Yearly Archives: 2016

Roger Schank at OEB

by reestheskin on 31/12/2016

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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.

 

 

CC-BY or CC-BY-NC?

by reestheskin on 30/12/2016

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A post by David Wiley and a response from Stephen Downes. I use the NC, and will continue to do so. Then again, whilst I want people to use my online material, I still think there is a legitimate debate to be had about how you finance teaching materials. The Ascent of Man cost a lot.

(The ever insightful) Gregory Clark, an economist at the University of California, Davis, finds that students with Norman surnames from Domesday are still over-represented at the universities of Oxford and Cambridge. Economist.

Bloom’s taxonomy

by reestheskin on 28/12/2016

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All to often people mortgage their honesty in order to purchase that which their colleagues mistake for rigour.

I think I get it. In fact, I wrote these words a few years back. The context was some of the absurdity of Bloom’s taxonomy and the empty rituals of learning outcomes. I haven’t changed my mind, but will keep saying the same thing until things change for the better. Original post here.

On diagnosis

by reestheskin on 26/12/2016

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“In the village in which I live there is a pleasant doctor who is a little deaf. He is not shy about it and he wears a hearing aid. My young daughter has known him and his aid since she was a baby. When at the age of two she first met another man who was wearing a hearing aid, she simply said, ‘That man is a doctor.’ Of course she was mistaken. Yet if both men had worn not hearing aids but stethoscopes, we should have been delighted by her generalization. Even then she would have had little idea of what a doctor does, and less of what he is. But she would have been then, and to me she was even while she was mistaken, on the path to human knowledge which goes by way of the making and correcting of concepts.”

Science and Human Values, Jacob Bronowski

Xmas day and it is all about food

by reestheskin on 25/12/2016

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Geoff Norman opened my eyes to the (useful) parallels between cooking and medicine (‘Medical expertise and mashed potatoes’). This little quote from the Economist, is at a mature tangent:

Compare this to the fate of Lymeswold, which was created in the 1980s and touted as the first new English cheese in 200 years. It was initially highly successful, but when demand outstripped supply, the manufacturers cut corners and released stocks before they had matured, resulting in its demise less than a decade after its birth.

Sounds a little like some aspects of doctor training in the NHS.

“I think the dilemma Brexit poses for Scotland is pretty intolerable,” he says. “If Scotland has to clean out all its universities of European citizens there are really horrible things that are going to happen.”

The economist, Angus Deaton, in the FT

The drugs don’t work

by reestheskin on 22/12/2016

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Roy Lilley:

“Banking regulators failed and now we have no money. Does the NMC make nursing safer? No. Does the GMC make doctors safer? No. Regulators are the dust-carts that follow the Lord Mayor’s Show of life. There is an utter fiction that regulation improves anything. The catastrophes of history are testimony to that.

Health regulation fails because humans, doctors and nurses fail. They may fail because we do not support them, educate them or motivate them, fund their purpose or demand too much. We regulate activities because they are complicated or vital. That is our mistake.”

Go read, The Audit Society: rituals of verification by Michael Power.

The price of success

by reestheskin on 19/12/2016

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“David Cameron began 2016 in 10 Downing Street and ended it at DePauw University in a small Indiana town, speaking for a reported £120,000 an hour. The former British prime minister is now paid almost as much for a 60-minute speech as he used to earn in a year, as he tries to make sense of his own historic failure: Brexit.” FT

MOOCs and things

by reestheskin on 16/12/2016

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Video is cool. Text isn’t.

Houston, we have a problem.

Medical school 2020, week 8

by reestheskin on 15/12/2016

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Exams begin next week. Type-A Anita is particularly nervous. Beginning last week she has refused to learn anything that is more in-depth than the NBME questions: “only high-yield.” She interrupts class once per day to complain when a professor gives more detail than the Step 1 exam books do. She also requests clarification about the number of questions per exam topic. She dropped her sweet Midwestern demeanor and submitted a formal complaint to the administration when an older physician said males have to work more to learn patient interviewing because women are more naturally caring.

via Philip Greenspun

Nice turn of phrase that seems apt way beyond its intended target, attributed to the physicist, John Stewart Bell (NYRB 10/11/2016).

” I hesitated to think it might be wrong, but I knew it was rotten”

OEB16 musings

by reestheskin on 13/12/2016

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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):

  • You cannot hide from the question of value. You can think about this is terms of money, time, inner wealth or job prospects, but the calculus has to exist somewhere. If the learning takes place in an institution that performs other tasks and has other goals (research, outreach, engagement, certification), this value has to be factored somewhere. Cross subsidies will be under challenge, whether they are they are sensible, or not. Sensible for whom?
  • I am, to use somebody else’s phrase, a libertarian paternalist when it comes to higher education. I really do think I can guide people through difficult terrain. But putting glorious autodidacts to one side, to what extent do many students need coaches, and under what conditions. The answer, at least in some of the domains I know about, is far less than we like to think. And, those who require least guidance are, in many senses, those we want most.
  • Content. What is the content, how is it presented, how does it hang together, how tested is it, how has it been curated, how personal is it? I will start ranting about this soon, so I will shut up now. Except to say, it is not a rant: this is so important.
  • How important is place? Where is the community? How do you maximise the sense of place?
  • How do you balance private study with communal learning. What is the right balance, and how does the answer influence costs?
  • I can see differences between MOOCs and other forms of non-institutional learning, but only of degree. Penguin books, and BBC OU broadcasts were open to many of us, and used by many of us. But they only allowed local conversations, rather than networked learning. We can — or at least –could do a lot more now.

Why is this online?

by reestheskin on 12/12/2016

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The annual cost of protecting our digital world from hackers will exceed the benefits of being connected by 2019, according to a study by the Zurich Insurance Group and the Atlantic Council, Here.

Well, I guess it is sensible for Insurance companies to be cautious. But I continue to be amazed by how much sensitive information around health care and university personal data is put online — just because we can. NHS systems have been hacked, and university sites are continually under assault. There is a lot of personal data stored, that could be used against people. This is the spreadsheet obsession of top down management, where data is equated with reality, and surveillance with caring. And that is before people try to sell it.

Ignorance kills

by reestheskin on 11/12/2016

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From a review in the FT of Steve Silberman, of what sounds like a book for our time, ‘How to survive a plague’, by David France.

“Jesse Helms, the five-term Republican senator from North Carolina, personally blocked spending on Aids prevention, treatment or research for years, pontificating from the Senate floor, “We’ve got to call a spade a spade, and a perverted human being a perverted human being.”

“Some of the most haunting passages in the book record twists of fate that delayed effective prevention and treatments for years. A young chemist at Merck who suspected early on that a class of drugs called protease inhibitors might yield promising avenues for research was killed on Pan Am Flight 103, downed by Libyan terrorists over Lockerbie, Scotland, in 1988. Years passed before other researchers went down that road again, discovering a drug that became a template for the “cocktails” that have turned HIV infection into a manageable chronic illness rather than a certain death sentence.”

Med school 2020 week 11

by reestheskin on 09/12/2016

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Sunday evening a few students were invited to my favorite professor’s cabin. She is a never-married woman in her late 60s who has dedicated her life to the craft of trauma surgery. She entered medicine expecting to go into family practice. While a third year student, she requested to be sent for her family medicine rotation to a rural area. She drove into the mountains to a small mining town of 10,000 with two family physicians. Although regretting her decision at first, it was here that she learned to love emergency medicine. Sitting around the bonfire, she shared vivid memories of driving the ambulance up moonlit dirt roads to a mine and going down the shaft to retrieve injured miners.

What has changed in trauma surgery? “Well the cases have changed,” she answered. “I started out treating young males in high-velocity, multi-trauma injury cases: car accidents, gunshot wounds, stabbings. Now it is mostly low-velocity cases: an elderly patient who has fallen. The family feels terrible for not having been there when the trauma occurred. The family flies cross-country to say ‘Do everything you can to keep Grandpa alive,’ not understanding what this requires doctors to do.  Too often they ignore palliative care.” She’d learned about hospital funding priorities: “It is easy to find donors for a state-of-the-art pediatrics wing; there is no money to remodel a decrepit geriatrics ward.” Her bonfire advice to us: (1) find a field where you will get more interested in it as you go on; (2) you can be happy in more than one residency field (i.e., don’t cry if you don’t get your first choice).

Statistics for the week… Study: 8 hours. Sleep: 6 hours/night; Fun: 2 outings. Example fun: Camping with Jane and Sunday BBQ at trauma surgeon’s cabin.

Here.

The bonfire advice (1) is very true (‘find a field where you will get more interested in it as you go on’). Just tricky. Note the ‘editor’s comments: “From the editor: Health care is nearly 20 percent of our GDP. The surest way to be a full participant in this massive and growing sector of the economy is to get an MD.”)

OEB16

by reestheskin on 07/12/2016

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I am just back from OEB16 in Berlin. A really terrific meeting, which I enjoyed more than I anticipated (my philosophy; check out that I wasn’t missing too much: I was wrong). I will write some more later. And although I have been to Berlin many times, on this occasion I had time to see much of the city. Also  to chat  with some bright and talented young people who have left the UK, fed up with Brexit and the State of the UK, aiming to make their life there.

College is dead; you just don’t know it yet

by reestheskin on 02/12/2016

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Roger Schank at OEB16. But this is just the hook. What is going on is that school isn’t working, and people end up having to go to college, with a resulting increase in expense for both students and the state. It is wasteful — except for those selling degrees, and a proportion of students.

Reminds me of the Alan Kay quote, to the effect that the US has the best high school education in the world — it is just a shame you have to go to College to get it. Of course if you go to graduate school….

Thoughts crossing in the night

by reestheskin on 01/12/2016

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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.”

Medical school 2020, Year 1.

by reestheskin on 26/11/2016

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Well the US version

Anatomy begins at 7:00 am sharp.

Although even the dermatologists in Vienna were hard at work at 7am, I remember. It is just that the surgeons were there even earlier. Link here.

Mega-silliness

by reestheskin on 25/11/2016

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In 1978, the distinguished professor of psychology Hans Eysenck delivered a scathing critique of what was then a new method, that of meta-analysis, which he described as “an exercise in mega-silliness.”

Matthew Page and David Moher here in a commentary on a paper by the ever ‘troublesome’ John Ioannidis, in his article titled, “The Mass Production of Redundant, Misleading, and Conflicted Systematic Reviews and Meta-analyses

To which, some of use would say, this was all predictable when the EBM bandwagon jumped on the idea that collating some information, and ignoring other information was ‘novel’. Science advances by creating and testing coherent theories of how the world works. Adding together ‘treatment effects’ is messier, and more prone to error. Just because you can enter data in a spreadsheet, doesn’t mean you should.

The mess that is Higher Education in the UK

by reestheskin on 24/11/2016

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This —‘Remaking Tertiary Education’ — is a terrific read. The report’s author Alison Wolf, asks: “How did we get to where we are? The obvious answer is ‘Government funded it this way’ and of course that is correct.” But the UK Higher Ed community was cheering all the way. £££££££.

I first came across Alison Wolf, reading her book ‘Does Education Matter?’ a few years back. The answer is, of course, much more nuanced than the many providers like to think. The most recent report points out that the current direction of travel is unsustainable, and that the students and tax payer are accumulating large debts. Once you have the blank cheque tax-payer-backed scheme, providers will expand and expand, with little end in sight ( tip: a marker of quality for UK universities is finding an institution that is not trying to expand undergraduate numbers). This was all pointed out at the time, but was buried under the trope of ‘education, education, education’. What Wolf has been right about for a long time is how the expansion of the historical 3/4 year degree level course has been to the detriment of technical education. And the needs of the population.

The graph below gives you some idea of what has happened, and there are two figures that should accompany it:

  • The contribution of student loans to net government debt is forecast to rise from around 4 per cent of GDP today to over 11 per cent in 2040.
  • 30 per cent of the English workforce being overqualified for their role, compared with an OECD average of 22 per cent. (quoted here).

alison-wolf-report

 

 

This is a massive bubble, not in learning, or producing rounded citizens, but in certification. And it is evident not just at Bachelor’s level. UK Higher education 3/4 year degrees need to be cut drastically.

‘I feel truly ashamed.’

by reestheskin on 23/11/2016

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Sir Keith Burnett (VC, University of Sheffield) who accompanied Theresa May on a trade mission to India, quoted in the THE. Another quote provides a flavour:

I have tried to stay positive for the past four years as I’ve seen things rot. I have groaned as changes in visa regulations pushed more and more potential students away. The government has assured us that it was not deliberately trying to reduce the numbers. Well, that may be the truth, but the results are in. A 50 per cent drop!

Other countries are rubbing their hands with glee at our stupidity. Ms May is announcing that her trade mission has seen £1 billion in deals announced for the UK. But remember that international students are worth £14 billion to the UK economy every year. That’s equivalent to more than one major trade mission a month.

Now, this is indeed about direct threats to UK universities, but I will not be churlish here. You cannot have a strong and robust society without fine universities. What is worth remarking on, is how rare it is to see plain English being used to state the ‘bleedin’ obvious. That plain language is rare reveals how politicised the whole of education (and health) is in the UK. Remember the antithesis of science is not art, but politics.

Making new ideas

by reestheskin on 22/11/2016

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Another great video of Alan Kay, explaining how intellectual revolutions occur ( ‘appoint people who are not amenable to management’)

Careers in medicine

by reestheskin on 21/11/2016

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UCAS has just released its data on medical school applications for this year (2017 entry)……A few bits of background information are useful first. Total applications in 2015 were 82,034 for 7,424 places, which leads to the oft-cited ‘one place for eleven applicants’. However these numbers include multiple applications by students. The number of individual applicants was 20,100 and success at gaining a place depended on country of origin. Success rates were 40% for UK applicants, 10% for EU applicants and 20% for non-EU applicants.

Andrew Goddard, here. I am surprise that the acceptance rate is this high, but I guess there is a lot of self-selection. I do not have a good feel for what is influencing career choices, but the baby boomers had it better — once they got in, sadly. I will stick with my default opinion and change as the evidence changes: what happened to teaching, will happen to medicine. Politics is a dominant negative mutation, and all buckle before it.

You have the MOOCs and bla-bla-bla

by reestheskin on 19/11/2016

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“You have the MOOCs and bla-bla-bla – you can quote me on that,” he says, laughing, “but the real revolution that has happened is in YouTube, Wikipedia, Minecraft, and people publishing things on the internet.”

I think MOOCs are interesting, mainly because of the light they cast on dated and inadequate models of university mass education, but he is right.

Mark Surman of Mozilla.

Tacit knowledge doesn’t fill cells in Excel spreadsheets.

by reestheskin on 18/11/2016

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This (‘Meaning and the Nature of Physicians’ Work’, NEJM 275;19:1813-5) is one of the best things I have read in a long time. It is right on some big issues, and is only depressing if you think positive action is not possible. The article speaks to the dehumanisation of the practice of medicine, and what happens when there is a gulf between those who practice, and those who think that a summary of practice is the same as actual practice. Tacit knowledge doesn’t fill cells in Excel spreadsheets. It is of course, not just medicine that is changing this way, but other professions — look at what has happened to schoolteaching and the bogus politics and ‘common sense’ that masquerades as evidence in education.

“The contribution of student loans to net government debt is forecast to rise from around 4 per cent of GDP today to over 11 per cent in 2040”. Here

Yesterday’s ideas

by reestheskin on 16/11/2016

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There are lots of downsides to technology making it harder for some things to be forgotten. But lots of advantages too. I use a simple diarying App that is available on mobile and Mac, Day One.

One of its nice features is that gives you the option to see comments you have made on the same date in previous years. Now, like many people I tend to often agree with myself — at least over the short term— but it is fun to read earlier musings and wonder if the nuance needs changing, but also to see the same underlying memes appearing again and again. Often, I am still in agreement, with my earlier comments. Sometimes not. Here is one from three years ago.

On the usually sound principle that there is nothing in UK medicine that can’t be made worse by the involvement of the General Medical Council

Nigel Hawkes in BMJ,10 November 2012

Optimising the production of Masterpieces and genius work

by reestheskin on 15/11/2016

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There is a witty spoof on the ‘contact hours = quality education’ debate (sic) in the THE. AKA why are ministers so stupid.

Ministers are concerned that despite large differences in the quality of novels, they all seem to cost the same. From now on, under the National Assessment of Fiction Framework (NAFF), the quality of novels will be scientifically measured according to the number of pages they contain, and prices will be set accordingly. Ministers are said to be delighted to have finally proved that Riders, Jilly Cooper’s 900-page epic, is three times better than Jane Austen’s insubstantial Pride and Prejudice.

It reminded me (yet again) to track down something I had read many times on Brian Randell’s web page here. Computing was lucky because the inventors got to do so much before the academy tried to close it down.

Masterpiece Engineering, T. H. Simpson, IBM Corporation, (Via Brian Randell’s web page here.)

“Here on this spot in the year 1500 an International Conference was held”.

It seems that a group of people had gotten together to discuss the problems posed by the numbers of art masterpieces being fabricated throughout the world; at that time it was a very flourishing industry. They thought it would be appropriate to find out if this process could be “scientificized” so they held the “International Working Conference on Masterpiece Engineering” to discuss the problem. As I continued walking round the garden, now looking a little closer at the ground, I came across the bones of a group, still in session, attempting to write down the criteria for the design of the “Mona Lisa”. The sight reminded me strangely of our group working on the criteria for the design of an operating system.

Apparently the Conference decided that it should establish an Institute to work in more detail on production problems in the masterpiece field. So they went out into the streets of Rome and solicited a few chariot drivers, gladiators and others and put them through a five week (half-day) masterpiece creation course; then they were all put into a large room and asked to begin creating. They soon realized that they weren’t getting much efficiency out of the Institute, so they set about equipping the masterpiece workers with some more efficient tools to help them create masterpieces. They invented power-driven chisels, automatic paint tube squeezers and so on but all this merely produced a loud outcry from the educators: “All these techniques will give the painters sloppy characteristics”, they said.

Production was still not reaching satisfactory levels so they extended the range of masterpiece support techniques with some further steps. One idea was to take a single canvas and pass it rapidly from painter to painter. While one was applying the brush the others had time to think. The next natural step to take was, of course, to double the number of painters but before taking it they adopted a most interesting device. They decided to carry out some proper measurement of productivity. Two weeks at the Institute were spent in counting the number of brush strokes per day produced by one group of painters, and this criterion was then promptly applied in assessing the value to the enterprise of the rest. If a painter failed to turn in his twenty brush strokes per day he was clearly under-productive.

Regrettably none of these advances in knowledge seemed to have any real impact on masterpiece production and so, at length, the group decided that the basic difficulty was clearly a management problem. One of the brighter students (by the name of L. da Vinci) was instantly promoted to manager of the project, putting him in charge of procuring paints, canvases and brushes for the rest of the organisation.

Some people try to optimise the shit out of everything. Or, as we might say in South Wales, ‘tearing the arse out of it’.