Claudia Ruitenberg

The Canada Health Act (CHA) is clear “that continued access to quality health care without financial or other barriers is critical to maintaining and improving the health and well-being of Canadians”. Failure to attend to these barriers may lead to inequitable distribution of the health care system’s intended benefits, constricting the CHA’s aspirations towards health equity, unravelling a key thread of the fabric of Canadian society, and impinging upon citizens’ abilities to enjoy their civil and political rights. As physicians are key actors in health care delivery, it is paramount to understand whether and to what degree they are formed through medical education to work for the realization of the social right to health care.Using a theoretical framework of Western citizenship, a methodological approach of Foucauldian genealogy, and methods of critical discourse analysis applied to an archive of over 120 texts, this dissertation considers what kind of physician the competency-based medical education system produces. Analysis of the discourses of medical professionalism, health advocacy, and social accountability suggests that current educational policies and practices produce medical experts primarily focused upon providing high-quality individual clinical care. While this skill set is necessary, it is insufficient to deliver on medical education’s claim that it is fundamentally anchored in meeting societal health care needs and to prepare physicians to work for the equitable distribution of the health care system’s intended benefits.In its place, this work proposes that the medical educational system shift from a focus on medical experts to medical citizens. Centring the latter subject position in medical education neither excludes the provision of high-quality clinical care nor negates the clinical activities of the former. Rather, it broadens how we think about physician competence and, in turn, considers how current medical educational practices may be re-purposed to shape physicians who inflect the social and political responsibilities of citizenship medically and put the equitable realization of the social right to health care at the centre of their professional efforts.

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This study explores what can happen when a collective of art teachers come together to reside in a space that allows them to practice their impotential for nine months, deactivating the necessity to act as teachers, always in a mode of production (Agamben, 2013). Doing nothing at the site is not idle-ness but a radical gesture of conviviality (Illich, 1973). The distinction between what we cannot and can Not do is one I will emphasize in this dissertation, and is based on the philosopher, Giorgio Agamben’s (2013) distinction between (in)ability (something we can or cannot do) and (im)potentiality (something of which we can choose Not to do it). Through the creation of an experimental practice at a storefront site in Chicago called Spaces for Possibility, the artist collective enters into a heterotopic space (Foucault, 1984), a real place, where teachers can imagine what other worlds might be possible. As an artist collective made up of ten public school art teachers, and a researcher as participant, we put old uses, a building, to new use and queer use (Ahmed, 2020) as a space for possibilities to arise or not. In this experimental project, I employ research creation practices that support creative, affective and sensory processes of worlds unfolding, and being made, of stories accumulating and being re-arranged, of modes of responding and corresponding with each other (Ahmed, 2010; Haraway, 2017; Manning, 2014; Stewart, 2007). These practices afford me as a researcher the ability to create and design an experimental project that follows what is made or not made, documented and collected as events, scenes, and stories that build up as affects and other forms of accumulation at the site of this research, affording the researcher space to let emergent events unfurl without predetermined outcomes (Haraway, 2017; Stewart, 2007). The promise in this study is in how we come to the space permitting ourselves to imagine what other worlds we wish to inhabit as teachers, while we also put into question the ethical dilemmas of use and our potential to act.  

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The healthcare environment reflects and embeds sociocultural norms, including heteronormativity, which pervades workplaces through policies, cultural norms and informal interpersonal interactions. Coming out is a process of continual identity management. Subsequently, there is evidence that lesbian and gay people (LG), both patients and healthcare professionals (HCPs), engage in significant identity work to manage who they tell about their sexual identity, and in what circumstances. For patients this can result in barriers to healthcare that can substantially affect their health and wellbeing. Radiation therapists (RTs) are a group of healthcare professionals who treat people diagnosed with cancer using radiation therapy. HCPs, like RTs, are subject to explicit and implicit bias, and may feel they need to disguise or downplay their sexual orientation at work. This research explored the issues of LG RTs and their experiences with managing sexual identity in the workplace, and how this has impacted their relationships with co-workers and patients. The research used an authoethnographic narrative inquiry approach. Three LG participants from a large Canadian urban cancer centre worked with the researcher to co-construct stories of coming out at work using their shared personal histories. An iterative development process was used. The co-constructed stories include fictionalised narratives of identity management as a radiation therapist at work, relationships with patients and peers, the experiences of sexual minority patients and the researcher’s accompanying lived research journey. The results showed the participants engaged in highly contextualized and continual identity work and utilized a series of different strategies or tools. Additionally, it was clear that both the discourse around professionalism, and the pervasive biomedical healthcare culture served to further inhibit disclosure at work.There is growing evidence that some patients from minority groups, including LG patients, feel more comfortable and may have better health outcomes when treated by healthcare professionals from the same background. For RTs, coming out at work might be a risky business. However, it seems likely that focused attention on improving the work environment, so RTs can be open about their identities in the professional setting would be beneficial for both patients and staff.

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This dissertation situates current Chinese international students in the historical flow of internationally mobile Chinese people since the late 19th century. Informed by their predecessors’ significant contributions to China’s political transformation in the 20th century, the doctoral research conceives of these students as political subjects ‘in the making’, and examines them as potential influencers on China’s democratization efforts in the upcoming decades. This doctoral study examines how Chinese international students become and/or are made into political – and possibly democratic – subjects through their engagement with democracy while pursuing degrees at universities in Canada and the United States. Adopting a qualitative case study approach, the study recruits twelve students from two sites, one on the Canadian West Coast and the other on the U.S. East Coast. It collects data on participants’ engagement with democratic discourses and practices in their two host countries with three methods (i.e., qualitative interviewing, observations, and document gathering). Findings demonstrate that international mobility in higher education has significant bearings on participants’ political subjectivity. Particularly noteworthy is that half of the twelve participants emerge with increased commitment to democracy and increased competence to effect democratization in China. Increased commitment and competence were closely related to students’ engagement with three kinds of democratic practices: 1) those associated with learning and unlearning about democracy, 2) those associated with democratic elections at the regime level, and 3) those associated with organization design and management. Further, students’ engagement with democratic practices occurred largely in two spaces related to their education: 1) the conceptual space entailed in disciplinary studies, especially those in the social sciences, 2) the structural procedural space entailed in the electoral politics of the two host countries and politics in Chinese international student organizations. Finally, the dissertation research illustrates how democratic practices were related to different spaces, including conceptual and structural procedural spaces.

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Students, teachers, and instructors in early childhood education (ECE) in British Columbia (BC) have dedicated time and effort to understand and interpret children’s ideas and actions and teachers’ practices. Despite our willingness to perform as well-prepared professionals, we have not agreed sufficiently about common and extended uses of philosophies and strategies that might broaden our perspectives. While we have strived to prepare ourselves for interacting and fostering relationships with children, their families, and other educators, it is not uncommon that educators interpret children’s ideas and actions according to dominant discourses of how children should develop. Much scholarly attention has been given to pedagogical documentation in BC and other contexts. However, dialogue and mutual understanding of the possibilities for documenting children and teachers’ pedagogy have not happened sufficiently within and across the institutions whose mandate is to provide an early years education that does not normalize children’s initiatives and needs but rather fosters children’s competence and interdependency with others and the world.This study proposes hermeneutics, or the art of interpreting, as a valuable philosophical and educational approach in ECE for understanding and interpreting children and pedagogies. By assuming a hermeneutical attitude, educators become part of a promising, ongoing dialogue with ourselves and others that gives value to our existence in the world and influences children’s experiences. The study illustrates that the systematic use of circles of understanding in the practice of listening, thinking, dialoguing, and creating pedagogical documentation helped early childhood (EC) students to broaden their conceptualizations of the child, pedagogy, and themselves. It addresses the participating EC students’ capability to deal with resistance and frustration and to remain in hermeneutic dialogue while they studied scholarly literature and collaboratively interpreted a text or object of study. It also examines difficulties and challenges they encountered. The study proposes that being and acting hermeneutically in ECE might provide a plurality of perspectives to engage in ongoing repeated circles of interpretation among educators that enrich our mutual understanding and encourage us to embrace differences thoroughly and respectfully.

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This study examines everyday media practices in environmental movements, activism campaigns, claims to education, and their relation to subjectification through various contortions of the verb ‘fold.’ Thinking with different types of folds (e.g., pleats, inflections, twists), it proposes concepts for investigating subjectification as a series of shifting spatial and temporal arrangements between a) environmental non-governmental organizations’ (ENGOs) campaigns and their educational intentions, b) residents’ media practices in ecological conflicts, and c) more-than-human forces and events of the Anthropocene. The project reconsiders media practices and environmental movement learning in ecologically perturbed times through the thought of Gilles Deleuze (1988, 1993), especially his concept of ‘the fold’ and its quadripartite architecture of subjectivity, comprising folds of knowledge, matter, force, and ‘the outside’ or death/extinction. I argue that subjectivity is produced through media and knowledge practices in ecological conflicts—not as a ‘being’ or the bounded contours of a human entity, but as an event and a process of folding inflected by more-than-human pleats. Situated within darker hues of ecological thought, this study engages with and problematizes the media practices of 24 residents in anti-oil pipeline movements in British Columbia, Canada (e.g., tracking online petitions, following (or not) ENGOs’ social media feeds, engaging in online news comments, photographing themselves at protests, writing letters to editors), and their ambivalent encounters with activism campaigns, digital strategies, and especially claims to knowledge and education made by six ENGOs in attempts to contrive ‘political subjects.’ The collection of chapters invites a textured and geometric reading, privileging proliferation over coherence. Subjectivity is folded and refolded in relation to media practices and education through a fieldwork in textures: a) an approach to research for thinking and ‘experimenting’ with subjectivity as concomitantly folded in multiple ways, and b) a mode of inquiry that examines how concepts and fieldwork inflect each other. I develop ‘folded concepts’ emerging from methodological conundrums, mapping the limitations of human thought, conflicting claims to education, media practices, and the more-than-human forces that affect them. Moving away from effects or what campaigns represent, the study focuses on what campaigns and practices do and affect.

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My study explores how indigenous Q’eqchi’ Mayas in Guatemala draw political cohesion from their cultural relationship to their ancestral territories when responding to violent dispossession by extractive mining corporations and mono-crop agriculture. Drawing upon participant observation and 39 interviews conducted in the municipalities of Panzós and El Estor in 2013 and 2014, my research considers Q’eqchi’s’ defense of territory (defensa del territorio) as a salient, culturally specific collective action that draws continuity from centuries of conflicts over control of land and natural resources in Guatemala. Throughout Spanish colonization, independence, entry into the world capitalist market, and 20th century political upheavals, conflicts over land have featured consistently. In more recent history, the 36-year internal armed conflict (1960-1996) was a focal point of Q’eqchi’ research contributors’ testimony on their longstanding and interminable suffering for their lands. As a result of favorable conditions for international investors since the signing of the 1996 Peace Accords, the Guatemalan government has opened up the country, and indigenous lands in particular, to large-scale investment and development. Based on my findings, and building on Liza Grandia’s (2012) framing of three “conquests” of Q’eqchi’ lands, my study offers the term “fourth conquest” (Knowlton, 2016), a conquest by corporation, to explain the unique conjuncture of forces Q’eqchi’s face today when defending their lands. Their current tactical focus on land titling and juridical certainty is a response to the renewed invasion of extractive corporations into their ancestral territories. Through applying informal and social movement learning theories, this study considers Q’eqchi’s’ political encounters in defense of land as moments of learning which shape them as political actors and subjects. For Q’eqchi’s, land represents the confluence of cultural and spiritual bonds, material sustenance, and struggles to end political marginalization. A study of the labors involved in defense of territory provides valuable insights into the culturally specific learning processes that both structure and result from myriad political interventions into community, municipal, national, and international politics. Q’eqchi’s are strategically forming short and long-term alliances, and adopting identity claims based on indigenous rights, human rights, Guatemalan citizenship, and their cultural ties to their ancestral territory.

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My doctoral thesis, titled, “From Experienced Teachers to Newcomers to the Profession: The Capital Conversion of Internationally Educated Teachers in Canada,” examines the recertification process of internationally educated teachers (IETs). My main research question is: What conceptions of the “good teacher” are evident in the recertification trajectory of IET participants in this study, and how do these open up or close down spaces for IETs to bring their experiences and voices to bear on reconstructing their professional identity in Canada? I argue that assumptions about good teaching intersect with factors such as race, ethnicity, gender, language, and immigration status. Building on Bourdieu’s concept of symbolic capital and its sub-category of professional capital, I explore the conception of the “good teacher” in a recertification program for IETs at the University of British Columbia, and I do so as a way of illustrating the dominant professional capital circulating in teacher education in British Columbia. I argue that, in the field of teacher education, the “good teacher” is a manifestation of a specific form of professional capital, which serves as “local currency” for the field. However, whereas IETs are required to convert their professional capital to the local “currency,” successful conversion does not guarantee successful integration into the teaching profession in Canada. One of the concerns that emerged from my dissertation is that teacher education in Canada, in spite of its claim to foster diversity, often becomes a site for social reproduction. Holding unexamined conceptions of the “good teacher” can lead teacher educators to favour and create teachers who are “like us,” and to discourage different forms and models of teaching.

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In this dissertation I analyze the relationship between education for autonomy and education for morality, and assess the implications of this analysis for debates between liberal, communitarian, and fundamentalist philosophies of education. A conceptual analysis of education based on R. S. Peters’ later work posits education as the expansion and deepening of awareness of those aspects of the human condition that are of particular relevance for a given socio-historical situation. In this sense, education can be conceptualized as the development of excellent perceivers of the human condition. I then posit nine fundamental awareness-promoting capacities whose development will be a necessary part of education: the five senses, critical thinking, empathy, imagination, memory, self-awareness, concentration, intuition, and language. Drawing upon an expanded account of Eamonn Callan’s conception of autonomy, I propose an integrative account of education for autonomy that includes social conditions, and educational and caregiving practices that facilitate autonomy. Drawing upon work in moral psychology, I conduct an analysis of the degree to which these elements of education for autonomy contribute to or hinder moral development. I conclude that education for autonomy and education for morality are mutually interdependent, and any overemphasis of one to the detriment of the other will be self-defeating. Finally, I argue that this analysis reveals the feasibility of liberal and communitarian philosophies of education that are balanced in their advocating of both morality and autonomy as educational aims, but reveals fundamentalist philosophies of education to be problematic insofar their stated educational aims are incompatible, and their methods partially self-defeating. Conceptual limitations of this study and areas in need of further research are discussed.

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My dissertation explores how journalists who self-identify as “transnational” shape their journalism to make human rights claims that trouble, open up and go beyond the nation-state. The project is a multi-sited, ethnographic, comparative case study of journalism education among two different transnational peoples: Romani/Gypsy and Saami (the Indigenous peoples in the current states of Norway, Sweden, Finland and Russia). Drawing upon 45 interviews with journalists and journalism educators, my research suggests there are two distinct strategies in how transnational peoples’ journalism is conceived, taught and assessed. These strategies influence and are influenced by larger socio-political contexts: the Saami media work within an Indigenous rights framework; their goal is to engage with journalism as a form of self-determination. This differs from Romani media programs, which are funded by non-state donors who aim to use Romani media as a form of claiming citizenship. These citizenship claims are both within a specific state as well as within Europe. In short, the political, economic and cultural contexts shape the journalism, and the journalism in turn shapes the politics.Although the differences are significant, both transnational groups recognized the power of journalism in agenda setting within, between and across borders. Through the framing of information in particular ways, journalists, editors and the media outlets, as well as the funding sources for this journalism, were all engaged in a form of agenda setting (Carpenter, 2007; 2009) and productive power (Barnett & Duvall, 2005). My findings indicate that a unique feature of transnational peoples’ journalism is recognizing and operationalizing power beyond that of the state; another contribution is a more robust understanding of objectivity in journalism – one that demonstrates how journalists can be credible, without pretending to be neutral. These are all important contributions to reimagining human rights advocacy beyond current discussions of transnational advocacy which still often privilege the state and tends to pay scant attention to journalists themselves. Learning from transnational peoples who are creating, teaching, and participating in journalism education in its many places, forms, and media allows us to make more sound connections between human rights and journalism.

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In this dissertation I analyse lesbian and gay picturebooks and the discourse of a censorship challenge to these books. I take a deconstructive approach to the material, using queer theory, children’s literature criticism and children’s culture theory to analyse the ways in which the knowledge/ignorance and adult/child binaries are reinscribed and undone in these discourses. I focus on absences of LGBT-specific language, physical bodies, difference and non-normative gender identities in the picturebooks, and analyse a wide range of media in a challenge in Lexington, Massachusetts which began in 2005. I argue that both the books and the discourse of the challenge have the effect of reinscribing a construction of the ideal child as ignorant and asexual. This conceptualisation of childhood dismisses actual children’s ability to absorb, challenge or disseminate knowledge, and refuses to offer them possibilities of non-normative genders and sexualities for their lives. I argue that, due to the focus on sexuality and the unavoidably pedagogical nature of children’s literature, the picturebooks inherently trouble the knowledge/ignorance binary. Due to this disruptive condition the normalising politics of the picturebooks are inadequate to prevent the books from becoming controversial. Queer picturebooks that resisted normalisation and represented real difference would better respect the intellectual and emotional needs of child readers.

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