In an interview for The Guardian Daniel Dennett expressed his interest in the concept of comprehension when asked
What’s the danger of a world where even the scientists don’t understand how this stuff works? by Carole Cadwalladr:
One of the big themes in my book is how up until recently, the world and nature were governed by competence without comprehension. Serious comprehension of anything is very recent, only millennia old, not even a million years old. But we’re now on the verge of moving into the age of post-intelligent design and we don’t bother comprehending any more. That’s one of the most threatening thoughts to me. Because for better or for worse, I put comprehension as one of my highest ideals. I want to understand everything. I want people to understand things. I love understanding things. I love explaining things to myself and to others. We’ve always had plenty of people who, for good reason, said, “Oh, don’t bother explaining to me how the car engine works, I don’t care. I just push the ignition and off I go.” What happens when we take that attitude towards everything?
Michael Gazzaniga describes Dennett's distinction between competence and comprehension in a WSJ article:
Competence is the ability to carry out an act, but comprehension implies that the organism (or robot) carrying out the act has intent and an understanding of what it is doing. As I like to say, you may have a theory about your dog, but your dog doesn't have any kind of theory about you.
Here is how Lee Shulman defines understanding:
When I profess my understanding, I am urged by my teachers to use critical reasoning, to demand evidence, and to make my arguments clear—to always ask, How do you really know? Skepticism, questioning, the demand for proof are at the heart of professing one's understanding.
According to Guyatt and Djulbegovic the practice of medicine should be based on all of the evidence:
The basis for the first EBM epistemological principle is that not all evidence is created equal, and that the practice of medicine should be based on the best available evidence. The second principle endorses the philosophical view that the pursuit of truth is best accomplished by evaluating the totality of the evidence, and not selecting evidence that favours a particular claim.
Scientific knowledge is complex, incomplete, fallible, and in constant revision. Also, evidence is important but insufficient in the practice of medicine. We must be careful not to think that certain tools assess our understanding, our knowledge, or even the application of evidence, Asimov reminds us:
Now where do we get the notion that "right" and "wrong" are absolutes? It seems to me that this arises in the early grades, when children who know very little are taught by teachers who know very little more.
Young children learn spelling and arithmetic, for instance, and here we tumble into apparent absolutes.
How do you spell "sugar?" Answer: s-u-g-a-r. That is right. Anything else is wrong.
How much is 2 + 2? The answer is 4. That is right. Anything else is wrong.
Having exact answers, and having absolute rights and wrongs, minimizes the necessity of thinking, and that pleases both students and teachers. For that reason, students and teachers alike prefer short-answer tests to essay tests; multiple-choice over blank short-answer tests; and true-false tests over multiple-choice.
But short-answer tests are, to my way of thinking, useless as a measure of the student's understanding of a subject. They are merely a test of the efficiency of his ability to memorize.
This issue has been brought up in the past by Barrows and Tamblyn as well:
The issue of validity is the major drawback to the use of this format. It seems quite evident from many studies that the basic behavior evaluated is the pure recall of information necessary to make the correct choice. Even in those questions that are cleverly designed to test the student's reasoning by asking him to interpret information and make diagnostic or therapeutic decisions, the correct choice is always in front of him or, as in the case of true-false or phrase-comparing questions, it is merely the choice of right or wrong. The PMP format represents a redesign of this multiple-choice question format so that it more closely resembles the cognitive challenge of the patient problem setting, yet without loss of its inherent reliability. As stated many times earlier, there is no evidence that the pure recall of information, despite the fact that it is well tested, in any way correlates with competence in clinical reasoning or the care of patients; therefore, if multiple-choice, true-false questions are used in student assessment for problem-based learning, it must be with the realization that they provide a reliable method of widely sampling information recall. Their ability to assess other behaviors, including the ability to apply recalled information appropriately in the clinical reasoning process, is problematic or speculative. This format certainly cannot evaluate the student's inquiry strategies, problem formulation skills or any of his clinical or interpersonal skills.
We must be careful not to fall into the illusion of knowledge due to only having a surface understanding given by some tools:
We argue here that people’s limited knowledge and their misleading intuitive epistemology combine to create an illusion of explanatory depth (IOED). Most people feel they understand the world with far greater detail, coherence, and depth than they really do. The illusion for explanatory knowledge–knowledge that involves complex causal patterns—is separate from, and additive with, people’s general overconfidence about their knowledge and skills. We therefore propose that knowledge of complex causal relations is particularly susceptible to illusions of understanding.
This illusion reminds me of the kinds of explanations given by Voltaire's character Dr. Pangloss from his book Candide:
Pangloss was professor of metaphysico-theologico-cosmolo-nigology. He proved admirably that there is no effect without a cause, and that, in this best of all possible worlds, the Baron's castle was the most magnificent of castles, and his lady the best of all possible Baronesses.
"It is demonstrable," said he, "that things cannot be otherwise than as they are; for all being created for an end, all is necessarily for the best end. Observe, that the nose has been formed to bear spectacles—thus we have spectacles. Legs are visibly designed for stockings[Pg 3]—and we have stockings. Stones were made to be hewn, and to construct castles—therefore my lord has a magnificent castle; for the greatest baron in the province ought to be the best lodged. Pigs were made to be eaten—therefore we eat pork all the year round. Consequently they who assert that all is well have said a foolish thing, they should have said all is for the best."
Comprehension requires a deep understanding that goes beyond competence.Tweet to @jvrbntz