Prompted by the demands for developing sustainable medical workforce, many medical schools around the world have been through significant curricular change over the last 30 years. Success in implementing a new educational model is predicted by a range of complex and interdependent factors. Among these elements, communication of the values, vision and key directions of the new program are essential. During the development of an entirely new medical curriculum at the University of New South Wales in Sydney Australia, imagery and metaphors from the nautilus shell were developed to aid in the exposition of a complex new medical education program.
Nautilus as a Shell
The chambered nautilus is a member of the cephalopod class of molluscs, the shell of which has a highly ordered but non-linear structure. This physical form provides key functionality to the actual organism, which resides in the outer chamber of the shell. The chambers of the nautilus are of ever-increasing size and are ordered in a spiral array according to a logarithmic progression (a Fibonacci sequence). Each nautilus chamber is connected to the foregoing and after-coming segments by a siphuncle that transports gases thereby permitting the shell to act as a float and rendering the organism able to traverse great depths of the ocean. This communication mechanism between earlier segments permits a dynamic response by the living organism to changes in the environment with which it directly interacts.
The Nautilus as a Metaphor in Education Planning
The physical structure of the nautilus shell provides a useful metaphor upon which to elaborate curricular design in medical education. The ideas and images of the nautilus as a metaphor which were used in the exposition included the following:
- Education of medical professionals is a non-linear, multi-dimensional process and extends beyond the two dimensions which many matrix models use;
- The designing of educational programs should work with and respect the inherent complexity;
- The model can include segmentation or modularity. Such modularity facilitates program flexibility and deconstruction, yet respects the inherent complexity;
- The capabilities of medical professionals should be ever expanding and build upon prior learning. New learning by individuals depends upon dynamic connection with prior experience and learning – learning must be adaptable;
- This model permits depiction of reiterative or spiral processes which are now embedded in adult learning theory;
- Great complexity can arise out of simplicity in order and proportion, beyond that which we can plan for.
That the Nautilus is an excellent metaphor for personal or institutional progress, growth, balance, long term survival and adaptability is not new. Oliver Wendell Holmes (1809 – 1894) as a physician, writer and Dean of the Harvard Medical School saw the Nautilus as a metaphor for human growth and behaviour immortalising this organism in his 1858 poem The Chambered Nautilus –
…Build thee more stately mansions, O my soul,
as the swift seasons roll!
Leave thy low vaulted past!
Let each new temple, nobler than the last…
Dr Wendell Holmes was so taken by the imagery that he had his bookplates engraved with an artistic rendering of the Nautilus shell with the motto per ampliora ad altiora which translates as “through greater breadth to greater depth”.