16
Footholds and Handholds:
Scaffolding Cognition and Career
Barbara Horberg Wimsatt
The availability of building materials and the ability to use them wisely impose a “historical legacy” on every engineered structure every bit as real as the constraints placed on organic form exacted by an organism’s evolutionary history.
—Karl Niklas (1992, p. 49)
This chapter explores the process of cognitive growth, especially the development of expertise (a later developmental stage than is commonly addressed) within the context of a profession. The profession both provides infrastructure and is open-ended in important ways. Cognitive development is intertwined with career development within the process of professionalization. I adopt a social or situated perspective on cognitive development within this framework and bring together the concepts of scaffolding, entrenchment, and generativity as explanatory. I also see this as happening through a dynamic coordination and integration of various resources over time, and with a focus on the interactions between mentors and trainees (see also Griesemer on hybridity, this volume). Thus it is related to the idea of distributed cognition, but extends to a larger class of evolving or developing cognitive systems that have an ongoing problem-solving trajectory as in (Nersessian 2006).
In order to explore these ideas, I present two detailed historical examples of cognitive development: the early scientific career of Craig Venter and the development of the scientific theory of Charles Darwin. Each illustrates the importance of integrating varied opportunities and resources, both as “building materials” Niklas 1992 or entrenchment (Wimsatt 2001) and through scaffolds that assist further achievement. I then present data from a study of medical doctors in advanced training, illustrating the various dimensions of encouragement, support, and promotion that they may receive. I also present excerpts from detailed interviews illustrating how some individuals developed through such commitment of resources of support and guidance in their interactions with mentors.
The Social Scaffolding of Cognition
Humans are profoundly social. Caporael (2003) emphasizes the fundamental importance of cooperation and coordination. She has argued that humans have “assembled“ repeatedly and persistently, throughout human history, into “core configurations”: various sized groups that perform vital joint functions such as the dyads of mother/infant care and bonding, the teaching of skills and information to the next generation, and larger tribal groups performing different vital functions such as cooperative hunting. The open and flexible nature of humans and human cognition, along with important tasks they must accomplish for survival and reproduction, makes cooperative social scaffolding vital. Sterelny too (2012) has argued that it is the social ability to cooperate and coordinate activities that, more than anything else, characterizes humans, and set the stage for human cognitive evolution. Central to this chapter is the deeply entrenched dyad of apprentice and mentor (or series of mentors) as they relate in an ongoing coordinative dynamic.
There has been an explosion of interest in the array of views that our cognitive abilities and achievements reside significantly outside our heads (see Robbins and Aydede 2009), must be supported by, are distributed in (Hutchins 1995), situated within, or in some ways depend crucially on the social and/or technological environment (e.g., Norman 1993; Caporael 2007; Sawyer and Greeno 2009). Clark (1997) and Wilson and Clark (2009) go further with the view that cognition is extended into the external world, and Nersessian (2006) studies evolving situated cognitive systems. Much of the emphasis has been on the affordance of artifacts and various forms of technology to augment our cognitive abilities. I presuppose their importance as well as the day-to-day acquisition of information and skill in medical training and other scientific work but focus instead on the social structures which boost or enhance these resources in the dynamics of cognitive development.
Many adherents of social cognition trace their views back to the work of Vygotsky, famous for his conception of the “zone of proximal development,” the importance of setting the goal of learning at a child’s potential level and of guidance to assist in reaching the next level, and generally of “tools for the mind.” This became the idea of “scaffolding,” further developed by Clark (1997).
For advanced stage cognitive development, learning is largely through the social/ cultural/artifactual realm and is not only determined by the individual agent (Clark 1997). Warwick (2005) documents how a change in examination practices led to changes in other practices that scaffolded not only individual learners but the discipline of mathematical physics as well; see also Wimsatt and Griesemer (2007). At all stages or levels, scaffolding—emotional, cognitive, and promotional—is important (B. Wimsatt 1997).
The Developmental and Grounded Nature of Cognition and the Role of Learning
Some adherents of social cognition also insist on the importance of development (Vygotsky 1978; Tomasello 1999), or entrenchment and generativity (Wimsatt 1986, 2001). Vygotsky and Tomasello view cognition as socially mediated and developing over time. Tomasello grounds cognition in the uniquely human capacities of teaching and learning; this in turn enables the generative mechanism of perspective taking. These capacities allow humans to share and ultimately develop or evolve cognitively through new abilities such as rule following, preservation of knowledge, and building incrementally on what is known—what Tomasello, (1999) calls “the ratchet.” Sterelny (2012) emphasizes the pooling and preservation of knowledge as a basis for building new knowledge or innovation and a critical stage in human cultural evolution. This same process is recapitulated ontogenetically in the cognitive development of humans through learning and building on what they know.
In a similar but slightly different vein, I view cognition as developing in a generative process—one in which individuals (or systems) utilize, coordinate, and integrate resources, both cognitive and emotive, in an ongoing (but not always incremental) problem-solving fashion. These problem-solving trajectories are stabilized through some or many bases or foundations that can be built upon (which I call footholds) and scaffolded through various kinds of assistance or supports (which I refer to as handholds). My use of “handholds” resonates with mechanisms described by Vygotsky as assistance provided to young learners by teachers and others which leverage their cognitive abilities, allowing them to reach levels they may not have achieved on their own. “Footholds” relates to the concept of “generative entrenchment” proposed by Wimsatt (this volume).
The distinction between the two concepts can sometimes be blurred. Generally, while footholds can be built upon (in this case cognitively), handholds tend to be more emotive and transitional. But handholds may go beyond mere encouragement to support which takes the stronger promotional forms such as information, critique, opportunities, and the like and can often be built upon as footholds. This is apparent in the two cases I present in the next section of Craig Venter and Charles Darwin, and illustrated further in the study of medical trainees below.
The acquisition of expert knowledge is a developmental process in which various foundational layers and critical events may shape a course of intellectual growth and generativity (Wimsatt 2001). In early stages sequential skill acquisition is necessary (Traweek 1992; Wimsatt and Griesemer 2007). At later intellectual stages it is more like a process of problem solving which can involve starts, stops, jumps, and even reverses, with paths that fizzle out or cannot be integrated with goals.2 However, having footholds to build on is crucial, and scaffolding supports, or handholds, are the mechanisms that facilitate the process.
I explore these processes by first considering illustrative cases of two important scientific careers to give a more general view of developing cognitive systems at different scales and to help to situate my views. This includes development of scientific research, for example, but also cognitive/career development. Finally I turn to data from my earlier study of advanced training of physicians and surgeons to further illustrate the development of expertise and some of the entrenching and scaffolding factors that make an important difference.
Entrenched, Scaffolded, Coordinated, Integrated, and Developing Cognition: Two Cases of Professional/Scientific Development
A foothold or basis could be a crucial decision, specific book, lecture, or mastery of some significant knowledge that was inspirational for setting someone on a particular path. Wilson and Clark (2009) write: “…we think that cognitive extension tends to be stepwise, building on the solid achievements of systems that have already earned their keep in some particular domain.” For instance Craig Venter’s ascent from full-time surfer to major scientist and inventor of the polymerase chain reaction (PCR), the procedure that made genomics possible, began with his successful stint as a medic in the army. This was an entrenching (Wimsatt 2001) foothold that gave him a direction and became generative. It led to his decision to get a medical education, but having barely graduated from high school, he realized he would have to start at a community college, with plans to transfer to a university (Venter 2007).
Handholds are assists or scaffolds in the process of traversing a specific developmental trajectory. A crucial handhold for Venter, in building his confidence, was the friendship and encouragement he received from a community college literature teacher who helped him overcome math anxiety, giving him the assists or handholds he needed to shape and further his academic interests. “Like so many people who have succeeded in life, I had some great teachers who encouraged and inspired me, taking a real interest in my education…. Bruce not only befriended me, but challenged my thinking and encouraged me to excel. My writing and self-assurance improved every week, not only in English but in subjects I had been quite hopeless at before, such as math” (Venter 2007, 50). Inspired by some successes, Venter really took hold academically and did well enough to be admitted to the University of California, San Diego, where he again found mentors who assisted and propelled him with encouragement, important introductions, and remarkable opportunities.
A biochemist, Gordon Sato, from whom he learned about and became fascinated by a technique for dissolving tissues to isolate cells, also facilitated an introduction to distinguished scientist Nathan Kaplan. Kaplan suggested he propose a research project. Venter drew on his experience as a medic in Vietnam as head of a cardiac arrest team and the use of adrenalin to stimulate the heart, and on the technique for isolating cells he had recently learned from Sato, (two more footholds or building blocks), to come up with an experimental idea. His own search of the literature gave him the final piece to put the proposal together: to determine the location of adrenaline receptors on cells. Kaplan liked the idea and decided to oversee and facilitate it, providing a lab and multiple contacts to help with the project and get the results published, thus launching Venter on his career path. This case illustrates the role of important footholds and a number of helping hands. It also shows Venter’s role in finding and interesting mentors in his cause. The rest of the story is not covered here but is history.
Charles Darwin’s (1958) trajectory offers another example of intellectual development, creativity, and invention through the knowledge, inspiration, actual assistance, and promotion from mentors and supporters. I can only touch on the myriad intersecting and reverberating interests and influences on Darwin’s thought and work, which is better documented than that of any scientist of any period in history. A childhood fascination with naturalism and various collections (mainly beetles) was followed by a sixteen-year-old’s encounters with the ferment of naturalists, free thinkers, and evolutionists at the University of Edinburgh. An intellectual journey (and style) starts to take shape. At Edinburgh, Darwin studied with and was mentored by geologists and evolutionary thinkers such as Robert Grant and Robert Jameson who were also admirers of Erasmus Darwin. There too, he initiated the pattern he was to pursue with John Stevens Henslow at Cambridge of engaging one-on-one with a mentor, primarily Grant, in peripatetic investigations of nature (Wikipedia entry, 2012).
As a student at Cambridge, Darwin was apparently intent on interacting with and learning from Henslow; he was called “…the man who walked with Henslow” (Darwin 1958). Henslow was an exceedingly important influence on Darwin and on the development of his career and, quite probably, on his thought; see Darwin and Henslow: The Growth of an Idea (Nora Barlow 1967). As the title suggests, Henslow fostered and actually laid the groundwork for aspects of Darwin’s evolutionary thinking. In addition to mentoring, befriending, and encouraging Darwin, he shared his own research on variation and adaptation, key components of Darwin’s evolutionary views. According to Kohn and colleagues (2005), Darwin may have profited from a unique circumstance: Henslow was the only major figure working in botany to focus on and catalogue plant varieties. They speculated this may have been the result of the application of Henslow’s training in mineralogy and study of how crystal structures vary (Kohn et al. 2005).
Examples of other handholds or scaffolding afforded by Henslow were including Darwin in regular intellectual gatherings at Henslow’s home, introducing him to the geologist Sedgwick, who invited Darwin on a research trip to study the geology of Wales, thus exposing Darwin to geological stratification and distribution of species and field research techniques. It was also Henslow who recommended Darwin for passage on the Beagle Voyage, made sure that Darwin took along the first volume of Lyell’s Principles of Geology, communicated with him regularly during the voyage on his findings and cared for samples of extant and fossil specimens sent back, and read Darwin’s field notes to the Cambridge Philosophical Society and published them.
A number of key factors came into play in forming Darwin’s conception of evolutionary theory. Along with the interest in variation from Henslow, Lyell’s theory of uniformitarian gradualism was a template, or model, which served as a guide, which Darwin took with him on his voyage and absorbed. It is believed that he viewed both geological and biological phenomena that he witnessed with those templates in mind (two important footholds). Although his theory of coral reefs departed from Lyell’s, it was generally confirmatory of Lyell’s overall views. Subsequently Lyell embraced Darwin, promoting him at the Royal Society, securing him a speaking engagement there to read his paper on coral reefs, and strongly encouraging his work. Thus he too played the roles of teaching, inspiring, and subsequently promoting his young colleague (Sponsel 2011).
The historian Paul Brinkman focuses attention on the role of vertebrate fossil investigation and the succession and distribution of species as a key influence on Darwin’s view of succession, ultimately of descent with modification, and rejection of the fixity of species. Darwin’s own collecting and comparing of fossil vertebrates with extant species and study of published work by paleontologists, geologists, and comparative anatomists on the voyage helped to crystallize his belief in the biological continuity of species. Brinkman suggests that an especially cogent discussion of succession published by Robert Jameson (1831–1832) and included by Lyell in the third volume of his Principles may have tipped Darwin in this direction. In identifying his fossil collections he was helped by Lyell and many others (Brinkman, 2010). This demonstrates again the impact of the web of material, social, and ideational scaffolding on cognitive development.
A further, and arguably even more important, foothold was not one of mentoring. Darwin could see how selection could occur through breeding but needed a demonstration that it must occur naturally. The concept of the struggle for existence, given limitation of resources, acquired by Darwin purely from reading Malthus, gave him the final piece of the puzzle to explain evolution. Variation and adaptation, gradualism, and finally fitness and selection were concepts that Darwin drew upon from a variety of sources and with the help and encouragement of a number of other scholars, firsthand experiences, and with the insight to see how they fit together. This theory was not a willy-nilly collection of ideas. The synthesis of many independent sources of converging evidence led Darwin to develop a robust theory (Wimsatt 2007, chap. 4). All of this scaffolding cannot account for Darwin’s staggering achievements; the question is—could he have achieved them without these?
Footholds and handholds in a developing cognitive system or trajectory can be seen as a series of problem-solving resources that are integrated over time. Such disparate pieces as the inspiration, encouragement, guidance, and knowledge gained from many resources, along with his own insight, Darwin successfully integrated over time, resulting in his groundbreaking and monumental theory. Hutchins’s (1995) influential study of shipboard “distributed” cognitive tasks show individuals playing, and developing through, different specialized but coordinated roles in carrying out a complex navigational task. It illustrates the power of intellectual interdependence and coordination.
Nersessian and colleagues (2003; Nersessian 2006) studied “Research Laboratories as Evolving Distributed Cognitive Systems.” They distinguish their study from that of Hutchins as being an ongoing problem-solving process, in which history remains important and various disciplines and individuals are recruited to contribute their perspectives. Another example of an evolving integrative1 cognitive system is David Wake’s scientific research as studied and analyzed by James Griesemer (in press). Wake’s research was ongoing over several decades, during which he sought to engage with and integrate many new methodologies and perspectives as they emerged such as ecology, development, behavior, and others, while not forgoing his original morphological foothold. He also adopted the use of one model taxon, the lungless salamander, and a collection of particular problems as focal points. In each case he was trying to combine different perspectives, adding new tools to his toolbox as a way of solving specific problems and integrating different perspectives.
These kinds of processes if successful, may create a meaningful whole. What are the criteria for combining disparate, distributed parts into a functionally integrated whole? Wilson and Clark (2009), writing about what constitutes a true cognitive extension, appeal to its stable and robust character. Caporael also emphasizes the importance of integration through coordination: “Coordination refers to the skillful integration of diverse elements into a harmonious operation” (Caporael 2007).
Our intellectual trajectories involve learning from and using the work, insights, skill, and wisdom of others for guidance and to bootstrap our own endeavors. Through this, we receive such cognitive and emotional support as helpful criticism, encouragement, molding, direction, connections, and many nuanced informational and promotional aids to intellectual as well as career development and growth, especially from mentors and even peers (B. Wimsatt 1997). None of this is to diminish the role individuals play in identifying the trajectory they need to pursue, seeking out and integrating valuable resources, and working with and interesting mentors through their contributions, enthusiasm, and effort.
Careers as Developing Cognitive Problem-Solving Trajectories
In this section of the chapter, I focus on professional and career trajectories in which cognitive skills develop. In 1997, I conducted a study of young men and women as they were finishing medical training (either residencies or more advanced subspecialty training—fellowships). I surveyed them with an extensive questionnaire and interviewed a subset of them in order to understand how their career decisions were made at critical junctures in their careers and what factors they believed contributed to their decisions and to the further development of their careers as professionals. I suggest that their intellectual and skill development were intertwined with their career and professional development. I also sought to show that encouragement and other supportive experiences through diverse resources are a crucial factor in assisting this process.
I started with the idea of decision making as an initial foothold. My original study involved career decision making and professional development at critical junctures in professional training, and factors that individuals believed contributed to their decisions, their ultimate career trajectories, and professional development. Such decisions constitute a commitment, a foothold on a trajectory. This both opens up new possibilities and forecloses on others. Once an individual decides on internal medicine, for example, that individual may either continue into one of the medical subspecialties (another decision point) or stop as a general internist, but a career in surgery becomes highly unlikely.
Rationality alone did not guide these choices. Even at this initial stage, an important factor in these individuals’ decisions as well as their professional development was the kind and amount of guidance and encouragement they received (and anticipated receiving on the basis of early contacts) from faculty (Wimsatt 1997). A recent study on children’s decision making (Warneken and Rosati, 2012) found that even young children, in making decisions, evaluate the possibility of cooperation in potential partners. Analogously, women trainees in my study tended to choose or migrate to more female-typed specialties and to feel more encouraged to do so, or discouraged from choosing more male-dominated specialties.
The profession, its traditions and organizational structures (curriculum, knowledge base, specialties, and subspecialties), provides infrastructure, or institutional scaffolding for the development of expertise. While the institutional framework of the profession provides the organization and standard resources for an education, on the negative side, as Bielby and Baron (1984) argued, it may afford mechanisms to funnel individuals to different sectors of the profession with differential degrees of prestige, opportunity, and other rewards. These factors may partially account for the different career opportunities of men and women.
As my study shows, mechanisms through which such funneling takes place may lie in informal factors in which rotations with faculty guides in different specialties may afford mentoring scaffolds to augment the resources available and groom or encourage individuals or, by withholding it, the reverse (B. Wimsatt 1997).
These factors together sculpt and scaffold developing careers as can be seen in the different trajectories of men and women. Although gender is not the main focus of this paper, in considering the infrastructure of the profession as well as the effect of informal grooming and support practices, its inclusion seemed inevitable.
Professional development, whether in the sciences or humanistic disciplines, crafts, or arts, involves three important factors:
• The development of expertise, or higher-level cognition and/or skills.
• The ability to navigate and develop that expertise in a relatively open-ended (and therefore, more challenging) context.
• The ability to access support and other resources in the process of developing the relevant expertise.
Professional training is more open-ended, less structured in important ways than earlier education. Crucial decisions must be made, critical skills and knowledge must be mastered and honed, and the path is not always well marked. Role models and guides provide scaffolding in acquiring skills and navigating ambiguities at many levels of the process, from choosing an appropriate career path, to learning to perform an accurate diagnosis, to learning relational skills. Both in medicine and in other disciplines, there exists an apprentice system, in which novices develop skills in interaction with mentors. From a “situative” perspective, “…learning is the gradual appropriation, through guided participation, of the ability to participate in culturally defined, socially situated activities and practices” (Sawyer and Greeno 2009, 354).
The important aspect of this cognitive stage is that it requires going beyond the prescribed materials (as in a course) to developing and honing new skills, elaborating and applying them, and navigating a trajectory in a territory without a road map and with few road signs. It is partly because of this “going beyond” into unknown territory that individuals particularly need reinforcement and guidance from mentors and others.
Methodology
I studied a group of thirty-five male and forty-three female advanced trainees in medicine and surgery who had recently completed either specialty or subspecialty training. Questionnaires as well as interviews were used. The comprehensive nature of my questionnaire and the brief time period for collecting the data necessitated limiting my sample to a size that permitted personal recruitment of respondents.
Results: Where Psychology Meets Sociology
Encouragement, as commonly understood, is extremely important in boosting the self-confidence of individuals in any endeavor. However, I expand the notion of encouragement to the various powerful forms of resources that can make a considerable difference in the cognitive, professional, and career development of individuals. The cases of Venter and Darwin revealed many of these often invisible kinds of supportive elements. Individuals I interviewed had also profited from these kinds of support.
Below is a rough categorization of dimensions of support or resource commitment that scaffold professional and career development.
• Support/validation: enthusiasm, encouragement, reassurance, praise.
• Help: critique, ideas, explanations, references, demonstrations.
• Sponsorship, promotion: professional information, introductions, professional invitations, intercession (recommending the aspirant for a job, fellowship, or other opportunity).
Table 16.1 shows the professional/career support of women versus men based on the three types of increasingly strong support listed above, according to their self-reports on nine different, more specific subspecies of these three broad types. The table reports difference scores between women and men in three frequency of response categories: Frequently, Occasionally, and Rarely, with some examples of each type: (1) encouragement, (2) help (with tasks, e.g.), and (3) sponsorship and promotion.
Table 16.1
Indicators for the evolution of national populations of synthetic dye firms
Note: Bolded items in the table refer to items discussed. Vertically, resource commitments increase in strength from top to bottom. Horizontally, frequencies are cumulative across rows left to right. Number of variables per panel in which differences between proportions of men and women favored men, that is, men’s scores were positive; women’s scores were negative: I. 6 out of 9. II. 7 out of 9. III. 9 out of 9.
1. The resources represented by the variables in the left column increase, roughly, in strength and benefit to career development from top to bottom. All of these resources are valuable, but not all equally valuable, in building expertise and professional advancement. For example, praise or “recognition of achievement” is beneficial for boosting confidence but does not carry the career impetus as would invitations to collaborate on research. In any program there are stars who attract unusual attention and receive a greater commitment of supportive and promotional resources. At this end of the spectrum (located left and bottom of table) are those relatively few individuals who benefit from frequent and strong supportive resources.
2. The column headings indicate frequencies of receiving these supports, from left, the most frequent, to right, the least frequent. The frequency columns are cumulative from left to right; thus “≥ occasionally” includes “frequently,” and similarly for “≥ once or twice.”
3. Thus individuals who receive strongest benefits of these resources and receive them most often clearly are most advantaged.
4. These categories are not exclusive; thus some individuals have probably received the stronger and weaker forms of supportive resources and received them frequently. Various combinations of these are possible.
5. At the level of greatest frequency but lesser resource commitments (in the table left column, upper rows), women had a slight edge over men on three variables: “recognition for achievement,” “help with tasks,” and “professional guidance.” At the level of greatest frequency and strongest resource commitment (left column and bottom rows) this reversed (starting with “special assignments” and “information about opportunities” the signs changed from positive to negative), and it is especially noteworthy that 20% of men and only 2% of women claimed to have been frequently invited to participate in research (see the “research invitations” row, “frequently” column, in the table); similarly, 26% of men versus 5% of women said they frequently collaborated on research projects with mentors. These two results were highly significant, both at 0.009.
6. At the middle frequency level, most individuals of both sexes received recognition at least occasionally, but the stronger examples of sponsorship and commitment of resources, the variables at the bottom part of the table, favor a much larger proportion of men. Thus, for “information about opportunities,” women, 39%, versus men, 60%; “contacts made,” women, 36%, versus men, 54%; “invitations to professional events,” women, 34%, versus men, 51%; “research invitations,” women, 21%, versus men, 46%; “research collaborations,” women, 18%, versus men, 37%. Embedded in these resources are opportunities for both professional and cognitive growth in expertise.
7. At the other end of the frequency distribution (right-hand column), those who claimed they received some form of encouragement at least once or twice, almost everyone (93% of women and 97% of men) got at least a modicum of recognition, but within most other categories a surprisingly large number of both men and women, but especially women, denied receiving any of these potential benefits. For instance, 23% of women and 20% of men claimed to receive no professional guidance; 36% of women and 14% of men claimed to receive no information about opportunities (significant at .04); and 39% of women versus 17% of men said they never received invitations to professional events (significant at .05). Furthermore, even for those women who received at least a little of these forms of recognition, their proportion fell below that of men on every one of the variables.
To sum up the data, men profited from the very strongest commitment of resources, sponsorship, collegiality, and grooming: invitations to participate in research and frequent collaboration on research projects. At the middle range, including those who receive at least occasional manifestations of encouragement, men outstrip women on stronger and more frequent commitment of resources. Finally, at the lower frequency level, more women are left out completely. All in all, far more men seem to have gotten supportive resources, more frequently, of the kind that facilitate professional and cognitive growth and promote careers.2
Interviews: The Role of Mentors
In addition to the questionnaire, I sought a fuller understanding of the experiences of these trainees through personal interviews. These interviews illustrate the varied ways in which individuals develop professionally and build their careers through guidance, sponsorship, and the recruitment of appropriate resources. I present the interview material in a continuous form (rather than by segments and themes) to exhibit the developmental nature of individual trajectories.
The excerpts from one of my interviews with a male medical resident I will call Dr. T. illustrate some of the complexity that often goes into career decision making and the trajectory of a career. It also illustrates the role of a mentor in helping the novice to identify and crystallize his career interests and finally settle on a field of specialty out of the several possibilities he previously considered. It dramatizes the importance of the mentor in the development of his interest in the career and in building the career itself. It also shows the importance of a very early foothold.
This individual built on an emotive foothold. What had worked for him in his childhood, made him feel important, connected, and involved with significant others, he needed to put into place in his work life. But later that would be subsumed under other emergent interests, and these would be more often intellectual in character and developing out of new funds of knowledge that he was acquiring that had become increasingly important to him. Still, the need to find a discipline in which he could also have strong relationships with patients remained:
I think the environment I grew up in put me in a position where I ended up playing a very supportive role—either with family members or people close to the family—trying to help them through very difficult situations—which at that time … medically … I didn’t have that much knowledge, but more from the standpoint of trying to listen to people and offer advice, actually a fair amount even at a rather young age—looking back now. Taking psychology courses in college seemed like a natural transition—and med school seemed so far away then. You start to interact with the patients and I felt really comfortable in the field even though it was really early in my training—unlike a lot of other fields like internal medicine which seemed really overwhelming at the time—because I just didn’t have the experience or fundamental knowledge. So as I got more comfortable with medicine I realized that what I enjoyed about psychology I could do as much or as little as I wanted as an internist and still … relate to patients’ emotional needs.
And that’s what initially attracted me to hematology/oncology. That is what is without a doubt where the strongest patient relationships are formed. Very sick patients, very involved families; the hematology patients could easily have been relatives of mine … the bonding and the relationships there were much more intense than anywhere else and initially that was very attractive but, by the end of a year of doing that and watching these people have terrible courses, I realized that if I chose that for a career I’d be a wreck in no time.
Also, at the time I was starting medical school, I thought I would do a lot more research…
In this excerpt, the respondent is speaking of how he began to think more about disciplines in terms of how he related to the knowledge base in the discipline.
I had a lot of exposure to psychiatry in college research—so that in the beginning it was something that I felt more comfortable with in the early stages of training—which is the most difficult because you’re so new in everything. Hematology, I only felt comfortable in because of—back to the relationships and supporting people and family and stuff like that—but the field itself, I wasn’t particularly knowledgeable about.
Two things appear to be important at this point. New knowledge and skills and mastery gave him a new foothold, and he was able to combine that with emotional helping relationships with people, still essential for him.
So then as I got more comfortable with things, it turned out that the physiology and the day to day problems in taking care of the patients—I got more interested in endocrinology—which actually, early on—both in college and in medical school—I found totally incomprehensible … I think it was just the more exposure I got the better…
Dr. M. played a major role. I still view her as a mentor overall. She is just a fantastic physician in general. She’s very excited about her field which has a contagious quality. She seemed to be able to do the kinds of things I wanted to do. She had a great relationship with her patients … she was a general internist when she felt like being one and she also had the advantage of a specialty which had a very specific set of interventions.
At this point too, the emergence of a strong relationship with a mentor and role model made a crucial difference for Dr. T. These two factors, Dr. M. “had a great relationship with her patients” and was “…a fantastic physician…,” brought together the emotional and cognitive qualities Dr. T. was looking for and could build on.
This case also illustrates the dual aspect of mentoring mentioned by others whom I interviewed; the novice shows unusual interest in the discipline and works hard at the tasks before him. These behaviors may be an important attractor to mentors, and they can “build on that”:
She took an interest in me based on the fact that I worked hard and was very involved with my patients, and took care of the necessary details, and independently of that I had sort of expressed an interest in general physiology and she was able to build on that.
Dr. M. played an extremely active role in shaping his career interests.
… she thought I was one of her stronger interns and she clearly has a recruiting aspect to her job for the department, and she keys in each year on interns who she thinks are good and potentially interested and encourages them very hard actually to go into it, because they like to take a couple of their fellows from here each year. So she kind of saw her opportunity [laugh] with me, I think and really worked very hard on me to encourage me because I guess that at that point I had not thought of doing endocrinology. She’s a very dynamic lady, very outgoing and she usually gets what she wants. And I love this … she’s amazing … very powerful woman. There’s plenty of positive role models around here, but she’s the one certainly from a professional standpoint that I’d want to imitate if I could….
Yeah I actually spent more of what they call elective time which is basically—you can do whatever you want—and I elected to spend it with her as a junior resident and that was a very good experience and helped confirm in my mind that this was the right field for me….
She just … she found time to seek me out after that month we spent together. She looked out for my interests and … a few very nice clinical projects that have come up that she made sure she found me and got me involved with … like I said when she’s interested in something she really goes for it.
This case exhibits a number of the features of mentoring, already described, of the action of a mentor in weaving the protégé into the professional fabric to provide important opportunities for acquisition of cognitive skills as well as professional development. It also shows the protégé seeking out the mentor to continue building on and profiting from the relationship. And she, in turn, provided opportunities, “a few very nice clinical projects” for him. These mutually reinforcing interactions reveal mechanisms for how Tomasello’s ratchet works at higher levels of cognitive development. Over time he integrated various resources derived from developing professional knowledge, supportive interactions, and opportunities to build expertise with an early and very strong emotional experience.
These materials further demonstrate the role of encouragement and guidance and the interactive roles of mentor and apprentice. The mentor weaves the apprentice into the profession, and the apprentice, in turn, shows his interest in the specialty, which creates a further bond, leading to further mutually reinforcing interaction. Finally the mentor helps with the prized opportunity of a desirable project, residency, fellowship, or job.
Themes illustrated in the above case were echoed by several other interviewees:
• Mentors and getting a foothold on a career trajectory:
In college I worked in his lab and ended up working on a project which was accessible, and I was able to produce something, and I think the interaction grew as a result of that initial experience in the laboratory. Now I hadn’t decided what I wanted to go into, but because of the interactions we had … once in medical school I became interested in pulmonary … and there were courses in that specialty, and he taught a large percentage of them, and so he encouraged me at that point to continue my career in that direction, and I took a year off to get further academic training in that area.
The chief of the medical service … I had asked for advice on what to go into. I told him I was interested in internal medicine and in primary care. He encouraged me to go into geriatrics. I never would have thought of it but it really fit.
• Encouragement, inspiration, support:
He was my advisor for my M.A. thesis.… he sat in the audience and listened to me present it 5 or 6 times—he always had interesting comments or thoughts even if it was the fifth time he had heard it … and I thought that was special.
As a resident in medicine,… There was one person who I felt took a personal interest in me. This consisted in … constructive criticism, reinforcement.
In my fellowship, I have had a very strong mentor. She is a very wise person. This was not so much in terms of teaching per se, more encouragement and support, and it was more in terms of new perspectives on things, very enlightening ways of thinking about things.
• The economy of learning from more experienced, skilled faculty mentors and the mutual reinforcement of interaction:
I have a mentor here now as well. I have learned an enormous amount. They have taught me to find my way around the research industry. The deal is that I had an angle on their data which I am teaching them about and they are teaching me how to do the technical part. So we fit together like hand and glove. They familiarized me with their data, the analysis they are doing. They taught me everything from writing a proposal, writing the abstract, presenting the results. I had another mentor here also—a general research mentor who helped me develop a general research perspective in terms of learning how to learn, how to do research, to analyze the literature, to develop my own procedures, and so on.
• Opportunities that are career gold:
There was a 180° change. He helped me to get this fantastic fellowship.
He helped me get a residency which was a very special one—one that I wanted very much—at a place that ended up being a perfect location for me.
I came and presented my ideas here. I applied for and got an NIH grant. They liked it and wanted me to come and work here.
As these cases suggest, grooming often works in two directions. Mentors also derive benefit from working with enthusiastic and committed apprentices and have an interest in seeing the continuation and extension or expansion of their own work. Darwin, like Venter, may have been unusually good at recruiting mentors and advocates through his fascination with and application and extension of their work in pursuit of their own interests. (See also Dobbs’s [2005] “How Charles Darwin Seduced Asa Gray”). Both Darwin and Venter communicated their enthusiasm and commitment to relevant mentors and collaborators. In the case of Darwin and Lyell, it was, at least in part, the extension of Lyell’s theories by Darwin that created a bond which could be built upon. This kind of mutual benefit is also seen or implied in these interviews. More than once I heard of mentors being impressed by the trainee’s hard work and interest in the discipline.
On the other side, some individuals were discouraged and temporarily or permanently disabled by negative interactions. Unfortunately, I encountered this more often in women:
During the first year of (the residency) there is very little encouragement. And in my second year, I was in deep trouble. I was going to quit or I was going to be fired. One third to one half of the time I came home crying. There were a couple of attendings who were trying to get me fired (one of them was a woman). I didn’t completely understand it, but they were very vindictive, destructive people. When they left things got a lot better, but I was being watched. I was called in by the chairman and told that if I didn’t shape up I was out of the program. Yet I couldn’t find out what I had done wrong. I was too upset to say anything…. My parents initially tried to discourage me from going into medicine. They thought it wasn’t a good profession for a woman, but without them I couldn’t have made it; especially during the period when I was having so much trouble, they were very supportive. The scars that were left by the second year of residency are still there. No one knows about that. Self-confidence is my biggest problem.
It would appear that just as encouragement can lift the spirits of individuals and boost their confidence to succeed, so destructively negative experiences can have a long-term impact on confidence. One of the men whom I interviewed spontaneously offered his opinion on the situation of women during the course of our interview:
I’ve actually gotten a fair amount of support and positive feedback. I actually think the system as a whole is very bad at that. It’s certainly there to let you know when you screw up, but it’s not very good at giving you positive feedback. So I’ve been lucky in that respect. Other people who have gone through the same thing with me at the same time, and as far as I’m concerned did as good or better job and just didn’t get the feedback…. I don’t know. Some of it may just have been being in the right place at the right time. Some of it is, undoubtedly, women have to work twice as hard to get the same level of recognition. Yeah. My best friend who went through residency with me is a woman … had to do twice as much as I did … and even then it was like somehow that wasn’t enough. So … she’s not the only one who’s had that experience.
For a variety of reasons, some probably institutional, men appear to be mentored in a more effective way than are women. The form of mentoring I refer to is an ongoing interactive process through which an individual’s interests are shaped and her or his career develops over time. This is how careers develop. This is also how career decisions develop—through the various resources, especially active help, reinforcement, and promotion of mentors. According to recent studies cited by The Economist, a sponsor dramatically improves a woman’s career prospects (Hewlett et al. 2010).
In the study which I draw from, two other results bear on these points. First of all, men were far more likely to claim to have “close collegial relationships with mentors” (50% of men vs. 15% of women). Secondly, men reported receiving more career resources—such as being invited to do research and collaborating with faculty on research projects. These reports all point to the greater benefits received by men and on the importance of mentoring relationships. Being treated as a junior colleague, being incorporated into projects through which important skills and a greater sense of competence can be acquired, all are the rungs in the ladder to higher level careers and skills. The above interviews illustrated this kind of process, but they also went further in portraying its developmental nature.
These cases were of individuals who had extremely dynamic and fruitful relationships with various mentors. In one (excerpted) interview a male fellow described a career built through interaction with a series of mentors (as well as simultaneous mentors) who offered guidance, support, and detailed strategic advice. In all cases, the interactions with mentors and the building of the novices’ careers progressed over an extended time period, sometimes through a number of stages. As these interactions progressed, the novices were increasingly able to focus in on and identify the specialties and interests which would give them a foothold. Presumably, along with their growing interests and commitments, their competence and self-assurance also increased. Of course, not all mentoring has this character—sometimes encouragement, help, and support may come in one or more isolated episodes, and there is undoubtedly a spectrum in which these cases are at the stronger end.
Three other men interviewed exhibited another strategy; all were very strongly attached to various mentors, but they did not give much indication of a highly reciprocal interaction. Nevertheless their attachment to these mentors was extremely important to them. They learned what they could and took as much as they were able from the relationships. In their minds, these were their mentors.
The interviews I presented revealed other strategies for individuals to make their way: being conscientious and doing the best job they know how, drawing bits and pieces of help and support from various quarters. This was a path followed by some of the women whom I interviewed and quite probably by some men as well. Not everyone is a star, but many more men are likely to be put in the star category than are women. And even including the next level down of more average individuals, men appear to receive stronger mentoring.
In historically male-dominated disciplines such as medicine, female entrants may feel intimidated in seeking support and guidance. In the study described here, several women expressed fear of asking for help in a variety of problematic situations such as performing a difficult technique and were fearful of reporting a frustrating or destructive interaction with faculty. Another factor was the perception some women held that they should be independent and not require support; thus they sometimes may have avoided seeking it. It would appear that an institutional system of advising, and/or advocacy, beyond merely mechanical evaluations, would be valuable if personal guidance was not available. This is a difficult problem because some individuals didn’t know whom they could trust.
People did not seem to turn to fellow students for advice although this could be another avenue for finding support. However, a surprising number of women in medical training were the daughters of physicians and turned to their fathers as role models and for support.
Summary and Conclusion
My contribution to the growing body of work on social or situated cognition is showing how the “ratchet” of cognitive development works, especially as applied to a later cognitive stage that involves the development of expertise, and sometimes, innovation. Cognition is embedded or situated in and develops through the social realm. It is scaffolded by interacting with, absorbing, coordinating, and integrating various resources of people, information, procedures for using technology, and opportunities for growth (all parts of a developmental trajectory) in the acquisition of professional skills and expertise. Much work on situated cognition deals either with microscale or everyday problem solving through the use of energy-efficient heuristics and/or scaffolding artifacts (Wilson and Clark 2009; Kirsch 2009) or school-focused learning as situated (Sawyer and Greeno 2009). Tomasello focuses on development and grounding human cognition in our social affiliative nature, allowing us to learn from others, build on our ability to take the perspective of another, pool information, and build on what we learn, ratchet-wise.
By portraying how individuals build expertise and construct a career in a larger scale ongoing problem-solving process, I make two contributions to the literature. First, I focus on a later stage than commonly discussed: the specific process of professionalization and career building, which exemplifies a more open-ended problem-solving niche, through which cognition and expertise develops. Second, I give examples of mechanisms that contribute to the “ratchet” of cognitive development. I describe the process both in terms of generative footholds, such as a major decision, the identification of an interest, or the mastery of some knowledge, and facilitating handholds or scaffolds, such as the role of emotional support through encouragement and other mentoring collegial resources: information, direction, and especially, at the more sociological level, creation of opportunities.
Like Nersessian, I cover a specific developmental process which utilizes a variety of resources over time: she studies the use of diverse resources in an ongoing process of problem solving in a scientific laboratory; I focus on the developmental process of career/expertise formation through the institution of professionalization. I discuss in new systematic detail the recruitment, assembly, and integration of diverse cognitive and emotive resources from mentors and other supporters. The development and use of artifacts as well as people are prominent in the work of Nersessian and others; I presuppose their importance as well as that of acquisition of information and skill in medical training and other scientific work, but focus instead on the social/cognitive structures, footholds and handholds, which enable these.
Acknowledgments
I am extremely grateful for the support, careful reading, and many helpful suggestions on this chapter from Linnda Caporael, James Griesemer, and William Wimsatt. Thanks to Billy Wimsatt for encouragement and help. I also want to thank Paul Brinkman and Alan Love for last-minute advice on Darwin, and finally Charles Geyer of the Statistics Department at the University of Minnesota for his generous and inventive help with the statistical analysis of the table included in this chapter. He created a way to analyze the data when no one else even came close.
Notes
References