dialogue method. In 1875,
Christopher Columbus Langdell, then dean of the Harvard Law
School, decided that the lecture method of teaching black-letter
law made no sense. And so he invented a new pedagogy that
gave greater agency to students to engage with cases, analyze
them, defend their explanations, and argue with one another,
all under the control of a Socratic teacher. Across America
today, from law school to law school, the pedagogy of a contract
law class is the same at all institutions. They practice what
we at the Carnegie Foundation have been calling a "signature
pedagogy." It pervades all courses in the first year
and cuts across all institutions teaching law. If you ask
people what they are teaching, they'll answer that they're
teaching folks "to think like a lawyer," and,
sure enough, a mode of thinking is being developed across
the profession. The students catch on very quickly.
In addition to pervasiveness and routine,
the level of engagement in first-year law classes stands out.
At any moment the professor may say, "And Mr. Shulman,
do you agree with Ms. Smith's account of the case? If
you do, I'd like you to repeat in your own words her
account. If you don't, begin by giving your account
of Ms. Smith's courageous attempt to summarize the facts
of the case and then offer your own argument." While
impressed by the engagement level of students in medical rounds,
one might counter that it's not hard to keep six students
engaged. Well, a contract law class might have 120 students
in a semicircular lecture hall--curved so that students
can see one another, and with the faculty member typically
at the bottom of the circle. The faculty member always makes
eye contact with students when engaging in quasi-Socratic
dialogue. The level of engagement with 120 students is the
same qualitatively as with six students in clinical rounds.
Another interesting commonality is that both pedagogies begin
with the faculty member saying "tell me about your case."
Although distinctive, signature pedagogies
share some general features. By studying the pedagogies of
professions and their signatures, we gain insights into teaching
that cross both professional lines and the divide between
the liberal and the professional. Educators of lawyers can
learn from educators of physicians. For example, lawyers are
not taught to practice; law schools are nearly devoid of clinical
instruction. Law schools do a brilliant job of teaching students
to think like a lawyer, a marginal job of teaching students
to practice like a lawyer, and a questionable job of teaching
them to be professionals with a set of values and moral commitments.
The pedagogies of medicine, however, put enormous emphasis
on learning to practice the profession. Education is a seamless
continuum in which each segment has consequences for all others,
and the pedagogies of the professions also may yield insights
into teaching in the liberal arts or even in K–12 settings.
Let's return to my hypothesis about
the distinctive features of signature pedagogies: they're
pervasive, routine, and habitual. These features are adaptive,
because learning to do complex things habitually in routine
ways liberates the mind to concentrate on other things. We
all know the dangers of routine. There are great virtues to
the routines of signature pedagogies, however, and these routines
differ by purpose. Legal education routines develop habits
of mind. Clergy education routines develop habits of the heart.
Clinical rounds in medicine or studio design in architecture
or engineering develop habits of the hand, of practice and
performance. Moreover, routines permit students to spend far
less time figuring out rules of engagement, which enables
them to focus on increasingly complex subject matter. One
persistent error teachers make is to get a bright idea for
a different way of teaching and then to spring it on students
without preparation. Suddenly, a teacher unleashes a combination
of group collaborative learning with portfolios and technology
and expects students to respond positively to this new game.
The students don't even know how to begin.
Another universal feature of signature
pedagogies is that they make students feel deeply engaged.
Students feel highly visible and even vulnerable. A persistent
problem of most forms of education is that they permit student
invisibility, which breeds disinterest and leads to zoning
out and non-learning. Learning requires that students feel
visible and accountable. Signature pedagogies make it hard
to disappear and become anonymous. Furthermore, signature
pedagogies tend to be interactive, meaning students are not
only accountable to the teacher but also to fellow students:
just because it's your turn to talk doesn't mean
you can say whatever you want. In fact, "accountable
talk" is one feature of signature pedagogies. The student
must build on what somebody before has said; he or she must
respond, must offer counterargument, new data, and cogent
commentary. So signature pedagogies breed accountability of
performance and interaction, as well as simply removing the
cloak of invisibility.
This accountability leads to a much higher
affective level in class--students feel more anxiety
when participating in signature pedagogies. That anxiety derives
from the risk involved in putting forward ideas and defending
them, from knowing that one must be prepared for class, from
the fear of making a fool of oneself. The anxiety is either
adaptive or paralyzing. Managing levels of anxiety is a major
responsibility of the teacher, but is also a responsibility
of the collective. Because they all feel it, students must
learn how to simultaneously challenge and support each other's
thinking. In these settings, the presence of emotion, even
a modicum of passion, is quite striking--as is its absence
in other settings. I would say that without a certain amount
of anxiety and risk, there's a limit to how much learning
occurs. One must have something at stake. No emotional investment,
no intellectual or formational yield.
The last thing I'll say about signature
pedagogies is a contradiction, for I'll make the Darwinian
claim that they survive because they succeed. At the same
time, I'll make the Newtonian claim that some things
continue just because nothing deflects them in another direction--pedagogical
inertia. Despite inertia, signature pedagogies survive because
they succeed more often than they fail in producing student
learning. However, almost all signature pedagogies need repair;
there's likely a price to be paid in achieving a signature
pedagogy. Case dialogue is a powerful pedagogy, but law schools
have to do something about the fact that, as effective as
they are with habits of the mind, they don't teach habits
of the hand or of the heart. Medicine also must do something,
because medical training takes too long. Also, unlike in engineering,
where students refer back to math and physics in designing
mathematical models, clinical reasoning rarely references
the basic sciences. Why? Moreover, the medical curriculum
is disappearing. The essence of clinical rounds depends upon
sick people going to the hospital and staying in bed. But
how will anybody learn about gall bladder surgery if the patient
is sent home after eight hours, which is standard these days?
Even signature pedagogies must adapt to changes in the conditions
of work and in society and to evolving norms of practice.
Ritualized patterns of all kinds--direct
teaching, laboratory investigation, collaborative design,
Socratic exchange, clinical rounds--model values and raise
emotions. They make signature pedagogies, for better or worse,
pedagogies not only of uncertainty but of formation, because
students develop personal identities and values growing out
of pedagogical interactions. I say for better or worse because
sometimes signature pedagogies don't model what we ultimately
desire in professionals. For example, in law classes dealing
with damages (torts), someone raises a hand and says, "I know
that's the law, but it doesn't seem fair." And all across
the country the professor responds, "This class is not about
fairness, it's about the law." As Karl Llewellyn notes in
his lovely book The Bramble Bush (1981), law school's
first year requires you to check your conscience at the door
and learn to think and reason like a lawyer. The challenge
of legal education is to ensure students don't forget to reactivate
their consciences before they leave. Alas, that's too often
an example of the failure of a pedagogy of formation. Therefore,
the Carnegie Foundation is studying the education of ministers,
priests, and rabbis and trying to understand the pedagogies
that characterize formation in those professions.
I could say so much about the education
of clergy, but I'll make one point only. A key signature
pedagogy of the clergy is homiletics, learning to preach.
Teaching someone to give a sermon is not a course in performance
or rhetoric. As Evans Crawford, for many years dean of the
chapel at Howard University Divinity School and professor
of homiletics, described it to me, homiletics involves making
a connection between interpretations of sacred text and critical
analysis of social, political, and personal problems in a
theologically authentic way--and giving a heck of a good
sermon that moves people emotionally to engage in that connection.
Note the importance of connection. One connects hermeneutics,
the deep, interpretive understanding of sacred text, to constantly
shifting political, personal, and societal problems, and further
connects these two realms by acts of persuasion and inspiration,
conducted by and large through the spoken word.
It's no accident that the practical
action attached to the Bible course I audited at Howard University
Divinity School was called "prophetic ministry."
Students don't just study Hosea and Jeremiah; they go
out into the field and act in a Hoseac or Jeremiac way, whether
lobbying on the Hill or working with the homeless. This is
powerful stuff. It's the essence of what is meant by
moving ideas into practice and transforming practice into
social responsibility and moral behavior. And all of this
is done under conditions marked by the shifting sands of the
uncertain world around us. That's what these pedagogies
of uncertainty seek to achieve.
Raising expectations and keeping
In translating AAC&U's expressed
mission for the next ten years regarding liberal education
and what students can and should learn, I want to convey excitement
about "raising our expectations and keeping our promises."
We all must get smarter and become much less sanguine about
what we can and cannot do pedagogically. Part of what we have
to learn we must learn from one another within the universities
and colleges, broadly construed. One source of learning, I
argue, is the study of successes and failures associated with
signature pedagogies of the professions. Are there signature
pedagogies in undergraduate liberal education? One could argue
that such a signature pedagogy is, by default, the large lecture.
But it lacks precisely the distinctive features of signatures
that make them so powerful. Students are disengaged, invisible,
unaccountable, and emotionally disconnected most of the time.
Some of us would plead that liberal education's signature
pedagogy should really be the seminar, featuring kinds of
interactions between students and teacher that more readily
mirror signature pedagogies in the professions. And I believe
we are learning that we can accomplish many of those features
even within a large-group setting.
At AAC&U's 2005 annual meeting,
journalist and Carnegie Foundation Visiting Scholar John Merrow
previewed his documentary "Declining by Degrees"
and featured the case of Tom in his presentation. Tom teaches
astrophysics (every undergraduate's first love) to over
one hundred highly engaged students, almost none of whom are
majoring in the area. As I analyzed what Tom was doing--how
he organized instruction, used wireless response devices distributed
to the students (clickers), moved from large- to small-group
interaction and back within a traditional lecture hall--I
realized he was modeling features of signature pedagogies.
Students had lost invisibility because they had to engage
in an accountable click, and their names were on that clicker.
When students vote for an option on the screen, everyone knows
how they voted; they're not entitled to anonymity. Then
students talk to one another and get to revote. Tom was, to
me, a vision of the possible. He's not some charismatic
figure. He's an ordinary teacher in a discipline that's
really tough to teach to people who aren't majoring
in it. But he feels it is his responsibility that those students
learn astrophysics. And he's not just meeting them halfway;
he's going all the way and bringing them along. That
kind of teaching should be within the grasp of any faculty
member. It is not magic, it's pedagogy.
I shall conclude by returning to the
medical Morbidity and Mortality conference that reported on
infection rates of central lines. During the last half of
the meeting, the facilitator noted that every major hospital
has a problem with high infection rates for central lines,
especially in the femoral artery. Unfortunately, it's
easiest for medical practitioners to run a line in the femoral
artery. (Perhaps running femoral lines is analogous to running
lecture courses; they're not necessarily the most effective,
but they deliver the goods to the largest number at the lowest
cost.) In any case, the facilitator mentioned that Johns Hopkins
had decided that the high infection rates were unacceptable.
The medical school dean and the university president met with
the teaching hospital staff and decided they knew enough to
reach a zero percent rate of infection. The problem was not
absence of knowledge of best practice, but absence of discipline
and commitment to apply that knowledge. Therefore, they developed
a protocol for running central lines.
The protocol involves things such as
how carefully and frequently hands are washed, and not making
things easier on oneself by using the same line to draw blood
and to deliver medication, because the odds for an infection
zoom up every time that happens. Nurses enforce the protocol
and oversee each procedure, and nurses are empowered to abort
a procedure as soon as they see protocol being violated, whether
by an intern or by the department chair. Every nurse was handed
two phone numbers--the home phones of the medical school
dean and the university president--and was told that
if a physician didn't follow protocol and refused to
abort the procedure, they were to phone one of these numbers,
even at 3:00 a.m. It only happened once. The infection rate
at Johns Hopkins for that procedure is now approaching zero.
Like infection rates, the failures of
liberal education are often procedural. In the Morbidity and
Mortality conference, the discussion of acceptable levels
of infection sounded like arguments about acceptable levels
of student failure. If one-third of students drop out in the
first year, some may be ready to claim that those students
simply shouldn't have entered college. What if a hospital
said that if it lost a third of patients, those patients never
should have been admitted because they were too sick? Faculty
and teaching institutions have lots of impediments, just like
physicians. But what if at some universities the president
was called every time a student failed? We can do so much
better, and research in the cognitive sciences and other fields
supports this. I know we lack the resources. I know we lack
the administrative and policy support. I know some students
we inherit are already deeply wounded. Nevertheless, we have
to make the commitment. We need to respond to the pedagogical
imperative. And if we do, then raising expectations and keeping
promises will not be empty rhetoric but prophetic ministry.
We can hardly afford to do less.
Llewellyn, K. N. 1981. The
bramble bush: On our law and its study. Chicago: Kazi
Lee S. Shulman is president of the Carnegie
Foundation for the Advancement of Teaching.
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