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Do We Need to Close the Door on Threshold Concepts?

Megan E L Brown1, Paul Whybrow2, Gabrielle M Finn1,3

  • 1Health Professions Education Unit, Hull York Medical School, University of York, York, UK.

Teaching and Learning in Medicine
|March 27, 2021
PubMed
Summary
This summary is machine-generated.

Threshold Concepts theory in health professions education faces critiques regarding its articulation, knowledge base, and identity formation. This commentary suggests using Threshold Concepts as a reflective prompt rather than a prescriptive theory.

Keywords:
Threshold conceptsliminalitymedical educationprofessional identitytransformative

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Area of Science:

  • Health Professions Education
  • Educational Theory
  • Pedagogy

Background:

  • Threshold Concepts, defined as transformative ways of knowing, are widely used in health professions education.
  • Despite their prevalence, critical examination of Threshold Concepts as a theory in this field is underdeveloped.
  • Existing critiques from adjacent educational fields offer valuable insights for a deeper analysis.

Purpose of the Study:

  • To critically examine the application and research of Threshold Concepts within health professions education.
  • To apply existing critiques from other educational fields to the theory of Threshold Concepts.
  • To assist scholars in critically evaluating the use of Threshold Concepts in their work.

Main Methods:

  • Analysis of Threshold Concepts theory through the lens of three significant critiques.
  • Examination of critiques including the 'floating signifier problem,' 'body of knowledge problem,' and 'professional identity problem.'
  • Application of these critiques to the context of health professions education.

Main Results:

  • Threshold Concept theory suffers from a lack of articulation and inconsistent operationalization (floating signifier problem).
  • Identifying a singular body of knowledge presents challenges and can reinforce power dynamics (body of knowledge problem).
  • The theory's conceptualization of identity formation is problematic and conflicts with constructionist views (professional identity problem).

Conclusions:

  • Educators must consider the tacit messages and potential reinforcement of power dynamics when using Threshold Concepts.
  • The theory's lack of articulation makes it problematic for structuring curricula; it is not a substitute for learning outcomes.
  • Threshold Concepts should be used as a reflective prompt for pedagogical discussion rather than a prescriptive theory of identity development.