Some updates to ed.derm.101
I have posted some new audio SoundCloud answers to questions from the first three chapters of ed.derm.101 Part C.
There is no big Pharma in education
“Investment firm GSV Advisors recently estimated the annual global outlay on education at $5.5 trillion and growing rapidly. Let that number sink in for a second—it’s a doozy. The figure is nearly on par with the global health care industry, but there is no Big Pharma yet in education. Most of that money circulates within government bureaucracies.”
On difficult students
After a spell as a lecturer and reader at the LSE, he returned to his East End roots at the economics department at Queen Mary College, recruiting an impressive roster of academics and students to its venue in a former biscuit factory on Bow Road.
He was known for giving chances to mavericks: if a headteacher warned of a student’s “difficult” nature, Peston would normally take them on.
From an obit of Lord Peston FT
This brought to mind something in Craig Venters excellent autobiography, A life decoded. He described how he was so busy doing science — and publishing — as a student, that he failed some mandatory graduate exams. The faculty had to ‘invent’ an appropriate exam for him — which of course he passed. They obviously didn’t have to deal with the QAA or GMC.
Education is not just about means, but about maintaining intellectual diversity. We have to be concerned about variation, too. It is all too easy to concentrate on minimum standards or pass marks, without considering whether what we are doing, harms those who as a society we are most in need of.
Welcome
A new welcome video for our Edinburgh Medical School dermatology module. Judging by the gesticulation, I must have some Italian blood in me (or so somebody tells me).
Using Keynote to create simple voiceovers
Just because some colleagues asked:
The importance of forgetting and painful retrieval for learning
This is another useful talk from HILT. One problem that bugs me with both undergraduate teaching and learning, and clinical expertise when you are qualified, is the dynamic between measures of competence at a defined time point, and the influence of exposure on the pattern of competence over time. People often assert that because you have some skill at timepoint X, that somehow ‘clinical exposure’ will maintain that skill over time ( I am not talking about revalidation here, simply because most accept as currently construed revalidation is not credible). However, keeping knowledge accessible is not just a function of formal learning, but a function of how often you encounter particular clinical problems. The dynamics are worth thinking about. To maintain competence for rare disorders, you must encounter them at a certain rate. However, it seems to me possible that ‘routine clinical practice’ may not allow enough encounters to allow this competence to be maintained at the rate that is required. [So, the rate required to maintain competence, is greater than the rate at which you might routinely encounter the problem]. This is of course why we might use simulation, or attend clinical meetings, or spend much of our life talking about ‘cases’. If you want high level competence, you have to control the ratio of mundane to advanced case-mix. This is one of the reasons you need a hierarchy, and why a consultant delivered service, is not compatible with high level clinical competence (yes, I am skipping over a formal proof, here!). Some of this is at least tangentially related to this video by Robert Bjork — he of desirable difficulty). It is not exactly the rugby training mantra of no gain without pain, but something cognate; and that our tacit yesteryear views of competence are being destroyed.
A more engaged audience yields high ad rates (or student learning)
From an article in today’s NYT
Last year an Interlude video of Bob Dylan’s “Like a Rolling Stone,” which let viewers flip through a fictional TV wasteland — infomercials, game shows — in which actors mouthed Mr. Dylan’s lyrics, got more than 70 million views. Recently, an interactive video for “Stayin Out All Night“ by the rapper Wiz Khalifa, a Warner artist, was viewed 3.8 million times, while a conventional version on YouTube got only 3.6 million views. “This Interlude technology is game-changing,” Mr. Khalifa said in a statement. “I’m very glad to be at the forefront.” For Warner, as well as for advertisers that have begun to use Interlude, the appeal of the technology lies in how it lures people to be more active viewers. According to Mr. Bloch, the company’s chief executive, 90 percent of Interlude’s music video viewers make choices while watching (videos will play even if a viewer does nothing). A more engaged audience yields higher ad rates,
Well, I haven’t sampled (no pun intended) the technology, but the key point is familiar to anyone who knows anything about how students learn: they have to engage, and the more effort them have to put in to any teaching session the more they will learn. Remember Robert Bjork’s phrase: desirable difficulty, in learning.
LMS/VLE and the walled garden
This is a nice post about a talk by Audrey Watters on how the dream of ‘the’ portal hasn’t died (unfortunately). What do people think links are for? What do people think a web is?
I like Gerd Gigerenzer’s writings (see for instance The Empire of Chance and Simple Heuristics that make us smart) and I am sure it is not his fault that the same stories keep coming round again and again. This story on the BBC web site treads over old ground but of course the lessons remain the same (even if the book is different). Doctors don’t like working using Bayes’ theorem in clinic — at least not if we have to use algebra, rather than real numbers (as Gigerenzer makes clear). And I still think we do a poor job of teaching medical students statistics. But something niggles me about his line of argument, and in part it it is not a million miles away from some of Gigerenzer’s other work on heuristics and ‘quick and dirty’ computation.
One view of expertise is that doctors somehow work from ‘basic principles’ and then work out what to do. This used to be the dominant view of medical expertise: we had to understand the physiology, so that we had a live model in our brain of what was happening to the patient. This may well be true in some instances, but more often it seems to me that the burden of knowledge to do this is so great, that we just follow simple shortcuts or heuristics— or we read it off look-up charts. I actually think this is sensible. We don’t need to fret about the molecules, just as I don’t need to worry about machine code or C+ when I write this blog. What Gigerenzer is drawing attention to is the absence of the relevant cognitive prostheses that takes care of the number crunching for us. Of course if the prosthesis existed, we would play with it, and actually become more at ease with the algebra.
Textbook prices
There are some tremendous textbooks, Molecular Biology of the Cell, to quote an example, but many are dull. I understand a little about the business of textbook production, and change seems long overdue. My own efforts are of course very humble, but I am working on improving things. This graph does not attest to much innovation: more Eroom’s law than Moore’s law.
http://qz.com/225483/runaway-college-textbook-inflation-is-about-to-get-disrupted/
http://qz.com/225483/runaway-college-textbook-inflation-is-about-to-get-disrupted/
“it’s a worrying sign for philosophy in the academy. Someone who’s very good at conveying complex philosophical ideas in plain English– a good teacher, in other words – has come to the conclusion that a university is not the best place for him to be”.
[simnor_button url=”http://philosophypress.co.uk/?p=1159 ” icon=”double-angle-right” label=”Interview with Nigel Warburton ” colour=”white” colour_custom=”#fff” size=”medium” edge=”straight” target=”_self”]
Professor Cooper described a “very special pedagogy” at the university, based on face-to-face teaching, “high contact hours” and “intensive problem-solving”
[simnor_button url=”http://www.timeshighereducation.co.uk/news/regents-park-place-for-a-leader-who-can-command-respect/2012123.article” icon=”double-angle-right” label=”A very novel strategy for a University ” colour=”white” colour_custom=”#fff” size=”medium” edge=”straight” target=”_self”]
Teaching statistics to medical students
The situation was a familiar one. Some time back, I was gossiping to a medical student, and he began to to talk about some research he had done, supervised by another faculty member of staff. I asked what he had found out: what did his data show? What followed, I have seen if not hundreds of times, then at least on several score occasions. A look of trouble and consternation, a shrug of embarrassment, and the predictable word-salad of ‘significance’, t values, p values, statistics and ‘dunno’. Such is the norm. There are exceptions, but even amongst postgraduates who have undertaken research, the picture is not wildly different. Rarely, without directed questioning, can I get the student to tell me about averages, or proportions, using simple arithmetic. A reasonable starting point surely. ‘What does it look like if you draw it?’ is met with a puzzled look. And yet, if I ask the same student, how they would manage psoriasis, or why skin cancers are more common in some people than others, I get —to varying degrees—a reasoned response. I asked the student how much tuition in statistics they had received. A few lectures was the response, followed by a silence, and then, “They told us to buy a book”. More silence. So this is what you pay >30K a year for? The student just smiled in agreement. This was a good student.
Statistics is difficult. Much statistics is counter-intuitive and, like certain other domains of expertise, learning the correct basics often results in a temporary —or in some cases a permanent —drop in objective performance.** That is, you can make people’s ability to interpret numerical data worse after trying to teach them statistics. On the other hand, statistics is beautiful, hard, and full of wonderful insights that debunk the often sloppy thinking that passes for everyday ‘common sense’. I am a big fan, but have always found the subject anything but easy. But, like a lot of formal disciplines, the pleasure comes from the struggle to achieve mastery. I also think the subject important, and for the medical ecosystem at least, it is critical that there is high level expertise within the community. On the other hand, in my experience many of the very best clinicians are (relatively) statistically illiterate. The converse is also seen.