Quality and constructed knowledge: Truth, paradigms, and the state of the science

Abstract

Context and truth: Education is a social science. Social science knowledge is related to its context of origin. The concept of global 'truth' in education is therefore of limited use when truth is tempered by context. The wider applicability of our knowledge can only be judged if we look at the context in which that knowledge was produced and the assumptions that underpin it. This calls into question the idea that educational research is a quest for global 'truth', although in relation to programme evaluation, truth tied to context is an aim. An analysis is presented of the effects of social construction on research and evaluation processes, on the selection of paradigms, reporting and interpreting findings, and on the ethics of all this.Quality and improvement: Quality improvement is based on information selected, constructed and interpreted by those who gather, analyse or use it. The strength, and not the weakness, of our knowledge is that it is socially constructed, contextual and of its time. Increasingly looking for our own truth about educational quality, and not importing the truth of others, is crucial to the state of the science. In terms of quality development, using others' findings must be based on informed local judgement. In social science, those judgements are linked to social context and their associated ideologies.Implications for future work: The hallmark of social science is not a narrowing of focus and the search for one truth, but is a broadening of concepts, theories, paradigms, reported experience and method, and an intention for each to tell their own truth well. This will lead to a wealth of diverse views and analysed experience.The science of medical education must seek many truths.

Quality improvement as a statement of values

“…It is that spirit of continuous quality improvement that serves as the inspiration behind this year's State of the Science issue in Medical Education . Spearheaded by Janet Grant, Danette McKinley and Jack Boulet, 8 the papers address philosophical questions pertaining to how quality is defined 9,10 as well as practical questions pertaining to what role regulation plays in quality improvement, 11,12 how particular aspects of curriculum and competence might strive towards enhancement 13,14 and what quality improvement looks like when considering issues of equity, diversity and inclusion 15,16 …”

“…It is that spirit of continuous quality improvement that serves as the inspiration behind this year's State of the Science issue in Medical Education. Spearheaded by Janet Grant, Danette McKinley and Jack Boulet, 8 the papers address philosophical questions pertaining to how quality is defined 9,10 as well as practical questions pertaining to what role regulation plays in quality improvement, 11,12 how particular aspects of curriculum and competence might strive towards enhancement 13,14 and what quality improvement looks like when considering issues of equity, diversity and inclusion. 15,16 This, of course, is just a sampling of ways in which the overarching principle of quality improvement 'sends a message about values', none of which should be treated as the final word on the matters addressed; such a mentality, after all, would not exactly align with the notion of continuous quality improvement.…”

Bridging health equity and quality improvement in medical education

“…In their recent paper, Grant and Grant highlight that enactment of QI is related to how QI knowledge is interpreted and co‐constructed by knowledge users 4 . When considering QI education, our field must be intentional about who we consider as knowledge users.…”

Quality improvement: An argument for difference

“…The papers included in this year's ‘State of the Science’ issue of Medical Education show that ‘quality’ implies different things in different contexts; further, they reveal that it is applied differently to many different aspects of education and performance. Grant and Grant, for example, argue that acquiring a generalisable evidence base as a means to define quality is an implausible aspiration 2 . Singh and Meeks offer a more particular perspective by pointing out that global standards for medical education fail to address the inclusion of disabled people 3 .…”

“…Grant and Grant, for example, argue that acquiring a generalisable evidence base as a means to define quality is an implausible aspiration. 2 Singh and Meeks offer a more particular perspective by pointing out that global standards for medical education fail to address the inclusion of disabled people. 3 Together, these papers suggest that treating such standards as a definition of quality may actually reinforce a lack of appropriate quality.…”