Photography as a pedagogic lens for exploring cultures of care

Kay Aranda, a Lecturer at the University of Brighton discusses recent research that examines the potential of photography as a pedagogic lens to explore cultures of care.

Having attended seminar two of the Social Science and Nursing seminar series and enjoyed the stimulating presentations and discussions on culture and care, we wanted to share our experiences of using photography to explore cultures and values based practice.

As a module team at the University of Brighton, we obtained funding from our Centre for Learning and Teaching to explore the use of visual practices in relation to culture and diversity. We purchased cameras for students to use in a learning activity on a pre-registration module and designed a project to explore how photography would promote the ability to look again or could slow down and transform learning about students’ own culture.

A values-based practice (VBP) approach informs the national educational and practice curriculum of English mental health nurses. This aims to re-examine and restate personal, professional and societal values and explicitly acknowledges emotions, conflict and ambivalence ‘up front,’ in discussions of culture and difference. This approach informs our VBP module which we all teach on. The premise of the module is therefore to offer a critical and political approach to culture and diversity by working with understandings that attempt to avoid fixed or static notions of culture, or culture as a pathologising description of a set of ‘exotically’ different attributes belonging to ‘others’. Rather, the focus is on all cultures, including dominant cultures, which we all inhabit and the implications of this for mental health mental nursing and service users’ experiences of care. We knew the use of the humanities and arts in nurse education are approaches known to promote students’ compassion and empathy and increase observational skills and awareness of dealing with health needs across cultures and are said to strengthen students’ confidence in and abilities to provide care.

During the module, students work in small groups and actively participate in explorations of their own culture by taking photos. Each group then presents their photos to the whole group and discusses the reasons for their choice and the values, norms and beliefs they identified, those they share and those found to be different. The guidance for the task encourages them to think critically and interrogate their own understandings and assumptions. In the feedback session we ask students to offer their own understandings (photo elicitation), while those facilitating the session draw attention to the content and themes present in the analysis and presentations overall. During the past three years the presentations and discussions have raised important questions about power and knowledge and understandings and the constructions of norms and difference.

Project and Findings

In our project we explored this activity in depth by using pre and post module focus groups, observation of the group work activity and follow up interviews six months later. We found photography makes visible situated, relational and collaborative learning and surfaces previously unidentified, unarticulated ideas about culture and values and we argue that these practices mimic important processes central to critical mental health practice and contemporaneous understandings of diverse cultures.

For example, prior to the module, students had ideas about culture and values but these were sometimes difficult to articulate or identify. Following the module, students were surprised to find they sometimes held strong values; but they more clearly recognised the complexity and difficulty of responding to and dealing with conflicting values. During the fieldwork, we observed good interpersonal and group work skills, interesting but sometimes challenging debates and discussions, and learning from and about each other. In the follow up interviews we found students enjoyed going outside to learn, they found listening to and learning from each other valuable, they enjoyed taking photos and felt photography provoked a different type of learning and level of discussion and dialogue than in classroom based learning. They also remembered the day more than any other session in the module.

What do we still need to find out?

We concluded that photography provides an important resource with which to unearth subjugated knowledges and promote critical understandings of culture and values, and thereby helps to address inequalities in mental healthcare. We still need to find out whether this type of learning promotes a reflexivity of both self and practice that is sustainable and lasts, and we also need to know whether it has any positive impact in practice for service users, and/or whether other creative methods would do this work as effectively.

For a full account of the project, do please see our paper which will be published shortly in the Journal of Psychiatric and Mental Health Nursing, entitled Let’s go outside: Using photography to explore values and culture in mental health nursing. Do contact us (Kay or Sharon, if you wish to discuss the project further or if you wish to learn more about how we have revised and now run the photography and culture session in our current pre registration programme.

Kay Aranda is Lecturer at the University of Brighton.

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