ABSTRACT
Pedagogy does not just employ metaphor, but is metaphorical, in that learning is not simply the reception, storage and retrieval of information, but the re-invention of information as the discovery of new knowledge, and the making of new meanings as ways of thinking and being. Medical education is an embodied, performed activity, where knowledge is realized in clinical acumen. A key component and outcome of medical education is tolerance of ambiguity or uncertainty, and this equates with being at ease with metaphor as a generative device. Medical education should also generate critical consciousness, and it is necessary to discriminate among metaphors for their potential negativity, for example in stigmatizing illness. Medical education, too, should be life giving, nourishing and elegant, while being professional. This requires a mix of the erotic (again, a metaphor, without literal ‘acting out’), the aesthetic and the ethical. While medicine has been shaped by masculine, mechanical, heroic, individualistic and militaristic metaphors, such reductive shaping is not appropriate for an emergent medicine concerned with collective enterprise and feminized wisdom and care. Individualistic learning theories are being replaced by social learning theories, where metaphors abound – such as ‘learning by expansion’, ‘networking’ and ‘negotiated knotworking’.
