"Double loop" learning

doi:10.1136/bmj.329.7464.502-a

BMJ 2004;329:502-503 (28 August), doi:10.1136/bmj.329.7464.502-a

Commentary

"Double loop" learning

Ed Peile, professor of medical education¹

¹ Division of Medical Education, Warwick Medical School, University of Warwick, Coventry CV4 7AL ed.peile@warwick.ac.uk

The first 150 words of the full text of this article appear below.

As well as sympathising with the patient, many respondents tothis case commentary found themselves engaging in the difficultiesfaced by the general practitioner.¹ Donald Schon, in Educatingthe Reflective Practitioner, described a "swampy lowland" whereinlie the problems of greatest human concern and where "messy,confusing problems defy technical solution."² Schon contrastsbeautifully the technical and rational approaches of the theoreticalhigh ground with the reflective approaches we often need inprofessional practice.

In interactive case reports, readers are asked how they wouldreact to a given situation. The usual response for professionalsis to delineate what Schon and his co-author, American psychologistChris Argyris, call our "theory of action."³ They describe thisas the theory to which a professional gives allegiance, andwhich, on request, he communicates to others. However, the theorythat actually governs his actions is his "theory in use," whichis often quite different.³

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