A Materialist Approach to Curriculum Studies

Abstract

Curriculum studies in medical education views the curriculum as a set of documents that are enacted through learning: a planned educational experience. Scholarship has divided the curriculum into parts - in action, on paper and as experienced - which are then studied separately. This overlooks the ways in which the parts of the curriculum are relational and co-constitutive. This thesis advances an approach to the curriculum as an interrelation between curriculum design, implementation and the cultural and political contexts in which education takes place.

Following this approach, this research examines the British general practice curriculum, which is understood to include not only the curriculum documents but also the experience of learning, the political and economic context and, as so much of learning general practice occurs there, the workplace.

Drawing on curriculum and policy documents, supplemented by interviews with fifteen GPs, and utilising a variety of Marxist theory to understand the economic context, this thesis employs a dialectical materialist methodology to critically interrogate the conceptualisation of health inequalities in the curriculum and considers the implications of these conceptualisations.

Findings reveal a contradiction between curriculum rhetoric and material conditions. While GPs are told they can significantly impact health inequalities, this is often not their experience in practice, where they are generally dependent on strategies to attempt to reduce the effects of deprivation on health on an individual basis. Notably, the structuring economic conditions of life in Britain are almost entirely absent from both the documents and practitioner narratives. GPs face an increasingly hostile work and learning environment, characterised by intense pressure, lack of autonomy and increasing proletarianisation, a situation often resolved by reducing their working time in general practice.

This research demonstrates that even within the nominally socialised NHS, capitalist logic infuses medical education. It argues that both written curricular content on health inequalities and GP workplace learning experiences are fundamentally shaped by the capitalist mode of production. This offers insights into not only why curricula can be resistant to change, but the fundamental economic roots determining educational experiences.

Date of Award	18 Sept 2024
Original language	English
Awarding Institution	University of Winchester
Supervisor	Sam Scallan (Supervisor) & Rachel Locke (Supervisor)