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Updated: Oct 7, 2025
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Published on: September 16, 2015
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Discomfort, Doubt, and the Edge of Learning
1A.K. Kumagai is professor of medicine and vice chair for education, Department of Medicine, University of Toronto, researcher, the Wilson Centre, University Health Network, and F.M. Hill Chair in Humanism Education, Department of Medicine, Women's College Hospital and University of Toronto, Toronto, Ontario, Canada.
Summary
Embracing discomfort in medical education, particularly through philosophical concepts like aporia, can foster physician excellence. Thoughtful guidance helps learners navigate uncertainty, promoting compassionate and just medical practice.
Area of Science:
- Medical Education
- Philosophy of Education
- Ethics in Medicine
Background:
- Discomfort is prevalent in medical practice and education but often overlooked.
- Philosophical concepts like aporia (perplexity) offer a framework for understanding discomfort's role.
- Existing educational models may not fully leverage discomfort for physician development.
Purpose of the Study:
- To explore the critical role of discomfort in medical education.
- To advocate for integrating discomfort into training for enhanced physician practice.
- To connect philosophical and psychological theories to practical educational strategies.
Main Methods:
- Philosophical inquiry into aporia and its educational implications.
- Application of educational theories from Paulo Freire (problem-posing) and L.S. Vygotsky (developmental zones).
- Utilizing pedagogical tools such as "making strange" assumptions and narrative reflection.
Main Results:
- Discomfort, when approached intentionally, can orient perspectives toward justice and humanistic practice.
- Problem-posing questions, deconstruction of assumptions, and storytelling facilitate reflection.
- Mentorship and dialogue support learners in navigating uncertainty, fostering a richer zone of proximal development.
Conclusions:
- Discomfort is a valuable, albeit challenging, component of medical education.
- Integrating discomfort can cultivate physicians with excellence, compassion, and justice.
- Educational strategies should foster environments where discomfort leads to growth and deeper understanding.
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