17-4
NOT
THIS
In scientific problem solving, it is important to
start with doubt and then systematically gather
information to figure out the most probable answer.
BUT
THIS
Helping health workers learn to solve problems in a questioning, step-by-step
way is not easy. Many find it difficult to accept uncertainty as a starting point.
They may be ashamed or afraid to admit their uncertainties—even to themselves.
Instead they may jump to ‘obvious’ answers, or even invent test results for things
they have not understood. Appearing to have the answer somehow seems more
acceptable than doubting and carefully searching for one. This is an attitude the
health workers may have learned in school, where good grades tend to be valued
more than useful knowledge.
This leap-before-you-look approach to problem solving, when mixed with modern
medical science, can give poor or dangerous results. For this reason, some health
professionals argue against teaching village health workers to use important
medicines or take on major responsibilities.
However, a reasoning, step-by-step approach to problem solving can be
learned. It can be learned by non-literate persons just as by medical students.
One reason why it sometimes presents special problems for villagers is that,
in a training situation, they often feel unsure of themselves. This is especially
true when instructors are professionals from a ‘higher’ level of society, or use
manners, dress, and language that make villagers feel inferior. Persons who feel
unsure of themselves, understandably, may have greater difficulty admitting their
uncertainties. I hey tear being laughed at or scorned
tor what they do not know. Afraid to ask questions,
they may try to guess at answers.
For this reason, development of problem-solving
skills needs to go hand in hand with group
learning methods that help build self-confidence
and greater social awareness.
EXPLORING THE SCIENTIFIC METHOD OF
PROBLEM SOLVING
Rather than starting off by explaining the steps of scientific method with big
words (hypothesis, theory, etc.), try looking at a real or imaginary situation in which
the different steps are used. Then encourage the health workers to figure out the
various steps for themselves.
It is best not to begin with the diagnosis of a medical problem, as this is still a
strange new process for many students. Instead, try to begin with a more familiar
problem-solving situation. In Ajoya, Mexico, the village team uses a ‘detective
story’, and the students take part in figuring out who is guilty. After analyzing
the different steps in the story, the group discusses how they can use the same
problem-solving methods in diagnosing and treating people’s illnesses.