Intended for healthcare professionals

Views And Reviews

The vanishing art of doing

BMJ 2019; 364 doi: (Published 03 January 2019) Cite this as: BMJ 2019;364:k5326
  1. Roger Kneebone, professor of surgical education and engagement science
  1. Imperial College London, UK
  1. r.kneebone{at}

Practical skills are becoming marginalised

In recent years I’ve noticed a change in some of the medical students I work with. They seem far less comfortable with “doing.” Many of them struggle with apparently simple tasks, like cutting out a paper shape with scissors or tying a reef knot. This makes me uneasy. Doing is an essential element of clinical practice. It is how we gather information, carry out procedures, and communicate with our patients. Although medicine depends on scientific knowledge, it is through doing that such knowledge is applied and clinicians convey care. Yet doing is becoming unfashionable, eclipsed by an undue focus on factual knowledge.

So how do we learn this “doing?” Like learning to speak a language, the skills of doing come naturally to children when they are very young. From early infancy we explore the material world through immersion. This starts at home—learning to tie shoelaces, making models, being in …

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