Beyond the bio-reductionist symbolic code: Experiences of multimodal education in Italy

Medical education is mostly based on a reflexive bio-reductionist paradigm, characterized by a technical language that is abstracted from the social materiality of the body and the disease. This linguistic code learnt during lectures is reproduced during the apprenticeships, in which a deceptive restoration of iconic and indexical links with the patient is integrated and exploited by the main symbolic modality of education. In this case, the implementation of multiple semiotic modes of meanings, such as visual and/or gestural, consolidates a rituality aimed to the embodiment of the medical role by the students (hidden curriculum) and to a further objectification of the patient. In Italy, groups of medical students and young doctors have been trying to experiment alternative multimodal practices of education and implementation of their competence. The aim of these experiences is to shift the focus from the pathology as a mere object of medical abstracted knowledge (and power) to the patient’s incorporated experience of illness and to the entire social and material process that determines health and disease. In these cases, multimodality is conceived as a strategy to restore a fair exchange of knowledge and practices with the patient, recognized as an active social subject in the whole care process. Through the comparison of these two medical educational approaches, the aim of this study is to demonstrate that an alternative medical education method should overcome the bio-reductionism paradigm. To this purpose, we will identify multimodality and its effectiveness not merely in the implementation of different tools (other than the linguistic ones) in educational practices, but in the adoption of multiple modes of sign relation beyond the hegemonic symbolical one.