A Deeper look at Constructivism – ontology and epistemology
Constructivism is a set of beliefs about how people learn:
But it is really much more than a theory. Brace yourselves…
Constructivism is a philosophical paradigm, based on:
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a relativist (as opposed to a realist) ontology, and
a subjectivist (as opposed to an objectivist) epistemology
(After Guba and Lincoln) 1
There’s quite a bit there to unpack though, so let’s take it step by step. Incidentally, don’t
worry too much about the words “paradigm”, “ontology” and “epistemology”. Philosophers
like them, but they scare most people. Let’s start with “paradigm”:

A paradigm is a set of coherent ideas and concepts which together provide a
scientific, philosophical or theoretical framework. So in a “paradigm shift”, a whole
new set of concepts are adopted as a fresh framework – such as when Einstein and
others brought about a paradigm shift in physics. The old Newtonian paradigm was
seen as only a special case, rather than the whole story, and quantum mechanics and
relativity provided the new paradigm.
Still confused? Don’t worry: for our purposes here, it’s more important to just think about
the difference between Relativism and Realism. Just carry on reading...
Let’s start with the statement:
‘Constructivism is based on a relativist (as opposed to a realist) ontology’

Ontology is the metaphysical exploration of existence; or put another way, the
(philosophical) study of the nature of being, existence or reality. It asks questions
like “what is an object?”, “what does it mean to say something exists?” and “if it
exists, what are its essential features: that constitute its identity?”
Relativism is a bit of a confusing term, as it’s not immediately obvious what is relative to
what! Nevertheless it is a fundamental concept, and worth exploring a bit. Relativism holds
that human beings have no direct access to the world “out there”. Most relativists would
agree that there is an external world, but argue that we can only directly access
representations of the world in our consciousness. Consider the colour “blue” (perhaps a blue
mug in front of you) – how do you know how this “looks” to another person? You and I both
have similar physical apparatus for focusing and capturing reflected light on our retina, and
Drs. Mark Waters, Ramesh Mehay, 2010.
similar pathways to the occipital cortex where the resulting nerve impulses are processed. But
the “blueness” of the mug is something we construct in our consciousness and is unique for
each of us. Maybe the phrase “Beauty is in the eye of the beholder” gives you a better idea of
relativism.
Realists don’t buy this explanation, and say, on the contrary, that the world “out there” is
perceived in a pure state by each of us, so (in this example) “blueness” is experienced
exactly the same by all human beings, because the property exists separate to us (in the glaze
on the mug), rather than being constructed in an individual’s consciousness.
Teaching and learning ideas:
1. Why not challenge those sleepy realist assumptions (either
your own, or learners you are working with)? Most people have
seen this image before, but familiarity doesn’t take away the
delightful double-take it offers us. Do we all see this picture the
same way? When constructing this image for ourselves, how
much of the construction is in the image, and how much is our
action?
2. Show a painting, and ask a group of learners to write a short
narrative of what the painting means to them. And then to discuss the different perspectives. Do
you really believe that there is only one universal way of interpreting it or are alternatives just as
valid?
So that’s the ontological debate.
In summary:
‘Constructivism is based on a relativist ontology’ basically means
Constructivism is based on the notion that the truth about ‘what is what’ (ontology) is
socially negotiated (relativism)
Let’s move onto the statement:
‘Constructivism is based on a subjectivist (as opposed to an objectivist) epistemology’

Epistemology is a branch of philosophy concerned with the theory (or nature) of
knowledge, and comes up in the deeper bits of the educational literature quite a bit, as
it relates to the theories of learning. Epistemologists don’t accept that people can ‘just
know things’. They ask questions like a) What is knowledge anyway? b) How is it
acquired? c) What do people know? and d) How do we know what we know?
Again, from our point of view, we only need to focus on the two ideas of subjectivism and
objectivism.
Drs. Mark Waters, Ramesh Mehay, 2010.
A subjectivist approach has its foundation in relativism (see above) and therefore sees a
crucial role for the individual, concluding that knowledge cannot exist without individuals
to construct it. Knowledge is essentially subjective, as each individual will construct their
world in a unique way, depending on their background, the social forces acting on them, and
so on.
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Knowledge is created by the individual in light of such background and social forces.
There are multiple interpretations of any given situation: there is no single ultimate
truth.
A subjective ‘truth’ is only true under certain conditions, at certain times, or for
certain people.
The objectivist approach, on the other hand, is based on realism, and sees knowledge as
existing separately to individual people; that it is ‘mind independent’.
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Knowledge is therefore discovered rather than created by the individual.
There is only one universal truth (for example 2 plus 2 equals 4).
An objective ‘truth’ is true all the time; independent of any other conditions.
So that’s the epistemological debate.
In summary:
‘Constructivism is based on a subjectivist epistemology’ basically means that
In Constructivism, the true meaning of knowledge (epistemology) is internally constructed
(subjectivism).
Bringing both debates together:
Constructivism is a philosophical paradigm, based on:
 a relativist (as opposed to a realist) ontology, and
 a subjectivist (as opposed to an objectivist) epistemology
means
In constructivism:
 The truth about ‘what is what’ is socially negotiated (with others) AND
 That the true meaning of knowledge is then internally constructed.
All of this becomes important in a variety of ways, as it impacts on proof, the nature of truth,
and the validity of knowledge. Traditional science (and therefore medical science) is based
largely on the objectivist approach.
Drs. Mark Waters, Ramesh Mehay, 2010.
And a big difficulty for GP educators is: “How do I challenge years of objectivist-style
learning which is so unlike the subjectivist world of my practice?!”. Trainees who have just
finished their hospital posts and come over to their general practice attachment often have an
objectivist’s view of knowledge and learning. Helping them to realise the existence of a
subjectivist view can be quite challenging. In the UK, we go on at our trainees about
involving the patient in the management plan which features as a core competency in the
consultation observation tool (COT). Should this be regarded as a universal truth? Whilst
suited to the UK population, this might not be appropriate for training a doctor who plans to
work with a different culture, as in some part of India; there, patients would find it crazy to be
asked how they felt about the management plan of the doctor and would implicitly place trust
in them (why else are they are doctor?).
Teaching and learning ideas:
Explore the possibilities of subjectivism. Take a typical general practice patient story, and use case
analysis techniques to look beyond just the disease. Explore the patient’s individual narrative,
consider what other stories there are here: perhaps other family members, or the patient’s employer?
Think about the individual truths an individual doctor constructs from that narrative. How many
interpretations are there here?
Phew… maybe you need a chance to think that through or read this document again? Or
maybe this is all familiar anyway?
Anyway, here’s that definition of constructivism again from a page or so ago, for you to read
again now you’re totally down with all this philosophical language:
Constructivism is a philosophical paradigm, based on:
 a relativist (as opposed to a realist) ontology, and
 a subjectivist (as opposed to an objectivist) epistemology
means
In constructivism:
 The truth about ‘what is what’ is socially negotiated (with others) AND
 That the true meaning of knowledge is then internally constructed.
Suffice to say though, it is the constructivist view (based on relativism and subjectivism) that
makes most sense to us. And one of the key lessons this teaches us is that every learner is
individual, and will approach learning their own way, and construct meaning that is
unique to them. And that, pretty much, is what this chapter is about.
Drs. Mark Waters, Ramesh Mehay, 2010.
So as GP trainers, constructivism means that to understand our trainees and their learning,
beliefs or behaviours we have to be aware of their experience and culture (the historical and
cultural contexts) and recognise that they don’t just potentially see the world differently to us,
but experience it differently too.
References
1. Guba EG, Lincoln YS. Fourth Generation Evaluation. London: Sage Publications; 1989.
Drs. Mark Waters, Ramesh Mehay, 2010.