CS4: Expectations

A Family Medicine professor travels to an industrialized country to meet with the community partner to plan for an upcoming international service-learning project that he will lead with a class in the following term. While there, the region suffers from a devastating flood. The professor has to decide if he will still bring his students to a potentially unsafe location, but the community partner assures him that they will have a safe place for the students to stay by the time they arrive.

Training & Education

• Who has the ultimate responsibility to decide what is ‘safe’? Community partner? Professor? Students?
• Do you operate from an assumption there a perception that here is “safe” in contrast with danger in other locations?
• What assumptions are we making about safety?

Balance & Reciprocity

• Is the community ready to proceed with the project?
• How safe are international communities from you and your students?
• Where is the community partner in the decision-making process? What does decision-making in a partnership look like? What is an ethical approach to decision-making?
• What are the priorities of the project based upon?

When the professor returns to UBC, he re-constructs his entire course, shifting the focus towards solving the health problems in the community that will inevitably arise after a flood. He prepares the students in the classroom for the technical problems and clinical issues that will arise, and six weeks later they depart. As they drive into the affected region, one of the students brings the group’s attention to a one-acre square of perfectly cultivated green land in the community that is growing rice. The professor abandons his plan to solve the problems in the community, and decides to commence the project with a focus on the remarkable accomplishment the community demonstrates in re-building their agricultural system.

Some of the students struggle to see the connection between the agricultural system and their health project and are determined to go into the community with their plan to prevent disease and illness using a diagnostic method in which they find the “problems” and offer “solutions”. The students also express concern that their time in country is limited and they want to see the most results possible in their short time there.

Motivations

• How do students balance their own motivations with the priorities of the community and project sustainability?
• What is the community partner’s thoughts on the professor’s connection between the agricultural system and the community health project?
• How much of the students’ demand to see “the most results possible in their short time” is reasonable versus selfish?

Training & Education

• What is the appropriate balance and what role does (should) the professor play in raising these dilemmas in training and education, and ongoing interaction with students?
• What is the professor modeling to his students in regards to project planning and implementation?
• The professor reconstructs the course in consultation with who?
• What is the course they are getting credit for and is there a fit? Are they prepared?

In this scenario, students arrive in a rural placement so that they can have a combined experience of service-learning and clinical skills development experience. The professor planned for a traditional problem/solution international development model and worked with the students to identify solutions to the international community partner’s problems. While still at their home campus, the professor encouraged the students to advance problem solve the foreseen issues using a Problem-Based Learning model, and the students departed for the international site prepared to engage in hands-on clinical work.

Problem-based learning (PBL) is often used in university professional programs such as medicine and engineering where professors present case studies that challenge students to problem-solve beyond the textbook. PBL practitioners claim that their students can retain more of the course content when it is applied to relevant case studies and PBL “encourages student autonomy in analyzing cases” (Searight & Searight, 2009, p.1). Gradually the instructor’s becomes less relevant to the classroom process as the students take “responsibility for their learning…and address four dimensions of [learning]: What they know, what they want to know, possible causal hypotheses, and questions that can be answered through library research” (ibid).

Searight, H., & Searight, B. (2009). Implementing Problem-Based Learning in an Undergraduate Psychology Course. InSight: A Journal of Scholarly Teaching, 469-76.

Is there the potential for ethical questions to arise simply by the framing of the pre-departure lessons as “problems”? The language of international development work traditionally rests on an “us/them” dialectic that puts the western aid worker in the role of “problem solver” and the international community in the role of “victim needing help”. The students in this case study spent months of preparation in a mindset thinking the international flood victims were incapable of helping themselves in solving their own problems. For some students, the act of “helping” is so paramount that they will arrive at a site with piles of ideas, plans, supplies, and enthusiastic energy to pour into their altruism. At what point in the preparation of students is it the professor’s responsibility to instruct humility and observation, and at what point is the community partner invited to provide their own solutions to the problem as part of the classroom preparations?

Once at the international site, the professor notices that, within six weeks, the community has started to rebuild their agricultural system. The professor has a moment of humility and realizes that only a community with enormous assets, not problems, could rebuild from a disaster in such a short time. For this reason, the focus of the course shifts away from PBL and towards an Appreciative Inquiry (AI) framework; therefore, “rather than giving priority to the problems in [the] current practice, appreciative inquiry gives attention to evidence of successful practice” (Giles & Anderson, 2008). AI draws on Asset-Based Community Development theory that employs “asset mapping…to compile an inventory of individual and community strengths upon which a partnership could be established” (ibid).

Asset-based community development begins with the assumption that successful community building involves rediscovering and mobilizing resources already present in any community:

• The skills and resources of its individuals.
• The power of voluntary associations, achieved through building relationships.
• The assets present in the array of local institutions, the physical infrastructure of the community and the local economy.

The assumption here is that successful community development is asset-based, internally-focused, and relationship-driven. Although some resources from outside the community are often needed, the key to lasting solutions comes from within. The gifts and skills of residents and the assets of the physical community are always the starting place.

Appreciative Inquiry is a facilitated approach that asks, “What is working well and how do we build on it?” It focuses on doing more of what is already working, rather than focusing on fixing problems. It mobilizes strategic change by focusing on core strengths, then using those strengths to reshape the future:

AI involves, in a central way, the art and practice of asking questions that strengthen a system’s capacity to apprehend, anticipate, and heighten positive potential…AI seeks, fundamentally, to build a constructive union between a whole people and the massive entirety of what people talk about as past and present capacities: achievements, assets, unexplored potentials, innovations, strengths, elevated thoughts, opportunities, benchmarks, high point moments, lived values, traditions, strategic competencies, stories, expressions of wisdom, insights into the deeper corporate spirit or soul– and visions of valued and possible futures. (Cooperider, Sorenson, Whitney, & Yager, 2000)

AI asks you to imagine an ideal future with the underlying philosophy that there is a connection between what a community or organization focuses on and what type of future is created. The assumption is that by highlighting what is strong and vibrant about a community, it will continue to move in that direction. This approach involves first envisioning an ideal future – instead of focusing on needs, or problems – and then identifying assets, strengths and capacities within the community that can be built on to achieve that future. Because the ideal future is built on a positive core that is context-specific (‘the best of what is’ in the particular community) and because the community itself envisions the future – of which there infinite potentials – AI does not provide answers; rather it provides the process for a group of people to come up with their own answers and work towards these together. In a real life scenario, the next steps of the AI process would be to ‘design’ – start to pin down your ideal future into a very tangible vision and list immediate actions to take and then ‘deliver’ – actually doing those actions.

When leading students in an international service project, ethical practice in the field is a result of prioritizing the reciprocal relationship with the community partner. How might a faculty member compromise this relationship by starting with a position of negativity? Instead, AI establishes a relationship with the community partner from a place of positivity and, as a teacher, you are modeling respectful and hopeful interaction with the community partner, showing how “human systems are forever projecting ahead of themselves a horizon of expectation that brings the future powerfully into the present as a causal agent” (Cooperrider, 1990, 97).

Cooperrider, David L. (1990). Positive Image, Positive Action: The Affirmative Basis of Organizing. In Suresh Srivastva and David L. Cooperrider (Ed.), Appreciative Management and Leadership: The Power of Positive Thought and Action in Organizations (pp. 91-125). San Francisco, CA: Jossey-Bass.

Cooperrider, David L. and Srivastva, Suresh. (1987). Appreciative Inquiry in Organizational Life. In W.A. Pasmore and R.W. Woodman (Ed.), Research in Organizational Change and Development (Vol. 1, pp. 129-169). Greenwich, CT: JAI Press.

Cooperrider, D.L., Sorenson, Jr., P. F., Whitny, D., Yaeger, & T.F. (2000). Appreciative inquiry: Re-thinking human organization toward a positive theory of change. Champaign, IL: Stipes Publishing.

Giles, D., & Alderson, S. (2008). An appreciative inquiry into the transformative learning experiences of students in a family literacy project. Australian Journal of Adult Learning, 48(3), 465-478.