Reflections on palliative care, transformative education and Mezirow's transformative learning theory

Abstract

In transformative education, learners are supported to look beyond their own frame of reference to accommodate an alternative. Mezirow's Transformative Learning Theory (MTLT) proposes that transformative education occurs following an emotional event-a disorientating dilemma. This study aimed to review whether palliative care could be useful in fostering transformative education, and reflected on two questions, a) do shifts in frames of reference occur after disorientating dilemmas, and b) is it useful to see multiple frames of reference? Participants were three nurses and a doctor who were selected as an information-rich data source. A narrative method was employed in which participants were requested in interviews to describe their work in palliative care. Interviews were analysed inductively around the study questions. Participants described usefulness in seeing the perspectives of their patients and shifts in their frame of reference that occurred following disorientating dilemmas. The disorientating dilemmas were around caring for the dying and around changing roles from curative to palliative. However, data revealed complexities around MTLT in that a disorientating dilemma did not always result in a shift of frame of reference and seeing differing frames of reference could lead to complications in care. It is recommended that further study be carried out into MTLT and in particular into associations between disorientating dilemmas and shifts in frames of reference in palliative care practice. Studying palliative care education and training alongside palliative care practice would also enrich knowledge of transformative education.