Boys in white: student culture in medical school

Critical Analysis

Chapter 3: Perspective, culture, and organization

Most students enter design education with no perspective on the place and experience of studio. Some who have taken classes in art and design or attended an art and design oriented high-school may have encountered some of the constructs of a studio, but most students have not. Even for those who have, the job of being a student in higher education is very different than the job of being a high-school student. As a result, the problems the students encounter are unfamiliar, and they have few patterns upon which to draw to take action in these situations.

One way new patterns are formed is through repeated encounters with a certain type of problem; as Becker describes, “if a particular kind of situation recurs frequently, the perspective will probably become an established part of a person’s way of dealing with the world” (35). Perspectives in studio can be shared when students take on the same problematic situations, as with encountering expectations of publicness or expected behavior in critique. Over time, the perspectives of students in studio gain force, and have the “prima facie validation which accrues to those things ‘everybody knows’ and ‘everybody does’” (36).

A problem design students encounter is one of ambiguity: expectations from faculty are vague and inconsistent, and the assignments themselves are ill-formed, as design problems typically are. A perspective on how to address these problems may have yet to be formed. Language around these problems insists on risk-taking and failure, with those words poorly defined; as a result of an ambiguous situation framed by specific language, students begin to take action and those actions formalize. Ambiguity and risk-taking language is persistent, and the definition of a risk becomes normalized: it may be a risk of trying a new material, a risk of exploring an unexpected design idea, a risk of a new strategy for approaching a problem, a risk of a new tactic for approaching a problem, and in all cases, a risk of running out of time to complete an assignment by the time it is due.

The type of risk and the way risks should be ideally resolved become group perspectives—the perspectives are patterns of thoughts and actions that many students engage in. Risk-takers who deviate from the shared perspective—by taking different types of risks, responding to risks in different ways, or not taking risks at all—are deviants; risk-taking itself is a common, shared, and normalized activity, and so is not a deviant behavior.

Student culture is a way of understanding the coherence and consistency of the different perspectives at play in studio, and studio culture extends that coherence beyond a single participant—students—to describe a perspective held not only by groups of students but by the faculty as well. But the perspectives are not the same, and conflict, frequently. What’s more, the faculty “create the problems to which the perspectives of student culture comprises some kind of solution.” This is because the faculty hold power over the students, and “in principle, can control student activities very tightly and cause students to act in whatever fashion they (the faculty) want” (48).

Risk-taking becomes a problematic situational phenomenon. Some studio cultures have come to encourage certain types of risks to be taken; these are norms that are often unstated, or alluded to only gesturally, and are lost in the ambiguity that is normalized in the studio experience. Individualized attention from faculty adds small bits of clarity, which over time forge a student’s perspective and, when repeated enough and with enough autocratic emphasis, form a group’s shared perspective.

A force that lies, often undefined, under the emergent understanding of what makes a design good is what an instructor thinks is risky, and what is a risk worth taking, and how the place of studio is structured in order to perpetuate the group perspective related to normalized risk-taking behavior.

Chapter 5: The long-range perspective (“Best of all Professions”)

Students enter an academic experience with a naïve view of the profession they are studying. That may be due to a lack of knowledge about their selected major or due to an idealized view of the profession itself, and is enhanced or made obvious by a lack of models on which to draw during learning. In any group situation, members go through a learning process where they work to “define their situation sufficiently, although often inaccurately, to be able to adopt what seems to them appropriate behavior” (67). Students may have experienced art education in some way in high school; design is different than art, and it is very different than the sciences that were more likely taught and learned. But more important than the difference in subject matter is the different way in which it is learned, and this is where a challenge emerges, as “beginners may find the new environment so different from any they have experienced before that the understanding necessary to deal with it comes slowly or not at all” (67).

Becker described that students in medical school enter with a “wide-angle lens” (69), where their perspective lacks detail or specificity and instead tries to take in everything at once. This is not a difference between a short and long-term view; instead, it includes a long-range perspective that “may be emotionally intense, but is necessarily vague.” Studio is the same. Students hold an end-game that is fuzzy and poorly defined. The timeline to reach a goal is vague, the description is general and lacks detail, the path towards the goal is unclear, and the goal itself is often only a seed of an idea.

In medicine, the long-range perspective held by students is unspecific and idealistic, and students have mental images of “featureless patients, occasionally with other physicians, but most frequently with the student himself in the role of the ideal physician he hopes to become” (72). The resemblance to studio is clear. A wide-aperture lens combined with an unclear understanding of the profession itself forces an inward view in order to serve as some form of anchor to an otherwise disorienting new set of situations. Particularly similar is the idea of a “featureless patient,” where design is likely imagined as an idea of a product from a recognizable brand, but only in general—an archetype of a shoe or app built on the external messaging of the company that sells it.

But an environment is not abstract. It is specific, and is “always seen through the eyes of a specific group” (81); in both medicine and studio, “the students, with their idealistic long-range perspectives” understand their experience different than the faculty. Students may enter studio sharing the same unclear view as one-another. In a structured studio where a cohort moves consistently from class to class, they begin to be isolated from students in other disciplines, yet constantly surrounded by a uniformity of unknowing. In medical school, this model “insures that, although a student may have his own troubles, there are many problems the class as a whole has in common (89). Overload becomes one of those shared problems, where the faculty believe there is a “more or less standardized body of knowledge” that a graduate must know, and that likely leads to assigning more work than a student thinks they can get done in the time available (90). Students have a poor understanding of how long thing take and what they can actually accomplish, but “overload is easily recognized; it is simply a matter of how much work is required” and how many hours are available to do that work. Students don’t have a reasonable conception of either. As in medical school, students must “choose between study and leisure and often between study and sleep” (91).