You don’t learn to draw by knowing how pencils are made
These sort of aphorisms always make me to want to think harder about what exactly is foundational in medical education. The suspicion is that it is far less than we think. Schooling is full of wasted time spent learning things that are of little use, but easy to test, meaning there is little time for students to learn things that are useful.
The case for anatomy in surgery is robust and self-evident. If you remove tumours in the preauricular area or on the temple, you have to know what structures to avoid or which ones may have become compromised. If you ask any competent surgeon they will of course know what these structures are. But when you move into many areas of clinical medicine, I am always amazed by how much competent physicians have forgotten about all these things that were labelled ‘foundational’, and formed the basis of high-stakes exams. It is of course possible to be aware of schema, that structure your behaviour, and be unable to recall them — schema that experts implicitly know and novices don’t. But I suspect we need some sort of minimalism project, to work out how far we can go.
If we go back to the traditional kindergarten, kindergarten was first invented about 200 years ago. It was explicitly designed to be different than the traditional school, where it was primarily about delivering instruction, delivering information that students who then dutifully wrote down on paper and recited it back. The early kindergartens recognized that something very different was needed for five-year-olds.
There’s a real challenge today because even kindergartens are starting to become more like the rest of school with children filling out phonics worksheets and looking at arithmetic flashcards
Interview with Mitch Resnick
Incarceration as the educational business model. Medium
For obvious reasons, it’s difficult for researchers to know just how common the “smart drug” or “neuro-enhancing” lifestyle is. However, a few recent studies suggest cognition hacking is appealing to a growing number of people. A survey conducted in 2016 found that 15% of University of Oxford students were popping pills to stay competitive, a rate that mirrored findings from other national surveys of UK university students. In the US, a 2014 study found that 18% of sophomores, juniors, and seniors at Ivy League colleges had knowingly used a stimulant at least once during their academic career, and among those who had ever used uppers, 24% said they had popped a little helper on eight or more occasions.
“Taking notes on laptops rather than in longhand is increasingly common. Many researchers have suggested that laptop note taking is less effective than longhand note taking for learning. Prior studies have primarily focused on students’ capacity for multitasking and distraction when using laptops. The present research suggests that even when laptops are used solely to take notes, they may still be impairing learning because their use results in shallower processing. In three studies, we found that students who took notes on laptops performed worse on conceptual questions than students who took notes longhand. We show that whereas taking more notes can be beneficial, laptop note takers’ tendency to transcribe lectures verbatim rather than processing information and reframing it in their own words is detrimental to learning.”
I actually found this quite witty. But it is more than that. It playfully raises some of those issues about education, assessment, and certification. I would love to say medical education has got this right, but I do not believe that. It is easy to list the problems, but hard to solve them. Numbers and formal systems will always be used by those who understand them least, to exile judgement.
Veblen’s conspicuous consumption rides on:
Rather than filling garages with flashy cars, the data show, today’s rich devote their budgets to less visible but more valuable ends. Chief among them is education for their children: the top 10% now allocate almost four times as much of their spending to school and university as they did in 1996, whereas for other groups the figure has hardly budged.
Book review in the Economist: The Sum of Small Things: A Theory of the Aspirational Class. By Elizabeth Currid-Halkett
“I’ve written extensively on the now famous Georgia Tech example of a tutorbot teaching assistant, where they swapped out one of their teaching assistants with a chatbot and none of the students noticed. In fact they though it was worthy of a teaching award”
I keep reading this as ‘turbot’, and wondered what the fish things was. I guess the tutorbot would have corrected me soon enough.
“Children say they prefer IT in their lessons and courses? Do schools listen when kids say they prefer chips for lunch every day?”
An understatement follows:
Education policy is particularly vulnerable to political whims, fads and untested assumptions. From swapping evolution for creationism to the idea that multiple types of intelligence demand multiple approaches, generations of children are schooled according to dogma, not evidence.
Amen to all that. And not just school children, but university students. The Nature article is referring to: original paper here (The myths of the digital native and the multitasker. Paul A. Kirschnera, Pedro De Bruyckerec. DOI)
This is from CP Snow’s ’Two Cultures’. I have never read the book, always warming to critiques of it from others. But I like this snippet quoted by John Naughton, recently.
“I can’t help thinking of the Venetian republic in their last half-century. Like us, they had once been fabulously lucky. They had become rich, as we did, by accident. They had acquired immense political skill, just as we have. A good many of them were tough-minded, realistic, patriotic men. They knew, just as clearly as we know, that the current of history had begun to flow against them. many of them gave their minds to working out ways to keep going. It would have meant breaking the pattern into which they had been crystallised. They were fond of the pattern, just as we are fond of ours. They never found the will to break it.”
Maybe I should go back and look at it. CP Snow, Two Cultures
A large part of Kahn’s legend rests on his fame as a pedagogue, and although his parallel teaching career was driven by financial necessity, he became renowned for his ability to inspire students with a more elevated vision of professional practice than the technically advanced but psychically stunted approach characteristic of postwar American architectural education. (emphasis mine)
From a (book) review in the NYRB about the late architect Louis Kahn (Salk institute etc). “Psychically stunted.” Sounds like some other sort of professional education I am more familiar with.
One of the important things I learned from reading Herb Simon’s ‘Models of my life’ was his view that seldom did reading the academic literature feed him with new ideas on what to work on. I do not mean to imply that reading the literature is irrelevant, but that in some domains of enquiry the formal literature is often unhelpful when it comes to not so much thinking outside the the box, but realising the box needs throwing out and you need a chair instead. For instance, in med ed, I find most of the formal literature akin to chewing sawdust. It is dull and often the main motivation seems to be to advance one’s career rather than change the world. All of this came to my mind when I read the following:
It tells the remarkable tale of Athletic Bilbao, one of three clubs never to have been relegated from La Liga, the Spanish top division, despite having a policy of selecting only Basque players. Bilbao’s story emphasises a recurring theme of the book: the importance of development programmes for young players and the lengths that clubs go to in order to nurture footballers. Benfica, a Portuguese club, uses a 360-degree “football room”, walled by LED lights, to train players in over 100 scenarios. Targets appear for the players to hit with the ball; sensors measure the players’ effectiveness.
( a review in the Economist of The European Game: The Secrets of European Football Success. By Daniel Fieldsend. Arena Sport; 255 pages; £14.99.)
Now, readers will know that given the genes, I am more rugby than soccer, although I marvel at the skill modern footballers show. But what interests me and has interested me for a while is the relation between structured unnatural performance and fluency at performance. Now my phrasing may be a little ugly, and I do not think there is anything deep or new about what I am saying. Just take how we know you learn a musical instrument. How breaking up and sequencing of mini skills is necessary before you put it all together. People do not pay to listen to people play scales (although I will ignore, shred guitar aficionados), but rather they like songs or sonatas etc.
I would push this is the following direction. A real danger in undergraduate medicine is that we have become inured to the idea that learning situated in the clinic is the best way to learn medicine. At one time, I might have agreed. But out clinics have changed, but our ideas have not. One of the benefits of coaching and online learning is that we can make the offline — the clinic — work better. But also need it less, because it is not working well.
There are some interesting apparent paradoxes here. We need (pace the above quote) more ‘football rooms’, but as Seymour Papert argued, if you want to learn to speak French go to France and if you want to learn maths go to mathland. But are these real or virtual?
Despite this, less than half of developers consider their formal education to be “important” or “very important” to their jobs.
Well this is tech, but it is also true of any many fields of endeavour. But not all. We need to understand when and where the rules of the game change. This is not just about certification
Edward Tufte’s ‘The Cognitive Style of Powerpoint’ is funny. The problem is that it is not just funny, but deadly serious. Literally. His argument and case studies concern how humans died because people failed to understand how to communicate. And the title says it all. Powerpoint (at least its templates) degrades communication.
Communication is a big thing in medical education, and it is not unusual to have to sit through tedious talks on the subject. They usually start with Powerpoint slides, so at least you know that they are not going to say anything worthwhile and you can get your phone out and play.
Below is a memo, from Jeff Bezos, of Amazon.
Perhaps the single most important thing we could do to improve university education to is to remove all copies of Powerpoint. Words matter. Sentences even more.
This is from a book review on the ‘birth of cool’, by Robert Eaglestone in the THE.
Despite laying out some principles (“cool is…”), the book focuses on honed case studies of “the saints of cool” (as Hannah Arendt argues, we learn more from examples than from principles).
This little gem was new to me —but not the concept, or the principle…..
Academia tends to love rules, and formal systems, but for some domains of competence, they are grossly overrated. Formal logic is often not what is need, and we may seem more with a metaphor. Alan Kay’s aphorism: a different perspective may be as valuable as 80 IQ points.
Interesting interview in the FT with the African guitarist Lionel Loueke, if you like to think about learning and certification, a couple of truths. The first is how technology can help. ‘Slow it down’ has helped many of us. Being able to record yourself, and then listen ( a point Eric Clapton talks about) is an interesting example of how you blur the gap between private practice and the external ear provided by a teacher.
He first heard jazz when a friend played him cassettes by Wes Montgomery and George Benson. At first, Loueke didn’t even know that jazz was an improvised music. ‘I approached it like I was playing Afropop, and learnt it by ear,’ he says. ‘I slowed down the cassette by putting in weak batteries, then back to electricity to get the speed. That’s how I started jazz”.
And of course, certification has its limits, and the ‘place to learn’ in not always in the classroom. Papert’s ‘mathland’, revisited.
When guitarist Lionel Loueke was a teenager in Benin, boiling precious guitar strings in vinegar to make them last, he didn’t think that one day he’d be auditioning in Los Angeles for a place at the Thelonious Monk Institute of Jazz Performance. Or that the panel of jazz professors would include Wayne Shorter, Terence Blanchard and Herbie Hancock. And certainly not that Hancock would exclaim, ‘How about we just forget about the school and I take you on the road right now?’
We deal with children as individuals when we “teach” them as children. What is wrong with MOOCs is the “massive” part. Education cannot be both massive and actual education. Learning starts with a goal followed by questions when you have trouble reaching your goal. We each have our own questions and our own goals.
Clark is wrong about MOOCs because the very concept of massive education is oxymoronic. Education is only massive because we have created a world of schools that include classrooms and not enough teachers to do one on one education. MOOCs are an extension of a vary bad educational idea called lecturing. We have come to accept lecturing because it is everywhere and we all had to endure it.
Roger Schank. Worth reading in full.
One of my mantras is that unless we do the online better, we cannot make use of the offline opportunities. Online, should allow us to make better use of the bedside. The following are some quotes from an FT article on MBA degrees.
The great thing about a virtual classroom is that your students are already in a digital format, which means you can run algorithms that recognise patterns in facial expressions to assess understanding and identify students’ emotional state and levels of attention in your class,” says Prof Boehm. Analytics can be used in real time to address students whose attention is wandering or later to improve teaching plans or faculty performance, he adds.
Teaching staff also find students to be more engaged in the virtual classroom. “Because of the way students are positioned on the wall, a headshot from the chest up, it’s very difficult for them to text on their phones or work on their PCs,” says LizHess, managing director of HBX. “It’s very easy for faculty to see if people are distracted — they joke that there’s no back row any more.”
The technology looks terrific in the images shown. But there are other factors at play. Note the group sizes are small in comparison with what many undergraduates receive, and the investment in technology is focussed on those who pay most (upfront). If you look at the money apparently going into medical education, this should be the norm for most undergraduate medical students.
There is a good piece on Wonke by David Morris, dealing with the issue of how research and teaching are related, and the dearth of empirical support for any positive relation between the two. R & T are related at the highest level — some universities can do doctoral research and teaching well — and although I have little direct experience, the same can apply at Masters level. The problems arise at undergraduate level, the level in which most universities compete, and which accounts for the majority of teaching income. As ever, I think we have to think ecology, variation and the long now. What seems clear to me, is that research is indeed often at the expense of teaching, and that the status quo needs to be changed if universities are to continue to attract public (and political) support. Cross subsidies and the empty rhetoric of ‘research led teaching’ do not address what are structural issues in Higher Ed, issues that have been getting worse, driven by poor leadership over many decades.
For many universities this is a pizza and / or pasta issue: some of us like both. Just because the two show little covariation in ecological data, does not mean that they shouldn’t inform each other much better than they have over the recent past. On the other hand, scale and education are unhappy bedfellows, and staff time and attention matter. Do you really think about teaching the same way you approach research? If T & R do not covary, then are your students in the best place, and why did you admit them? Honest answers please.
I have written before about the problems that learning outcomes fail to deal with (Jorge Luis Borges and learning outcomes), but there is another cognate issue that bugs me from time to time. The following is a quote from The Undercover Economist in the FT
Should the rules and targets we set up be precise, clear and sophisticated? Or should they be vague, ambiguous and crude? I used to think that the answer was obvious — who would favour ambiguity over clarity? Now I am not so sure. Ponder the scandal that engulfed Volkswagen in late 2015, when it emerged that the company had been cheating on US emissions tests. What made such cheating possible was the fact that the tests were absurdly predictable — a series of pre-determined manoeuvres on a treadmill.
I think there is a very clear downside to making too precise what it is that students should learn. I actually think we need noise in the system, simply because assessment methods are imperfect and unnatural, and the more you seek particular psychometric qualities the greater the distance between what is important and what and how you test. This is not a popular position to take, and I confess I am one of the worst offenders in terms of producing tightly defined content. But if:
assessment drives learning
the I would add, to make a couplet
assessment wrecks learning
Nice piece in ‘Science’ with the title: ‘No easy answers: What does it mean to ask whether a prekindergarten math program “works”?’ Geoff Norman, many years ago, used the term RCT in the context of medical education to stand for Randomised, Confounded and Trivial. Research into what works and what does not work in education is hard, and most studies (IMHO) fail to inform. Education isn’t a product like a drugs is, and gee it is hard to demonstrate when and where most drugs will work if you do not have an understanding of the biology and large effects to play with and outcomes that need to be measured over the long term.
I think about this a lot, but have no easy rules to guide action. Which is, of course, exactly the problem.
From Audrey Watters excellent round up of the year that was:
I think it’s safe to say, for example, that venture capital investment has fallen off rather precipitously this year. True, 2015 was a record-breaking year for ed-tech funding – over $4 billion by my calculations. But it appears that the massive growth that the sector has experienced since 2010 stopped this year. Funding has shrunk. A lot. The total dollars invested in 2016 are off by about $2 billion from this time last year; the number of deals are down by a third; and the number of acquisitions are off by about 20%.
To the entrepreneur who wrote the Techcrunch op-ed in August that ed-tech is “2017’s big, untapped and safe investor opportunity.” You are a fool. A dangerous, exploitative one at that.
Lots of good reasons for this, but surely the main one is that the products are so awful. It is a big domain of human activity, although whether it is a market I will leave for the moment. But people may prefer to spend their money on something that works. And that is before we mention LMS. Of course we can just sell our students user data….
Lots more good stuff from her here, although a stiff drink may be seasonally appropriate.
I am often accused of being too cynical. Events in 2016 have not dissuaded me that my approach was not the right one. But I like this quote, which is new to me:
As George Carlin said: “Scratch any cynic and you will find a disappointed idealist.” Guilty as charged: I was an idealist and remain one, well, sort of. Tim Wu interviewed by John Naughton
Tim Wu’s last book, “The Big Switch: The Rise and Fall of Information Empires”, was magisterial, and of interest to anybody interested in education, tech and the web. His latest, has not been published in the UK yet, but tracks the relation between attention and advertising (‘The Attention Merchants’). In the interview Naughton reprises one of Herb Simon’s great insights:
The cue for his new book, The Attention Merchants, is an observation the Nobel prize-winning economist Herbert Simon made in 1971. “In an information-rich world,” Simon wrote, “the wealth of information means a dearth of something else: a scarcity of whatever it is that information consumes. What information consumes is rather obvious: it consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention and a need to allocate that attention efficiently among the overabundance of information sources that might consume it.”
Anybody who looks at how students want to learn, and the fractured landscape of content and ‘learning behaviour’, needs to think hard about this topic.
At the risk of raising the ire of many researchers, I should note that I am not basing my assessment on the rapid growth in educational neuroscience. You know, the kind of study where a subject is slid into an fMRI machine and asked to solve math puzzles. Those studies are valuable, but at the present stage, at best they provide at most tentative clues about how people learn, and little specific in terms of how to help people learn. (A good analogy would be trying to diagnose an engine fault in a car by moving a thermometer over the hood.) One day, educational neuroscience may provide a solid basis for education the way, say, the modern theory of genetics advanced medical practice. But not yet.
Keith Devlin, talking sense — again. I want to believe the the rest of the article but, worry it may not be so. But it contains some gems:
Classroom studies invariably end up as studies of the teacher as much as of the students, and often measure the effect of the students’ home environment rather than what goes on in the classroom.
This just adds to the problem that Geoff Norman (DOI 10.1007/s10459-016-9705-6) and others have talked about in course evaluations, namely that many studies — even accepting of the limitations outlines above — are riddled with pseudoreplication.
What is missing is any insight into what is actually going on in the student’s mind—something that can be very different from what the evidence shows, as was dramatically illustrated for mathematics learning several decades ago
But, like many outwith medicine, I think he puts too much store by the robustness of the RCT approach — even with digital tools to allow large scale measurement. RCT: ‘randomised, confounded and trivial’, as has been said before (Norman).
His introduction is at 1:10 and his talk begins at 25:00. I would skip the Andreas Schleicher (aka Mr PISA) talk, although Roger has something to say about testing. His style of presentation may make you think he exaggerates.
A nice way to end the year.
Video is cool. Text isn’t.
Houston, we have a problem.
I went to the OEB meeting for this first time this year. I was not certain how much I would like it, but found it really enjoyable. Not a meeting I would go to each year but, if you are interested in teaching and learning in the broadest sense, it is well worth a visit. I would go again.
One of the sessions I enjoyed most was a fairly small concurrent session with the title ‘The value and the price: discussing Open Online Courses’, chaired by Brian Mulligan (IoT, Sligo), and with panellists Stephen Downes(NRC, Canada), Nina Huntermann (edX), Diana Laurillard (UCL), and KonstantinScheller (European Commission). It was all wonderfully informal, with not too many people there and plenty of time for questions and discussion. I got involved too, rather than just listening. The discussion ranged widely over MOOCs (c or x), online learning, ‘conventional teaching and learning’ and other topics, but that is to be expected. You cannot discuss online learning without thinking about offline learning; you cannot discuss new tech, without discussing old tech; you cannot discuss scale without discussing one-to-one; you cannot discuss value without talking about money and non-money.
I didn’t take notes but the thoughts going round in my head (prompted no doubt by the panel were):
I am at the OEB16 meeting in Berlin. As ever, thoughts cross. If you go around the stands you have to ask about the relation between learning — a personal act — and all that you can sell to go with it. Software, hardware etc. And you have to wonder about the balance of goods and dreams.
Marcia Angell reviews Alice Gopnik’s ‘The Gardener and the Carpenter’ in the NYRB (November 2016)
‘Among the book’s strengths is that Gopnik leaves no doubt about where she stands on the peculiarly American way of leaving families on their own in an increasingly unequal society. “Middle-class parents are consumed by the pressure to acquire parenting expertise,” she writes.
(Gopnik quoted text)
“They spend literally billions of dollars on parenting advice and equipment. But at the same time, the social institutions of the US, the genre at originator and epicenter of parenting, provide less support to children that those of any other developed country. The US, where all those parenting books are sold, also has the highest rates of infant mortality and child poverty in he developed world.”