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Embracing an Embodied Approach to Learning

Learning Objectives:
1. Identify the topics that should be included in your institution's equity education plan related to the history of marginalization, dynamics of difference, and building solidarity
2. Define the aspects of embodied learning and its importance when embarking on equity related work
3. Describe how to use your own identity and personal experience to inform ways you can create safe spaces
0.25 Credit CME

This video is an excerpt from the AMA Advancing Equity Through Quality & Safety Peer Network session on Embracing an Embodied Approach to Learning. This activity will explore methods for facilitating open, honest, and thoughtful dialogue related to equity.

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Video Transcript

Normella Walker: [00:32] So I just want to take a moment to ground us in this idea of really participating with real talk. Often, we participate in superficial talk, but really real talk is what moves people. You know, being able to kind of go a little bit deeper, and the invitation is to do that. So as part of this, you want to validate humanity; invite you, you know, to have open, honest, and thoughtful dialogue with one another; to recognize that crisis, conflicts, and change can actually represent opportunity and growth; appreciate that we're learning, and when we're in learning mode, we're going to make mistakes, we're going to be awkward and clunky, and that's fine, we invite that to; and appreciate pauses, feelings, and reflections. Right? No need to be perfect in the space, and actually, what I'm going to ask you to do is let go of expertise as we engage with this learning today, and just kind of be open and surrender to kind of learning and growth. And then...this is only intended to be a beginning. This is such a huge topic, there's so much to discuss here, you know, and we're not going to get nearly what we need in an hour, but we're going to do the best we can. Next slide, please.

[01:55] So our suggestion, and we're not going to spend a lot of time on academic education, because these are things that you can kind of facilitate and learn for yourselves. I suggest is that you work with your DE&I office to cultivate and support the academic learning around these particular topics. Okay, so, one, the history of marginalization—that's going to be really important to focus on as you continue your didactic learning. Forms of racism, right, there's overt, covert, aversive, subversive. Honestly, the latter three are more prevalent and problematic than an overt racism. And so understanding how those things show up in very subtle ways is going to be really important. The forms of racism, but also the levels of racism intrapersonal, interpersonal, between people, groups, institutional and structural. We tend to remain at the structural level, but I will say, we also need to pay attention to all these other levels simultaneously. So we have to be able to chew gum, walk, clap our hands, turn our head at the same time as we do this work. Because the things that occur at the structural level could not happen if we didn't tolerate them internally, interpersonally, at the group level, and at the institutional level. So we actually have to be able to work at all these levels at the same time. If we don't, we'll continue to struggle to make progress. And so...and we're going to actually focus very, inter- and intra-personally today with the exercise we had planned for you.

[03:26] Also, just want to kind of recognize some other things on this list. We've got power, privilege, and oppression, and recognizing and understanding how those things work. Internalized oppression, and how it shows up as inferiority and also can show up as superiority. Authority, status, and domination. Conformity and control—you can read the list here—white supremacy culture, which we also refer to as white dominance culture, or capitalistic culture, probably better to be referred to in that way. Because when you actually look at white ethnic culture, it doesn't coincide with the concepts tied to white supremacy culture. But all that is a way of being that we have each been indoctrinated with, and we need to interrupt if we're going to do this work well. White fragility, tone policing, so forth. And then also cognitive functioning and cognitive error. So you know, there's a lot of buzz around unconscious bias and bias, but that's just one of many different ways in which we, you know, we have problems with our ways of thinking. So there are other types of errors, attributions, phobias that we have that we need to also make ourselves more aware of. Dimensions of diversity, intersectionality and how that shows up. And it's really crucial to understand identity development, identity presentation, so forth. Conflict transformation, and then change in resistance, because this is all about creating change. This is a change process, and we also have to be prepared not just to change other people or to change institutions, but we have to be able and be willing to change ourselves internally. And there's going to be external resistance as we try to do this work, and also, we're going to internally resist as we try to do it as individuals. So just want to name that. And then the whole thing is really about building solidarity, because change is actually a group process, it's a group function. If I change, and the people that I surround myself with don't change, then I'm likely to go back into conformity myself. So we have to kind of think of change not just as an individual thing, but something that we have to do as individuals and groups of individuals. Let's go to the next slide.

Guest: [05:40] Normella, can you just stay with that one just for a moment?

Walker: [05:43] Yeah, go ahead.

Guest: [05:45] Because we can do such amazing self-work, and then we're still in these containers that are toxic, and how we get pulled back into that. I just so appreciate you mentioned that, because I don't hear people speak to that very often.

Walker: [05:57] Yeah, that's real. And so this is, you know, there's this internal resistance that we fight within ourselves, because it means that we have to adopt new ways of thinking and being and reacting, and it's work. It's real work. It's emotional and psychological labor to do this. And then also under embodied learning. Let's go to the next slide. Yeah.

[06:20] So again, I'll let you take a look at the list of descriptors, but this is really what embodied learning is about. So Western education acknowledges four basic categories of knowledge: factual, conceptual, procedural, and metacognitive. But Western culture has largely separated cognitive knowledge from embodied learning, right? Physicality has been something that, in our context, is something that must be tamed or controlled to achieve cognitive performance. And nothing could be further from the truth. You know, there's knowledge held not just in our brains, but also it lives in our bodies. And we've been conditioned to ignore our somatic responses, right? The feelings in our bodies. And what we want to kind of cultivate today is an awakening of that. The ex—go ahead, Cheri.

Cheri Couillard: [07:08] Normella, can you talk a little bit about the purpose that being disconnected from our bodies serves in... for capitalistic culture?

Walker: [07:16] Absolutely. Right, so think about the exclusion that we witness, the exploitation, the violent abuses. That cannot happen without being detached. We have to be detached from our feelings in order to bear that, in order to tolerate that. And so in order for us to change that, we have to be willing to feel again. We have to get back into our bodies. And we need to listen to what our bodies are telling us. This is a big part of the work. And we've been conditioned not to listen. And it's not going to be easy to turn that around. So again, that that type of existence requires detaching. We can't, you know, bear what we've been able to bear without it. And I think what is also interesting is that we simultaneously objectify the body, as gendered, raced, aged, classed, disabled, sexually oriented, and diseased, as we think about this, too, and as we kind of go about, you know, interacting with one another. So there's a lot happening with the body work. And so we want to cultivate a more of a sense of embodied learning as you do this work.

Walker: [08:23] Next slide. Also, just want to say that introspective work, being self-challenging, using yourself as an instrument, understanding more about the self, is extremely crucial for doing this well, right? You are the most instrument—the most important instrument that you have in facilitating change. People often come to this work with this kind of idealistic and altruistic way of thinking about saving others. But without recognizing the things we need to explore and fully understand in ourselves, we're not going to really be effective with helping others. So it's not just about what's happening outside of you. It's about what's happening inside of you, as well as what's happening outside of you. Next slide.

[09:07] And here's a list of the dispositions, attitudes, and demeanors that are necessary for you to connect with. So more curiosity, humility, courageousness, flexibility, generosity, being able to question conventional hierarchies of knowledge, willingness to explore new possibilities that don't coincide with tradition, questioning even where tradition came from, right? And being open to being challenged without getting defensive ourselves is a big part of this—you got to be able to receive feedback yourself in order to give it to others effectively. Next slide.

[09:41] And then also the presence that you bring, right? So a calming force, knowing how to be fully present. We're in such rushed spaces, it's almost impossible for us to actually achieve full presence. It takes a lot of discipline to do this. Utilizing deep listening, right, cultivating good energy. This is the presence that you need to bring to do the work. And if you feel rushed right now you should, because I'm rushing. And this is the exact opposite, honestly, of what we need to be doing as we do this work. It takes time. You know, it takes focused energy, focused effort. So I just want to name the fact that I'm rushing, because I'm, you know, working within this paradigm that we have sort of committed to within an hour, but deep learning doesn't happen. So I just want to acknowledge and own that. Cheri, you want to pick up with the traps to avoid? Next slide.

Couillard: [10:38] Thanks. So we think about… So just slowing this down, because this is an important part. So when we think about how to do this work, and we think about the ways that we're currently doing it, and the degree to which it often ends up being an intellectual exercise, it's really important to understand that more important than sort of being able to explain a resistance tactic is being able to be the resistance tactic. To be really, really critically aware of how you're using yourself at any given moment, and all the functional aspects of your identity, to literally be the resistance in every space, every moment, every time. It's a artful, nuanced way of engaging with this level of deep, deep change that will lead to some level of permanence versus always being at risk of assimilation.

[11:35] So when we think about how to do this work in a deep, personal, embodied, choiceful way, right? It's really important to take a look at the typical traps that we get into in these DE&I spaces that end up just converting them into more oppressive spaces. So really paying attention to this, this deep question, this first one, it's savior syndrome. What are my true intentions here? What are my motivations for doing this work? How well have I interrogated what I'm about to say? And what purpose does it serve, because if I'm still thinking that I'm here to help anybody else, I'm still part of the problem. So really paying attention to that edge. We're paying attention to when and where we remain silent, what risks—have we stopped and really analyzed our relationship with the risk, when we're going to take them, how we're going to take them, what they're going to look like?

[12:33] Another trap to avoid in these DE&I spaces that keeps the work stagnant, is being unwilling to acknowledge all the levels of racism. So as you'll see, the exercise that we have designed for you really focuses and asks you to do the internal piece, which is where we find most people want to resist. It's so much easier to talk about systems and institutions and structures, right? Because then the onus of responsibility, and the locus, the internal part of that locus of control what we call your ability to actually control a thing, remains outside of you. So the accountability is less, it's more manageable. The responsibility isn't something that we have to stand up to in the same way. So we're really going to focus on that personal piece today to get into that gritty territory that is so easy to avoid, so easy to abandon.

[13:22] And then really thinking about how do we engage with emotions especially in, in a professional space? You know, resisting the call to do emotional labor in public—this is a really big dodge. Because when we do this, we get out of having to do the interpersonal work that creates spaces that aren't safe, containers that don't work, and it allows us to stay siloed even in our own minds away from our coworkers to get to a place of really deep understanding, strategy building, tactical planning, and a way to move forward in this work, get really mission aligned. So really resisting that emotionally, labor. Being the resistance, bringing the emotions into this space, allowing the body to guide how we share them, and then really making commitments to one another and ourselves to work with that material is what leads to pioneering work in this in this human space.

[14:22] So doing- versus being-addiction, action addiction, we are really moving...you will not hear us talk about action items. The action item that is important to us is the self-excavation so that you can just show up and be the resistance that we're talking about. And again, moving too fast around this point, we would ideally like to have two to three hours to do this session with you because that's how that's how long feelings take. And again, it's part of our strategy work to bring feelings back into the room so that people can embody this work in a different way. So going forward, if you do do this work in your own institutions really tried to challenge the status quo by carving out that time. And we can go to the next slide, please.

Couillard: [15:10] So we're going to set up this activity for you. And to do this—and like I said, it's going to be feelings based and introspective—we really…this is a moment where I'd like to ask you all to come into a little bit more presence than you're used to. So we're going to do this, I'm going to actually have you kind of take a breath, and I want you to ask yourself, "Okay, can I consent to opening up a little bit more here and stepping into my vulnerable self?" And the reason why I frame that as consent is because it's deeply important that we get to a place of actual consent around using our identities, and our emotional bodies in a purposeful way. And if you haven't psychologically consented to that, then you're going to be resisting the activity that's coming next. So this is a part of it, that we're really working on slowing down and examining in our own spaces, this real, real important piece of consent, and what parts of my identity do I consent to be present, and what parts don't I, and have I even thought of that is a whole body of work on its own.

[16:21] So it's very easy for us to come into these spaces showing up kind of like what this left side says, right? Like technical hierarchical, linear, action oriented, and comfortable. And it really takes an active, willful choice of embodied consent to get into this space of being able to learn, hear, receive, renegotiate, and change. And it's going to call into some, into the room some questions around our identities and the ways that we've always gotten to be and whether or not those still are going to apply, or if we still want them to in the future. So really getting into this flexible, dynamic, personal, authentic, and partnership based space of learning. So we can go to the next slide.

[17:06] And the reason we asked you for that moment of consent, is to actually give you a way to then step into this next tool of introspection. So we use this tool a lot in our work, because we think it really helps get to the place where we can do pioneering work in ourselves and in our groups and in our communities. So it's really, you know, where we want to get to in this work is that top righthand corner—it's that blind self, it's the information about, or excuse me, the undiscovered self, the information about you that you don't know, and that others don't know. So what is that unexplored territory where actual creative, innovative thoughts can come in, but have not yet been discovered, because it requires a level of vulnerability and, and thoughtfulness that maybe we haven't taken the time to consent to doing in a public space? So it's really important that we understand that the activity that we're going to have you do is asking you to go into this bottom right quadrant. It's asking you to go into this bottom right quadrant, say things maybe you haven't said yet, think of things you haven't thought of yet, and maybe feel things you haven't felt yet. And then asking you to, to bring this forward into the group in a vulnerable way. And that vulnerable way will really create what we're, we like to call purpose driven intimacy. So it's a deliberate sharing of self for the purpose of furthering the work. Normella, is there anything you want to add?

Walker: [18:45] Just briefly, to add a question about the blind self. And yes, so the blind self is an important piece of this, too. And those are the things that we don't know about ourselves, but that others know about us. And being open to feedback is a way to close that box, to reduce it, so that if we're hearing what other people are saying about us, then we can begin to see more deeply things that we are not able to see, you know? And again, instead of getting defensive when you get feedback, really taking that in and exploring it and working with it is an important part of looking at the blind self. So the way to make that smaller is to you know, to hear what others have to say and be willing to seek other knowledge around how you're feeling.

Video Information

Credit Designation Statement: The American Medical Association designates this enduring material activity for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships.

If applicable, all relevant financial relationships have been mitigated.

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Enduring Material activity for a maximum of 0.25  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 0.25 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 0.25 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 0.25 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 0.25 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 0.25 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.


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