Rev Je Kan Adler-Collins,

Fukuoka Prefectural University, Faculty of Nursing, Mental Health Japan

Ms Yukiko Ohmi

Fukuoka Prefectural University, Faculty of Nursing, Adult Nursing Japan

The Process of critical enquiry and of becoming critical as a practitioner: The

dawning of a new paradigm of global co-operation and educative understanding

or old colonial values repackaged and represented?

Paper presented at the British Educational Research Association Annual Conference,

University of Warwick, 6-9 September 2006

Abstract

The context of this paper is embedded in the telling of an educational story about practitioner

research grounded in our teaching practice as we investigate the process of our pedagogising our

claims to know and our knowledge into the development, implementation, assessment, and

evaluation of our curriculum for healing reflecting nurses in a Japanese university.

Our research context focuses on the process of becoming critical as practitioners. In Japanese

culture, critical thinking is not the same as in the West as it is bounded by a strong social context

of conformity and resistance to change. We will show our process of becoming critical of

ourselves as educators and as conscious human beings, and how we integrated our different

cultural understandings and values into our curriculum. We are not using critical in the sense of a

“bad” thing or to “criticize”; rather we are evolving in the Wink, (2005) sense of critical, namely

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“seeing beyond”.

The theoretical context was grounded in the concepts of heuristic living action research where we

engaged with curriculum issues, in terms of theory and design. We explore our understanding of

our own racial teachings, and the embodied values of one author’s (Adler-Collins) “whiteness”

(Adler-Collins and Ohmi, 2005).

We seek to extend our understanding of Japanese cultural response to the curriculum by the

analysis of our students’ data sets from their reflective journals, portfolios, and evaluations of our

teaching. We do this by heuristically immersing ourselves (Moustakas, 1990) in the process of

becoming critical. This is a dynamic process of learning where each author is striving to see the

other’s issues and set aside their own to facilitate a new understanding and merging of culturally

different ideas.

The contribution to knowledge this paper brings is that of the difficulty of importing educational

systems from one context-bound environment to another. The issues around colonisation of

knowledge and ethics are highlighted along with the need for global educators to be aware of their

own bias of race, gender and culture. This paper is not a theoretical account but an authentic

account of what happened in practice, the problems we faced, and the actions we took to resolve

them.

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1.0.0. Introduction

1.0.1.0 Defining our practice: Explicating our position

In our nursing practice and teaching we are faced with issues of loving compassionate

caring, against medical models of outcomes and interventions. We are faced with the

costs of care using the scientific approach, which conflict with humanistic approaches to

caring, and the delivery of care models. In our nurse teaching, we are faced with

professional academic standards in terms of learning outcomes, training objectives and

competencies of practice. Within these academic constraints, there is a constant tension

between the balancing of knowledge with caring. Increasingly we are seeing the

influence in Japan of foreign ideas and paradigms of educational practice in the field of

professional nurse education. This influence, it could be argued, is a natural progression

of the returning to Japan of higher degree holders and the PhD theses completed by

Japanese nursing scholars abroad, augmented with the use of foreign academics to teach

in nursing faculties in Japan. While agreeing in part with this sentiment we wish to raise

awareness as to how appropriate non-Japanese forms of the educational process are for

Japanese students. We wish to do this in an inclusional, Rayner (2003), sense of seeking

to move forward with a new consciousness and focus rather than seeking a separation of

thinking which could easily be introduced when one questions one’s own and another

cultural system of knowing.

As the two authors of this paper are from very different educational backgrounds and

have come together in a shared area of nursing and nurse teaching, our inclusional

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insights offer topics of interest for nurse education specifically and education generally,

as the globalisation of nursing and education continues.

.As part of our enquiry we are using a requirement of our university to raise levels of

critical thinking and awareness in our nursing students. We also question our methods of

teaching and learning, our citizenship and politics, and our social structures and systems,

relating to all aspects of our existence and community.

Defining our practice, making explicit our positional stance

In the telling of any story, it is important to understand what the individuals, who are

narrating, are talking about - in the sense of his or her values, practice and identity. At

this point there follows a short profile on the authors of this paper:

Je Kan Adler-Collins

I am English, a nurse, a Japanese Shingon Buddhist priest and a nurse educator. I moved

to Japan in 2000 after completion of my MA in education at Bath University. I started my

PhD in education at Bath University and conducted the research in Japan. My specialist

area was working as a nursing priest with communities in healing and terminal care. I

teach in the mental health department of the faculty of nursing of Fukuoka Prefectural

University where I am the only foreigner and male in the faculty that for the most part

speaks little or no English. I was appointed to my post to bring a new curriculum for

healing and reflective nurses into a new faculty of nursing.

Ohmi Yukiko

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I am Japanese, a nurse, and a nurse educator who has worked in nurse education for the

last seven years. I have worked as a research assistant in Japanese universities. I now

work in Fukuoka Prefectural University. I trained as a healing therapist in 2002 and

helped teach the healing nurse curriculum at Fukuoka Prefectural University.

Understanding the context in which our research takes place gives a depth of clarity and

unique insights to a complex process, one that engages with issues of the power of

knowledge, its control, and the politics of power in international, national and local

settings.

Normal research is complex at times, researching across different cultural understandings

can be problematic as the chance for misunderstanding is great.

This process is aptly described by Griffiths (1990), who says:

“research today presents itself as a minefield of conflicting polarities pertaining to

theories, methodology, the meaning of knowledge, etc. These are often represented in a

quite aggressive language and scathing denunciation of the other’s position.” (p. 43).

Within educational circles this is referred to as the paradigm wars, as described by Gage,

(1989). The same issue was referred to by Schon (1995), when he stated:

“Introduction of the new scholarship into institutions of higher education means

becoming involved in an epistemological battle. It is a battle of snails, proceeding

so slowly that you have to look very carefully in order to see it going on. But it

happens none the less” (p.32)

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We suggest that such events are common to all universities wherever they are located,

universities being the focal point for power conflicts as old and new orders engage in

what seems a timeless battle to move knowing and knowledge forward. A well-thought-

out research proposal may come to grief as it is shattered either by the research

committee or the ethics committee, where it is often the case that the methodological bias

of the power holders can and does block research that is considered by them as unsuitable

in its methodology. The level of our enquiry, embracing implementation of a national

policy for a new curriculum, brought us directly face to face with the politics and power

of education. The paradigm wars appear to be very real. Donmoyer (1996) says on this

subject :

“The fact is that ours is a field characterised by paradigm proliferation and,

consequently, the sort of field in which there is little consensus about what research

and scholarship are and what research reporting and scholarly discourse should

look like” (p.19)

Primomo (2000) highlights the increasing trend of Japanese nursing scholars achieving

higher degrees outside of Japan and bringing back the influences and ideas of their

studies. This adds to the problem Japanese nursing is facing in terms of professional

identity. A particular professor may favour what they learned as being more correct

than the knowledge of others and so the paradigm wars are once again fuelled.

Wolferen (1990) reminds us that this process is not a new one and, since the Meiji

period, Japan’s elite have picked and chosen from the West and used others’ skills and

knowledge in ways that would suit their purpose in maintaining power.

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[We question ourselves at this point, does academia present a fair and impartial equal

playing field for all forms of knowledge to stand with equal weighting in terms of

judgment of scholarship and hence legitimacy?

How are the tensions in nurse education being addressed concerning the dominant

medical model of teaching, which is logic driven with measurable outcomes, scientific

and quantitative in its methodology, balanced against the humanistic concept that

nursing is a caring and touching profession?

Has the dominant thinking of the science of nursing and evidence-based nursing

completely marginalized the art and craft of nursing?]

We have grave concerns as we watch the Paradigm Wars unfold here in Japan, which has

a feudal system of education. By feudal we mean that the professors have total control

over what low-ranking teachers can and cannot do. Such cultural influences readily lend

themselves to conflict. For example, you do not need “A” levels or a nursing degree to

change a bedpan or bed bath a patient, or to care with a compassionate heart for someone.

You do need in-depth underpinning knowledge to understand what you are looking at in

the bedpan and when you are caring for the patient. You do need in-depth knowledge to

plan an individual’s recovery. You do need in-depth understanding and knowledge to act

as advocate for your patients and to defend their rights until such time as they can regain

their own autonomy. All the above actions require a degree of critical thinking and reflect

Western concepts of what is needed and correct in nursing. While some Japanese scholars

would agree with the above, pedagogic conversations with senior professors would not

occur as the professor decides what is the correct path to follow. Japanese nursing has

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some unique problems relating to its culture of obedience to authority, which does not

encourage critical thinking or independent thoughts or actions outside the accepted power

structure. Kawashima and Petrini (2004) acknowledge the sudden growth in Japanese

nursing universities of what on the surface looks like a commitment to critical thinking;

however they agree with our findings that the actual practice of critical thinking skills in

a Japanese university is problematic.

The qualitative/quantitative debate in Japanese nurse education is highly polarised. We

show in this paper the development of the inclusional thinking approach, which may use

elements of both camps where suitable and offer a way for the different camps to unite

and thus bring about an end to the so-called paradigm wars. Bernstein (2000) warns us

not to “thoughtlessly dismiss what the other is saying as incoherent nonsense” (p.66). To

our understanding, he is defending the right of new forms of knowledge and

representation to at least find a level playing field as regards their validation by academia.

Our tension is that our work challenges not only the positions of academia and the

medical profession, even if it is accepted that our form of knowing is academic or

scholarly, but also some of our basic ontological values and “life truths” relating to

concepts of disease that are grounded in Chinese medicine, Eastern philosophy and

spirituality concepts that are still very alien to the West. It strikes me with great irony that

I am now in the East and teaching our subject from an Eastern conceptual grounding in

an Eastern university so colonised by Western forms of knowing that it rejects the very

history of its own knowledge base. This paper is set contextually in a complex web of

conflicting opposites. Adler-Collins finds himself as a white man in an Eastern society

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where male gender is the dominant aspect of society, working in the knowledge domain

of the female power base of the traditional profession of nursing, where he is fighting for

Eastern values against an Eastern system of education that has been, on the surface, so

colonised by Western forms of what is or is not knowledge that they cannot see in

themselves the colonisation that is taking place. However, as Wolferen (1990) clearly

points out, the bureaucratic control of the power behind Japanese education remains

unchanged and resistant to outside influences other than those that sustain its purpose.

Ohmi was educated in postwar Japan with its particular attention to memory or rote

learning. Such a learning style is culturally orientated in the Japanese university entrance

test. Learning skills which require learners to formulate their own questions or interests in

academia are not encouraged. She often finds herself with inner tensions caused by her

watching and learning from Adler-Collins’s ideas of education, enquiry and pedagogic

conversations being put into practice. She has experienced at first hand how these

methods are not understood and how Japanese faculty can see the enquiry as a critical

challenge to senior faculty’s power base.

We recognise that we are a product of our own educative journey, one where reflective

practice and researching our own understanding are now fundamental aspects of our

ontology. We recognise that each of us has a very different educational past and in the

same context the cross-fertilisation of other beliefs shows how complex human ontology

can be. For example, Adler-Collins’s beliefs are Buddhist and the dissolving of the

concept of our “I” is equally important and fundamental as his understanding of the

Western Euro-centric understanding of “I”. Ohmi struggles with Adler-Collins’s

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Western concepts of “self “and “I” and views her world from a more subjective

viewpoint. We both struggle with trying to see the separate areas of our complex selves,

the nurse, the teacher, the reflective practitioner and the researcher, as separate items or

areas. For us they are all part of our whole understanding and existence, in fact they

form our holistic/holonic (Wilber, 2000) concept of ourselves. Working together in an

inclusional sense of respecting the differences in each other and concentrating on what

brings us together, rather than on our differences which can push us apart, we evolved a

bridging of paradigms that allowed us to deliver our curriculum effectively. This bridging

of paradigms was forged in the classroom and grounded in practice. Extending it out of

the classroom into faculty has been problematic. Some of these issues have been

addressed in this paper.

2.0.1. How to become critical? Action planning of this paper

Facione and Facione (1996) define Critical Thinking as:

“a purposeful, self regulatory judgement, which results in interpretation,

analysis, evaluation and inference as well as the explanation of the evidential,

conceptual, methodological, contextual consideration upon which judgement is

made.” (p.129)

There is no Japanese definition of critical thinking. Mindful of the complexity of context

in which this paper is situated we wanted to keep the action planning simple and focused.

We therefore focused on the process we followed to introduce critical thinking to our

students by using the students’ data as an indicator.

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2.0.2. Data Sources and rationale

Student data came from four sources within the educational setting. These were:

reflective journals, group portfolios, session evaluations, and videos of classroom

practice. In this paper we engage with the students’ process of becoming critical by

looking at what each type of evidence can show us. Ethical permission for this research

was given by the ethics committee of our university. Constraints on the gathering and

use of data placed on us by the ethics committee are highlighted in the text where

appropriate.

Journaling is part of our research process. Adler-Collins created a website at

http://www.living-action-research.org which acts as our research journal and peer

reviewing space. Posting and responses are used where appropriate to evidence the last

element of the action research cycle, namely making public our claims to know

(Whitehead, 1989).

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Icons used within this text

As we are using multiple data sources we will represent each with an icon to provide

clarity as to what data is being addressed:

Reflective Journal

entryPortfolio entry

Session Evaluation

Video Data

2.0.2.1. The Reflective Journals

Fiscal and financial constraints present a challenge for nurse educators trying to broaden

the diversity and scope of teaching/learning methodologies (Riley-Doucet and Wilson,

1997). One method designed to promote the autonomy and self-direction of nursing

students is self-reflection combined with reflective journal writing. This process of self-

reflection was initiated in our pilot course cohort of freshman nursing students.

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Both authors kept a reflective journal. In this journal, we recorded our actions and our

thoughts and feelings, making particular notes about our intent.

On our course, students kept a reflective journal which was part of their course

requirements. Each recorded her/his experiences, feelings and thoughts after each

teaching period/session. This strategy was developed in a joint research project conducted

by a Canadian Professor of Education, Dr Andrew Dolbec of Quebec University, and

Adler-Collins. They evidenced their individual processes in reflective journals and

brought them together at the end of the research to see what, if any, similarities existed

between intentions and actions, and actions and feelings (Adler-Collins, 1997).

In the case of this first piloted course, the students’ responses varied considerably from

one line entries to long, thoughtful ones. Originally the students were required to write

their journals in English to help upgrade their English skills. This however was stopped

after negotiations with the class in terms of their learning contracts. The class opted for

Japanese. In terms of the analysis of journal contents we were not allowed to grade

students on their journals. The ethics committee refused permission for journal contents

to be graded on the grounds that the students may reveal personal feelings. As this

research was qualitative we wanted the students to write about what they were personally

experiencing and feeling. Clear instruction would be given to the students not to include

information they did not want to be read or which was of a private nature. Permission

was given by the students to use the journal data in future research papers or conferences

after appropriate actions had been taken to hide their identity. Students were marked on

task completion. If they had a journal entry for the required session they received credit.

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There were over 800 separate journal entries from the students about their thinking and

feelings concerning the healing course. In general, a level of thinking emerged that

brought home Freire and Macedo's (1987) phrase that the students’ words were “wet with

meaning” and they were experts at reading their worlds. Translation proved to be a

problem. The normal procedure is to translate and then back-translate to see if the

meaning is the same. This did not work in Japanese with its three different alphabets, as

each individual may choose a different Kanji as per their own understanding and feelings.

Translated texts were left as they were, no corrections to grammar or structure were made

and, surprisingly for the most part, the meaning of what the students were saying was

understandable. Examples from students’ reflective journals will be used in conjunction

with portfolio and session evaluation evidence to give three insights to their thinking.

Here then are two examples of students’ journal entries:

HTR０３３２１０２０“we discussed the "energy field" into the group. It is said that our body has the

"body" and the "energy object" which are a foregone conclusion in relation to

each other, and is realized 1 as individuality object. Since all that are starting in

the energy field to us, such as illness, stress, etc. of mind and body, appear, I think

that it is very important, in order to know my own body and the state of the heart.

I was very much surprised, and thought that it was uncanny.”

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HTR０３２１０１９

“I felt a strange atmosphere, when going into the classroom of healing each time.

Peculiar air flows and the music which a translation does not understand to be a

smell like a scent somehow is drifting all over the gloomy classroom. Even pain

was felt for my having a class under such circumstances in the beginning.

However, it became the last lesson this year, and when I had noticed, I was

familiar with this peculiar atmosphere completely. Although I do not yet

understand well whether it must carry out in such an environment when

performing healing, Mr. Je Kan's room is also thought that the same atmosphere

is flowing. “

2.0.2. . Portfolio Evidence

The introduction of portfolios as a means of gaining evidence of critical thinking

processes is a new concept in Japan. The object of this task was for the students to build a

group portfolio. Each week the students were given the lesson theme to research on the

internet, in the library and via any other medium. They had to bring all their collected

materials to the next class and complete their portfolio building for that lesson. Students

were required to paste in from their reflective journals the entry relating to that lesson. By

this means an educative learning trail was provided between the topics, and learning

outcomes that were achieved included researching skills, critical thinking skills, group

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working and task allocation. The students kept and built a group portfolio recording their

engagement with the subject content and their synergy with the topic. The dynamics and

contents of their journals proved to be inspirational to us as teachers. As we will show

from their portfolios, their engagement with the curriculum elements allowed them to

synergise the subject material in a very Japanese way. The portfolios can be seen at

http://www.living-action-research.org/Student%20portfolios%202003/Student

%20portfolios%202003.htm

Originally, students found the portfolio concept difficult as the idea was new to them.

They were used to being told what to learn in the banking education sense (Freire and

Macedo 1987; Kawashima and Petrini, 2004). The students were required to mind map a

question (Buzan, 1991) using free association from keywords, backed up by their

required homework and prior research of the question topic; for example, “What is

holistic nursing?” The following observation is taken from Adler-Collins’s research

journal:

“At the start of the mind mapping task, rather than the actions I expected of each

group individually commencing the set task, we noticed however that the class

acted in what Ohmi sensei said is a very Japanese manner. Nobody moved from

their seats, everyone was checking what everyone else was doing. There was a

very subdued level of conversation, then with what seems like an unspoken

command each group started as one. I found this most disconcerting and was

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reminded once again not to have expectations based on my European experiences

of individualism as being the norm here in Japan where a completely different set

of cultural norms were in play. I have to admit however to a sense of relief when

activity started.”

Adler-Collins journal entry session 2 C001, October 2003

Here is a picture of one group’s first attempt at mind mapping:

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As you can see, the thinking is constrained, white space dominates the page and no

connections between knowledge elements have been made. Only two colours are used.

From this one piece of evidence little can be seen of any form of engagement or critical

processes taking place. However, when the session evaluations associated with this

lesson are viewed, a deeper picture starts to emerge.

Students’ responses

Question １３ Session Evaluation – Session

2_C001 English Grammar has not been corrected.

I was able to talk with those who talk for the first time.

When group discussion was carried out to healing about something,

although I did not think specially or did not necessarily debate,

I was able to tackle it in the atmosphere made friendly.

I think that a group or activity was completed happily. I think that

relations were able to become very good by doing one thing into a

group.

It was very good that it was able to discuss writing many things all

together.

I thought that what is necessary was just to be able to carry out

group activity many more after this.

Me. This lesson was really pleasant.

It discussed with the member of a group and the portfolio was

created.

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It is having discussed not accepting it a group.

It let group work pass and opinion exchange was completed with

everybody about healing.

All together, the opinion was shared and it was able to write freely.

Group work

When it discussed into a group "something is ? with healing", I was

pleasant for me to have heard various opinions.

HTR０３２１０４１ “I did not get used to telling everybody one's opinion, but was considerably puzzled from

the start. I was able to write only one to other men having written their thought rapidly.

When I carried out to the next, it was thought that it was made to want to tackle more

positively. Although the teacher had said that teamwork was important for a nurse, I

think that that is actually really right. Even if those who are not intimacy, those who

become acquainted for the first time, or a disagreeable person becomes together with

what man, we will think that we have to pull together. I thought that the method of this

lecture was good in order are very beneficial and to train itself, before we go away into

society. I could see myself what action and attitude take calmly, and thought that it was

good.”

HTR０３２１０４９

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“It is difficult for me to think, since it has not been concerned in old life even if asked a

"Reflective journal." Education is healing again. Some thoughts like incomplete

combustion remain about healing which I performed last time. My intention cannot be

seen in wanting what to really carry out by this lesson. I do not understand why such a

thing must be discussed by the lesson of healing”.

Here then is the next page of this group’s student portfolio:

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Even without understanding Japanese you can see the change and the progress being

made. Interestingly it is very neat in its presentation, very ordered. Different group

members were actively starting to contribute. Ideas still seemed to be bounded by white

space. Knowledge connections have yet to appear.

Students’ responses .

Question １３ Session Evaluation 2 C002

When discussing all together, the person who seldom talked

until now said much opinion today. That [ my ] was very glad.

Since the opinion was added very much for me, it was good.

He had not been enjoyed though it was regrettable today.

Creation of a portfolio

Although the education which we have received usually had

seldom been considered until now,

if I thought anew this time, I have noticed various things.

The various opinions of the man of a group were able to be

heard with group work. Its thought

has been explained in a picture or language.

Conversation in a group

Portfolio creation

He was able to understand Mr. Je Kan's English.

It discussed into the group.

I was able to grow familiar with the men of a group and was

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able to make talks more smooth than last time.

It was able to discuss exactly all together [ of a group ].

The talks by the group progressed smoothly.

Many things [ in a group ] were discussed.

My group work was pleasant.

HTR０３２１０４９‘If I think "education is really what", it can be predicted that they are culture and

tradition and will be indispensable to character building. What is a portfolio?

"A portfolio collects study things, in order that he may evaluate the growth of learning,

and a change spontaneously on many sides from many sides and in the long run and may

employ in new learning efficiently."

HTR０３２１０ 50

“About the educational portfolio, we considered saying with something that it is

educational. We discussed what education was from Mr. Je Kan's talk. I thought that

education is culture, and our group is a community, was a home, and a system, or

personal relations.

For example, there is a hiragana as a symbol of Japanese culture. Only Japan is using

the hiragana, and when making a character write as education, it begins from a

hiragana. Of course, it starts with the alphabet in the country in the English area. Thus, it

was thought that education changed with culture.

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Moreover, probably, education changes also with environment of a community, a home,

etc. Upbringing and education called manners are made at each home, and, probably, it

changes also with areas.

I think that personal relations are also concerned with education in addition to this. How

we will concern itself with people also learns.

About a system, I did not understand with now sufficient one. Although I understood

when I was called knowledge, I had said that knowledge was in a system in explanation

of a teacher. However, I was the feeling of "being ? with a system." From this time, the

portfolio was likely to go well.

The next page of this group’s portfolio:

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We can see now that the boundaries between the knowledge elements are starting to

overlap. The rotation of the page has changed to allow different members to contribute

from different sides in a nonlinear way. Connections are being made with knowledge

elements. This group is still only using text as its medium.

Students’ responses

Question １３ Session Evaluation – Session 4_C００１Students’ session evaluation critical comments

As for me, it was good that it was able to think of itself. who considers the

title of "being ? with oneself" and does not think usually

As for me, having quarrelled over an opinion into a group was pleasant.

I was able to consider " deeply for some in "self.

It was good at the time of the talks by the group that it was able to think

even by having extended man in the universe for me. Moreover, as for me,

it was interesting that a certain group questioned other groups. I can hear

the opinion of other groups and think that I was good.

Although I had not considered "self is ? with ? truth" until now, I was able to

get the opportunity to consider at this lecture.

I was able to hear the opinion of men other than myself and idea which are

not thought of in my idea.

I was able to hear the opinion of persons various about the theme what self

is.

We were ourselveses, and we discussed into the group, understanding

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English.

Group discussion.

Opinion exchange into a group

"Who am I?" was considered. I was able to think by myself.

I was able to hear the opinion of the man of a group, and the various

opinions of the man of

other groups with group work.

HTR０３２１０４１“It was the lecture which gazes at itself about self today. I had not considered "he

is who?" etc. recently. When I am young, I am gazing at the mirror, I do not

understand anymore "where I to have come from" or whether "whether I to be

actually whom", and had thought. But, I did not understand, and became

strangely and what is always considered was stopped. At this lecture, by the

group, we introduced ourselves and suited. As for us, he can express to others

what human being it is according to the external feature or the internal feature. I

live until now and a certain himself thinks now that I am real myself.”

HTR０３２１０ 50

“I found that our world was constituted by not one but various things. It was

rather difficult for me to consider "it is? as itself." Of course, the cell constitutes

"me" and it is a gene. However, not only it but the grown-up place, environment

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and a family, a friend, an acquaintance, or various recollections. I was felt, when

what is called itself was realized, just by there having been such a thing.”

This next picture shows the students using different elements

of knowing and ordering the ideas and concepts in a hierarchal sense.

Pictures are starting to appear; individual reflective journal entries are

added. Connections are being made.

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2.0.3. Web based testing and evaluations

Technology is an important part of today’s nursing, as is information. Adler-Collins

designed a system of tests on the web for the cognitive element of the course. It included

research skills, “surfing the web”, and online evaluations of the sessions. A sample of the

online evaluation can be found at the following URL:

http://users.smartlite.it/jekan/quizzes/

phd_evaluation_page_c003_session_eval_session_4.asp. Follow this link for an

interactive media presentation of the thinking and rationale behind the design and use of

the session evaluation. The presentation is in streaming media and viewable in any web

browser.

http://www.projectstreamer.com/users/jekan/2.1/2.1.html .

The theoretical structure of the healing curriculum used a framework of Western

approaches to encourage critical thinking in our nursing students and ourselves. This

framework consisted of reflective journals, portfolio building and session evaluation.

This framework was new to Japan but still provided a strong base on which the students

could build. Students’ reflective journals showed a different kind and level of

engagement to that produced by the session evaluations. We feel that this is important

and needs further explanation. The session evaluation was a web based questionnaire

based on 16 questions. Questions 1 to 12 were designed to produce statistical

information relating to environment, content and ability to understand, and questions 13

to 16 were designed to be qualitative instruments. For example: what did they like best

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about the session? What did they like least about the session? How could the session be

improved? What would they like to study more?

Participation in the session evaluation was not optional but was part of the curriculum

process. The thinking behind this is that nurses have to evaluate and pass on information

accurately and honestly. This is a basic foundational requirement for nursing. Using a

computer web based system offered the students practice at entering information and

giving their opinions, something they are not experienced at doing from the Japanese

education system (Shiraikawara, 2001). The ethics committee of our university decreed,

as with the reflective journals, that the content of the session evaluations was not allowed

to be graded as this information was confidential. It was again a matter of process. If

students completed the required evaluations, they obtained the appropriate credits.

At this point we wish to discuss the use of questionnaires. Any questionnaire is at best a

snapshot of what an individual is feeling at the time the questionnaire is filled in. In terms

of data reliability, questionnaires have to be treated with caution, as all the information is

subjective and biased. Due to limitations placed on this research by the ethics committee,

we had no data on the students other than what was observed in the classroom and as a

direct result of classroom activity. We were not, for example, allowed to ask what

brought the students to this classroom, their ages, family background or experiences. This

could have been helpful in assessing the credibility of their responses. We had no option

other than to accept at face value the responses of the students. With this in mind, our

analysis can only suggest that a process is in play or that there appear to be relationships

to this or that. The strength of the analysis depends on good quality data that in turn

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stems from the good design of the data collection instrument, i.e. the questionnaire, and

of the collection process. A crucial part of good research design concerns making sure

that the questionnaire design addresses the needs of the research. To put this in another

way, somehow we need to ensure that the questions asked are the right ones and are

linked to the research aims. Deciding what are the right questions to put on a

questionnaire is a key aspect that needs to be addressed by the researcher (Oppenheim,

1968).

Despite the limitations we operated under, our session evaluations provided interesting

data as to the “Public face” and the “Private face” of the students. If the students had a

difficult time with the subject contents they would mark in the negative on the

questionnaire. This we viewed as their public face. This trend, however, did not repeat

itself in the reflective journals, which were more private, thoughtful, and showed insights

that went deeper than the lesson contents. This we viewed as their private face.

In Japanese educational culture, considerable importance is placed on information that is

obtained from questionnaires, particularly if it is from students about their teacher’s

performance. Such information is passed through a software package such as spss. The

resulting information is treated as research evidence that is often used in teacher

appraisal. We believe that treating subjective data from a questionnaire as factual is poor

research practice.

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2.0.3. Experiencing knowing in the process of becoming critical

We believe that becoming critical is a process. Knowing is also a process, a deliberate

activity different from knowledge, which is an engaged construct of a commodity or

concept. We hold the positional stance that different types of knowing exist at different

levels of consciousness. Becoming critical and the degree of skill associated with that

criticality are linked to the consciousness the individual has about the process. No level is

more correct, better or enlightened that any other, just different. Knowing is insight that

arises in the moment of doing and is therefore part of the process. Knowing is more than

a “deliberate activity”. Some knowing, while still part of an engagement in an activity,

can be spontaneous and not necessarily germane to the activity. For example, Archimedes

is attributed with understanding buoyancy while having a bath and subsequently leaping

out of his bathtub and running naked through the streets of Syracuse shouting "Eureka”.

The insight about buoyancy was not a necessary part of engaging in the bath.

When we articulate the action of the knowing experience, we are moving the data of our

sensory experience through the filters of our own knowledge, from which we analyse,

categorise and attach values such as meanings and words. We would therefore contend

that knowledge is a construct or matrix of the emergence of knowing against our own

understandings. Knowledge may therefore bear no resemblance to the knowing from

which it claims its causation.

Moving into seeking an answer to what is knowledge and “how do I know?” is akin to

entering an abyss. We use the term abyss for we are plunging into the consciousness to

unexplored depths. The definition of abyss: “the primal chaos, bowels of the earth, lower

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world, bottomless or deep chasm” (Oxford English Dictionary, 1978) fails to describe to

our satisfaction where we were in time and space. Some would describe this abyss as a

place of darkness, for us it was anything but dark. Ohmi’s Japanese perception of the

abyss is one of chaos, something a Japanese individual would do anything to avoid.

Cultural conditioning made the prospect of entering the abyss difficult for Ohmi, and her

courage and determination to understand were remarkable. For without any terms of

reference or a framework on which to hold, the constructs of reality held by the mind, in

its uncertainty, will usually activate the emotion of fear. Understanding that this fear is

both an inhibition to enquiry and/or a solvent for dissolving old barriers to thinking is a

balancing act. At that particular moment where we empowered ourselves by giving

ourselves permission to enter a state of abandonment, many of the constructs of who and

what we supposed to be "I" ceased to exist. Yet at the same time there seemed to be an

inner core of us that was exposed by this very process of abandonment. Being open to

such an experience proceeded, as Polanyi (1964) describes, “…by a process of

spontaneous mental reorganisation uncontrolled by conscious effort” (p.34).

Were we seeing and facing our multiple selves each with a different form of knowing?

Had I found the diamond of self? What was this inner core of such wondrous sparkling

beauty? As each question evolved to consciousness we became aware that our abyss had

no bottom and was only limited by our own fear. Rather, the deeper we went the more it

expanded its depth, suggesting to us the mystery and the beauty of infinite knowing that

is available to the enquiring human mind.

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This intrigued us and forced us to re-examine our understandings of self. Was the

possibility that we were being self-limiting in trying to find a medium to fully and

lovingly represent our core values meaning that at the same time we were exploring the

essence of ourselves in relationship to the journey of our learning and ability to convey

this learning to our students and peers? We asked ourselves the following question:

Could we show that each aspect of self has a different way of knowing?

These forms of knowing are different from analytical knowing. In whatever form our

knowing presents itself to us, each aspect appears to give us a distinct and different way

of knowing. For example, when speaking of social knowing, which is related to the

context from within which the knowing evolves and is directly influenced by its

environment, Vygotsky (1978) states:

"Every function in the child's cultural development appears twice: first, on the

social level, and later, on the individual level; first, between people

(interpsychological) and then inside the child (intrapsychological). This applies

equally to voluntary attention, to logical memory, and to the formation of

concepts. All the higher functions originate as actual relationships between

individuals.” (p.57).

Bandura (1977) is in accord with Vygotsky’s ideas about the importance of

interpsychological learning. This theorist says of learning:

"Learning would be exceedingly laborious, not to mention hazardous, if people

had to rely solely on the effects of their own actions to inform them what to do.

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Fortunately, most human behaviour is learned observationally through

modelling: from observing others one forms an idea of how new behaviours are

performed, and on later occasions this coded information serves as a guide for

action." (p.22).

2.0.4. Learning: Coming to know

Another part of our thinking and knowing appears to be a contradiction to Adler-

Collins’s Buddhist beliefs about being, namely that all things exist and arise from the

causal plain of consciousness. For example, Descartes’s saying, “I think, therefore I am”,

does not place where he is in the phenomenon of the relativity of the world. This we

believe is exclusional and fragmentary thinking. Descartes appears just to be referring to

being but not where being is located.

Adler-Collins is concerned that Buddhist esoteric abstract thinking offers an interesting

spiritual framework but it has yet to explain the “everyday”. We are thinking of our

“everydayness”, the phenomenon of the everyday, as Heidegger (1962) suggests within

the structure of Being-in-the-world.

In attempting to characterize the everyday in relation to theory, it makes sense to first

distinguish the two by saying that the everyday is non-theoretical.

Such thinking is not without its problems. If we add that theory is non-everyday, this will

at least indicate that its relation to theory does not unduly determine my understanding of

the everyday. This danger is noted by Heidegger when he writes that "even practical

behaviour has been understood as behaviour that is "non-theoretical" and "atheoretical"

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(Heidegger, 1962). In distinguishing the everyday from theory there arises the further

difficulty of how the two are related.

We view our everyday living through the aspects of the active filters we are using in that

moment of knowing through doing. By this we mean, for example, that as we teach we

are using the aspect of us that is the teacher, grounded in our practice and supported and

informed both by our practice and the theory we attribute to be necessary for our role as a

teacher. When we change roles to a nurse, for example, we change aspects of ourselves

and the dominant aspect becomes that which is associated with our nursing practice, and

at the same time we engage with it and move into and out of it by adding to or modifying

the database of our nursing knowledge. We would therefore argue that multiple elements

of different aspects of relativity can function at the same moment in an inclusional sense;

inclusional, that is, from the positional stance that all the aspects of self inform the

dominant aspect but are not necessarily acted upon by it. The dominant aspect of self is

situational and relative to the events of the moment.

Heidegger points out:

“Everything we talk about, everything we have in view, everything towards which we

comport ourselves in any way, is being; what we are is being, and so is how we are”

(p.6). This everyday understanding of Being is vague and indefinite, yet it is a positive

phenomenon through which Heidegger seeks to make explicit “where we are” (Da-sein1 )

1 Heidegger develops his phenomenology of the "where we are" called Da-sein (Being-

there)

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2.0.5 A question of certainty within the constructs of knowing

by doing.

If Heidegger’s “where we are” in the everyday or “being there” is our world, then we

create a “being in the world” through our senses. Thence we make sense of our sensory

world through enquiry into and experience of that world. This gives rise to some

intriguing questions: How certain is our certainty? How real is our world?

Heidegger’s understanding of “everydayness” provides a base on which to build a degree

of certainty about our world and aspects of our living, and in the sense that we act. By

acts of making or doing, each commitment is to an aspect of “everydayness”, and we are

treating the act as a phenomenon which in turn becomes concrete in some way, and thus

it soon becomes an accepted absolute for and to us at that moment. Sensory abstracts

become certainties.

This applies equally to knowledge. We commit to what we know or believe when we

make what we know or believe part of our everyday living. Sometimes we commit 'to the

best of our knowledge', sometimes 'for all practical purposes', and so on, but we commit

nonetheless. It is not our knowledge that has the quality of being absolute, but our ability

to commit which brings about actions that build the certainty and the trust we have in

everydayness.

Through actions we experience certainty. The real basis of certainty is therefore statistics

and reason, perhaps even repeatability, but certainty comes only when we make the

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commitment. All that statistics and reason can do is to point us in the direction of

certainty. Therefore our grounds for certainty are based in our situational learning.

Lave (1988) argues that learning as it normally occurs is a function of the activity,

context and culture in which it occurs (i.e., it is situated). This contrasts with most

classroom learning activities that involve knowledge which is abstract and out of context.

Social interaction is a critical component of situated learning -- learners become involved

in a "community of practice" which requires certain beliefs and behaviours to be

acquired. As the beginner or newcomer moves from the periphery of this community to

its centre, they become more active and engaged within the culture and hence assume the

role of expert or old-timer. Furthermore, situated learning is usually unintentional rather

than deliberate.

Other researchers have further developed the theory of situated learning. Brown et al.

(1989) emphasize the idea of cognitive apprenticeship:

"Cognitive apprenticeship supports learning in a domain by enabling students to

acquire, develop and use cognitive tools in authentic domain activity. Learning, both

outside and inside school, advances through collaborative social interaction and the

social construction of knowledge." (p.33)

Brown et al. also emphasize the need for a new epistemology of learning -- one that

emphasizes active perception over concepts and representation.

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2.0.6. Multi-aspectual knowing and intuition

Two interesting themes for exploration in this section are the different types of knowing

and different aspects of knowing. Our knowing, in everyday living, is integrated as a

whole in a matrix of constructed images processed from our sensory data. Yet that very

wholeness has aspects within aspects. By aspects I am thinking of the multi-aspectual

form of knowing. For example, a pen is an inanimate object, but it has the potential to be

used not only as a tool for making marks forming lines but to formulate the written word.

Such symbols (words) are more than the object (pen), rather they are abstract extensions

into concrete form via the object. Not only are they abstract expressions but they have a

purpose and that is to convey meaning. In a sense they are contained in the potential of

the pen. Such thinking can be applied to any form of concrete expression in any medium,

a pen, a brush, a word processor. Therefore, to call a pen a pen is to include higher

aspects of knowing the potential properties associated with the praxis of a “pen”. The

boundaries of understanding the form and function of the object are restricted to the

cognitive and psychomotor skills of the user and the ability to write and read in the

language of the context.

In Buddhist teachings we are taught form, function, purpose. The pen has form, the

form’s function is to hold ink and enable a mark to be made, its purpose is open to the

individual’s intuition but it holds the potential to be used for writing, and writing has the

potential to convey and praxis meaning when read in the social and cultural context from

within which it was written. Another element is that the skill of writing needs to have

been mastered and also that the context in which the writing is used is socially

understood.

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Early human cultures had no written tradition and even today, in our Westernised

thinking high-tech world, some indigenous cultures still do not possess formal written

languages, relying instead on centuries of “oral knowing” and intuition that have served

them well in the sense of storytelling. This moves 'intuition' out of the realm of complete

mystery into something rich and tangible and yet ultimately beyond our full

understanding. Let’s take for example an Amazon Indian shaman whose memory and

knowledge of the medicinal properties of plants is extraordinary, and his immersion in

the rhythm and harmony of his environment gives rise to a different form of knowing that

we, as Westerners, should we go into his domain, could never achieve or understand.

The same thinking can be taken into our understanding of our domains of praxis, those of

nurse, teacher and priest. Each requires an engagement with different forms of knowing,

each has a body of theory that has to be learned as the accepted benchmark of what is

correct or acceptable knowing and practice in context. If we take some cameos of our

own intuition we can see that, for example, in our nursing:

When we come on shift and greet the patients, a form of intuitive knowing is like radar,

scanning the patient’s vital signs, and taking on board their spoken and unspoken signals.

We are assessing the words used, the voice stress, the silences, tone delivery, how the

patients position themselves, skin colour tone, breathing, life vitality, etc. All these inputs

are continually assessed against the database of our knowing, our experience, our

learning. Sometimes a sense of unease flags our attention as we intuitively sense that

something is wrong but actually do not fully know what it is that is bothering us. Heeding

such intuition requires us to look deeper and investigate further. As we write we are

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conscious of the problems that our thinking may cause our profession in terms of the

current trend of evidence-based practice. However, considerable evidence indicates that

much professional decision-making is not based on the “best evidence” but instead on an

individual’s subjective intuitive judgements concerning the appropriate actions to take for

a given clinical challenge. This intuitive approach has resulted in huge variations in

clinical practice and the outcomes associated with it (Tinkler et al., 1999).

Nursing has embraced this stance positively and has used intuition as the mark of an

expert in the field (Benner, 1984; Benner et al., 1999). How decisions are made is an area

of concern for health care professionals, policy makers, and the recipients of these

decisions. I believe that embracing intuitive judgements is a positive strategy of being

“professional”. However, it has to be balanced with scientific praxis. Few people would

then worry about questioning the underlying processes or evidence when a nurse’s

intuition is successful, as described by Benner. However, when the outcome for the

patient or client is less than optimal (e.g., they are misdiagnosed and given inappropriate

or ineffective treatment), the processes through which professional practitioners reached

their decisions may well be questioned (Lamond and Thompson, 2000). In our

curriculum we highlight the use of intuition and professional scientific judgement based

on practice and experience. We advocate that the two positional stances need not be

exclusionary, rather each informs the other giving a broader sense of knowing and thence

a more informed sense of praxis.

In our classroom we are performing the same process, but this time we are looking at and

paying more attention to our students’ eyes as they speak to us of their confusion, enquiry

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and understanding, and sometimes they are shining with comprehension. The class or

lesson dynamics have a feel about them. Some things teachers often sense intuitively: that

lesson went well, or something did not quite work there? Such intuitions when acted

upon usually turn up some problem or other that needs to be addressed.

2.0.7. Conclusion

Becoming critical is considered to be an important element of a nurse’s professional

development outside of Japan. In a feudal culture like Japan, becoming critical in the

Western sense will have cultural ramifications. Once a group of professionals achieve

the ability to become critical they will bring about change and offer new challenges to

existing structures and power bases. This will have shock waves throughout all levels of

Japanese society where the norm is to conform to the will of leaders.

Universities have a moral obligation to support their students in the workforce after

graduation if the university has encouraged critical thinking skills. Such nurses are likely

to experience difficulties and, as being part of the group is so fundamental to Japanese

thinking, particularly their association and identification with a company or hospital, the

critical thinking nurse may feel marginalised.

Critical thinking is a Western methodology. It remains for Japanese educators to develop

ways of integrating critical thinking in a Japanese way to the workforce and universities.

Some confrontation will be unavoidable as critically thinking nurses will challenge the

total authority of the medical profession over nursing and will present nurse education

and training with new challenges. Critical thinking is out of its Pandora’s box here in

Japan - only time will tell us if this has been a positive move for Japanese nursing.

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ADLER-COLLINS, J. (1997) Can a collaborative action research approach to my educational enquiry help express, define and validate my professional standards of practice? Bath, Bath University.

ADLER-COLLINS, J. (2005) Pedagogising a Living Educational Theory Curriculum for the Healing Nurse. Exeter, British Education Index.

ADLER-COLLINS, J. & OHMI, Y. (2005) Sticks and Carrots: Living, Holding and Developing our Educational Values Through Times of Transformation, Challenge and Change

British Education Index.BANDURA, A. (1977) Social Learning Theory, New York, General Learning Press.BENNER, P. (1984) From novice to expert: Excellence and power in clinicalnursing practice, Reading, MA, Addison-Wesley.BENNER, P., HOOPER-KYRIAKIDIS, P. & STANNARD, D. (1999) Clinical wisdomand interventions in critical care., Philadelphia:, W.B. Saunders.BERNSTEIN, B. (2000) Pedagogy, Symbolic Control and Identity, New York, Rowman

& Littlefield.BROWN, J. S., COLLINS, A. & DUGUID, S. (1989) Situated cognition and the culture

of learning. Educational Researcher, 18, 32-42.BUZAN, T. (1991) The Mind Map Book, New York, Penguin.DONMOYER, R. (1996) Educational Research in an Era of Paradigm Proliferation:

"What's a journal editor to do? Educational Researcher, 25, 19-25.FACIONE, P. A. & FACIONE, N. C. (1996) Externalizing the critical Thinking in

knowledge development and clinical judgement. Nursing Outlook, 44, 129-136.FREIRE, P. & MACEDO, D. (1987) Literacy: Reading the word and the world, South

Hadley, MA, Bergin & Garvey.GAGE, N. (1989) The Paradigm Wars and Their Aftermath: A historical sketch of

research on teaching since 1989. Educational Researcher, 18, 4-10.GRIFFITHS, M. (1990) Action Research: grass roots practice or management tool? In

LOMAX, P. (Ed.) Managing Staff Development in Schools: an action research approach. Clevedon, Multi-Lingual Matters.

HEIDEGGER, M. (1962) Being and Time, Oxford, Blackwell.KAWASHIMA, A. & PETRINI, M. (2004) Studies of critical thinking skills in nursing

students and nurses in Japan. Nurse Education Today, 24, 286-292.LAMOND, D. & THOMPSON, C. (2000) Intuition and Analysis in Decision Making and

Choice. Journal of Nursing Scholarship, 32, 411-414.LAVE, J. (1988) Cognition in Practice: Mind, mathematics, and culture in everyday life,

Cambridge UK, Cambridge University Press.MOUSTAKAS, C. (1990) Heuristic Research : Design, Methodology, and Applications,

New York, Sage.OPPENHEIM, A. N. (1968) Questionnaire Design and Attitude Measurement, New

York, Heinemann.POLANYI, M. (1964) Science, Faith and Society, Chicago, University of Chicago Press.PRIMOMO, J. (2000) Nursing around the world: Japan preparing for the century of the

elderly. Online Journal of Issues in Nursing, 5, May 31.

41 of 42 07/05/2023

RAYNER, A. D. M. (2003) Inclusionality - An Immersive Philosophy of Environmental Relationships, Palgrave, Macmillan

RILEY-DOUCET, C. & WILSON, S. (1997) A three-step method of self-reflection using reflective journal writing.

SCHON, D. (1995) Knowing in Action, The New Scholarship Requires a New Epistemology. Change, November/December 1995, 27-35.

SHIRAIKAWARA, H. (2001) A Nobel Laureate discusses Japanese education. Japanese Echo, 28, 59-62.

TINKLER, A., HOTCHKISS, J., NELSON, E. A. & EDWARDS, L. (1999) Implementing evidence-based leg ulcer management. Evidence-Based Nursing, 2, 6-8.

VYGOTSKY, L. S. (1978) Mind in Society, Cambridge, MA, Harvard University Press.WHITEHEAD, J. (1989) Creating a living Educational theory from questions of the kind,

"How do I improve my practice?" Cambridge Journal of Education, 19, 41-52.WILBER, K. (2000) A Theory of Every Thing, Boston, Shambahala Publications Inc.WINK, J. (2005) Critical Pedagogy, New York, Pearson, Allyn and Bacon.WOLFEREN, K. (1990) The Enigma of Japanese Power, New York, Vintage.

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