Metaphors – they can literally improve our HPSR teaching

It has long been shown that metaphors are fundamental to how we experience the world, understand it, and take action in it. Building on this insight, this blog highlights different types of teaching and learning metaphors, which influence both the teaching practice of educators and the learning experience of students. It argues that health policy and systems research (HPSR) teaching can be improved and the HPSR-field itself strengthened by reflecting on, discussing and perhaps even doing further research on teaching metaphors.

Far from being mere figures of speech or linguistic flourishes, metaphors are at the heart of how we understand and take action in the world – whether that world is life in general, our work in health systems, or teaching health policy and systems research (HPSR). As Lakoff & Johnson argued in their influential book Metaphors We Live By: “…metaphor is pervasive in everyday life, not just in language but in thought and action. Our ordinary conceptual system, in terms of which we both think and act, is fundamentally metaphorical in nature.”

Expanding and supporting HPSR teaching require many different strategies. Emerging educators in HPSR, for example, have highlighted challenges such as defining what exactly HPSR is, advocating for the worth of HPSR and establishing a place for it in the curriculum, and staying current with an emerging literature in which concepts and methods seem to be in flux. To this list one could add expanding the pool of educators, thinking about the qualification levels at which HPSR is taught, and finding ways to work together in a context of scare resources.

In addition to thinking about what we are teaching, the resources required for teaching and embedding HPSR teaching in our organisations, improving HPSR teaching also requires us to think about how we approach and conduct the teaching itself. Metaphors can be useful tools in such reflections and discussions.

Examples from the literature
There is, in the field of educational studies, an interesting body of work that explores the metaphorical underpinnings of teaching and learning practices.

In quite a philosophical and abstract way, authors such as Sfard have sought to describe foundational metaphors that reveal basic assumptions about how we conceptualise teaching and learning, as well as act in our roles as educators or students. She contrasts the acquisition metaphor (learning as acquiring knowledge, concepts, facts, meanings etc.) with the participation metaphor (which emphasizes learning-through-doing in particular contexts and entails becoming part of a particular learning community).

Much more practically, various researchers have documented the teaching metaphors of both experienced and prospective teachers. For example, Saban et al. studied the detailed metaphors of prospective teachers and sorted these into 10 categories, which are summarized below.

Approaching the task from a different conceptual perspective, Martínez et al. worked with experienced teachers to identify their behaviourist/empiricist, cognitive and situative/socio-historic metaphors. Returning to pre-service teachers, Gurney identified teaching metaphors of delivery, change, enlightenment, and humanics.

In addition to documenting and analyzing teaching and learning metaphors, Tobin has used vignettes to show both the combination of metaphors that teachers bring to the classroom and how changes in metaphors can bring about significant changes and improvements in the practice of teachers and the experience of students. As he concludes:

“The metaphor used to make sense of a role was a master switch for teachers’ associated belief sets. If a switch is thrown (i.e., the metaphor is changed) a host of changes follow (i.e., as new beliefs are deemed relevant to the role. Reconceptualizing a role in terms of a new metaphor appeared to switch an entirely different set of beliefs into operation.”

Such change is possible because, in as much as metaphors help us to understand and guide our actions, they are also always partial, so that a change in metaphor might bring a better fit with the situation or allow us to focus on aspects of the situation that were obscured by the previous metaphor.

How can thinking about metaphors support HPSR teaching and the field of HPSR?

• For individual HPSR educators or groups of educators in organisations, it can be rewarding to reflect on the metaphors they bring to the teaching task. This might stimulate different ways of doing and improvements in practical teaching tasks such as the presentation of information, organization of classes, and conducting assessments. However, it can also have wider relevance because our approach to teaching communicates (or not) other values such as inquisitiveness and collaboration that will impact the kind of graduates produced by HPSR programmes.
• Teaching metaphors can be a fruitful topic of discussion (and perhaps even research) among HPSR researchers across organisations and countries. As much as it is essential to talk about what we teach, who does the teaching, how we can increase teaching resources and how we can boost the recognition of HPSR, it is also necessary to reflect on how we teach. A consideration of metaphors is one potential entry point into such a discussion.
• Reflection on teaching metaphors can support and enrich the inter-disciplinary basis of HPSR. The standard definition of HPSR is that it is an inter-disciplinary blend of economics, sociology, anthropology, political science, public health and epidemiology. As we think beyond the doing of HPSR to the teaching of HPSR, it might serve us well to ensure that the discipline of education is a clear ingredient in this mix. The topic of educational metaphors presents one concrete way of creating a bridge between these different worlds.

Ermin Erasmus, CHEPSAA coordinator