worth a glance

As tech destroys jobs. And values.

by reestheskin on 06/02/2017

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If you want to explore the meme about tech destroying jobs (and value) there are some great quotes in a piece by Steven Levy about John Markoff, of the New York Times, stepping down. Some samples:

I used to tell people that the Times’ loyal readership was both its great strength and weakness. The good news was that they would read the paper until they died. The bad news was that they were dying.

Then when I went back to school one fall, the men were all gone. It was the fall of 1969 and the Union Bulletin had gone to offset type. The men in the aprons had vanished. They had been shipped off with the press to a small paper in Oregon. In their place were women in skirts working at Selectric keyboards.

The next transition happened 15 years later when I got my first job at a daily paper, the San Francisco Examiner. I was part of a new generation of reporters who went to the gym after work instead of the bar.

That’s another irony — that I was one of the first to write about the digital world, but when it really arrived it was pretty clear that I wasn’t going to be a digital native. When blogging began, John Dvorak told me that there was no point in doing it unless you posted at least seven times a day. “Why would I want to do that?” I thought. I had already worked for an afternoon daily and I never wanted to work for a wire service.

Some things won’t change. I’m certain that when the next corrupt president is impeached it will be because of the hard work and persistence of some new Woodward and Bernstein.

I have often quipped that high quality journalism could contribute more to health care in the UK than the Department of Health in London. This was once a daring proposition.

Worth a glance #25

by reestheskin on 16/11/2015

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“The digital revolution in higher education has already happened. No one noticed.” Clay Shirky. Stephen Downes comments ‘Like the elites, this article is late to the party, looking at it from a skewed perspective, but still willing to take credit for having discovered it first’.

After 40 years, Sony retires Betamax.The best doesn’t always win. (via Audrey Watters)

The University of Nowhere: The False Promise of “Disruption.” Review of ‘The end of college’ by Peter Carey.

Lessons from the PC video game industry: The future of media is here — it’s just not evenly distributed. Actually, I think there are lots of lessons here for higher education.

After Paris, something good.

An obsession with safe spaces is not just bad for education: it also diminishes worthwhile campus protests. The closing off of debate on university campuses.

The misery of some PhDs. Too often, all too lonely, and a system that is out of kilter with what is needed.

Why I’ve Stopped Doing Interviews for Yale. from mathwithbaddrawings.

Tech in schools: less is more. Nicholas Carr. But see this

Hackers vs. Academics: who is responsible for progress? Answer: it depends.

Med students are marginalized in the hospital. It’s time for that to stop.. Solutions, please.

Medical students’ sharing of patients’ images raises concerns over consent. Beware.

Academic Journals: The Most Profitable Obsolete Technology in History. Amen.

Worth a glance #24

by reestheskin on 17/10/2015

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For-Profit Colleges Accused of Fraud Still Receive U.S. Funds. “Consider the Education Management Corporation, which runs 110 schools in the United States for chefs, artists and other trades. It has been investigated or sued in recent years by prosecutors in at least 12 states. The Justice Department has accused the company of illegally using incentives to pay its recruiters. And last year, investors filed a class-action lawsuit, contending that the company engaged in deceptive enrollment practices and manipulated federal student loan and grant programs.” All a matter of degree.

Universities are infected with business speak — profit units, business units, line-managers, and all sorts of other verbiage (world class, cutting edge, ‘experience’). In part this reflects a confusion about what universities are for, and how not all successful institutions need to ape the latest corporate fads. Here is a nice example of how to write — and rewrite corporate memos.

The roadmap is also a plan to change how we work, and what we need to do that work. Product and Engineering are going to make the most significant structural changes to reflect our plan ahead bear the bruntWe feel strongly that Engineering will move much faster with a smaller and nimbler team We’ve got way too many engineers while remaining the biggest percentage of our workforce. And the rest of the organization will be streamlined in parallel and once we’ve cut that group we’ll have too many of everybody else.

Teacher spurns $11m offer in Hong Kong tutor wars. My take is that teachers matter — what happens in the classroom is central to how much students learn. This is not just about ‘experience’, or the curriculum or the student facilities. Economists have tried to model the value of a good versus bad teacher in terms of future earnings. The figures are very, very large: good teachers are massively undervalued. The problem is to work out how to identify and reward good teachers — and I do not know a robust way to do this, that is not subject to gaming. Just like Banking.

Coming, ready or not. I came to this article by Dean Ashenden via a tweet or re-tweet from Mark Gusdial (Computing education blog). I think it is a great read not least because he tells much of the story at his own expense. Lots of important messages about tech, learning and the classroom, going back to some of Larry Cuban’s work:

“From a Cuban perspective, outcomes and computers were merely the most recent in a long series of educational and technological fixes for the troubles of the classroom. Each had changed things somewhat, without really changing the way teachers (and therefore students) actually did their work. The brutal fact is that twenty or twenty-five students constitute a crowd, so teachers have to control and teach to the crowd. Teacher-centred instruction, Cuban argued, “is a hardy adaptation to the organisational facts of life.” 

If we are going to use tech to radically improve teaching we have to change the way we organise the classroom and what we expect of teachers. That is where resistance will be highest. I like Ashenden’s metaphor:

Of course, it’s not really the computer that wins. A combine harvester will not make medieval strip-field agriculture more productive, yet an assumption of just that kind can be found in many ways of using (and researching) technology in schooling. When computers are added to classrooms and nothing changes the conclusion is that technology doesn’t work. In fact, it is schooling’s strip-field system that is not working.’ 

Problem+++ Worth reading in full.

Worth a glance #23

by reestheskin on 12/10/2015

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A well-to-do cancer patient is nearing the end of her treatments. During an office visit, she says to her doctor, “I can’t thank you enough for the care you provided.” Should the doctor simply accept the patient’s gratitude — or gently suggest a way for her to show it: “Perhaps you might consider making a donation?” “We committed our entire estate,” Mr. Hyer said. And Mr. Hyer made a training video for doctors to learn how to effectively ask for donations. NYT

Blendle Is Up To Something Big. This is from the Monday note, and is about micropayments. The thinking is that if adblockers destroy one sort of business model, and keeping subscriptions to high quality journalism for more than a handful of journals per person is too expensive, how can we get traction for micropayments. For medicine and OER, we might think we do not need them at all. On the other hand, the idea of micropayments for individual book chapters is worth pondering. Does a book add value beyond that provided by individual chapters? Sometimes, clearly yet. But on all occasions? iTunes revisited.

Caution: delusions of personalisation (as in personalised medicine). Nice 101 on sources of variation in treatments by Stephen Senn. Variance components for the common man await.

Online university offers refugees chance to study for free. Kiron University, named after the centaur Chiron, known in Greek mythology for nurturing others in times of need, was founded last year by a group of students in Berlin.

Worth a glance #22

by reestheskin on 17/09/2015

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No money for ice for drinking water. I got this via my brother. When you have a health care system that works like this, you don’t have a health care system. Period. The other question for us academics, is to open up all that data suggesting that centres of excellence are not centres of excellence. Any dissociation, sinks us — or is hypocrisy. I seem to remember saying something similar at an interview awhile back.

The budget-cutters are coming – and research has no place to hide. Well, I do not know, but short termism is not just for the banks. Alison Wolf (not the author of this cited article) talks a lot of sense, and her view is that Higher Ed finances do not have a very rosy future over the next decade.

Claus Moser, statistician and culture-lover, died on September 4th, aged 92. I have a soft spot here, as it was Moser and Kalton’s book, Survey Methods in Social Investigation, that was my bible for survey research [when I was taught these things]. The article highlights that whilst he certainly did not think of himself as a mathematical statistician, I loved the discipline about sampling he preached, and how without it, your inferences are limited. Not that many medical educationalists seem to be too worried about such niceties.

Blackcurrant tango commercial.I got this via Bruce Charlton. Now that is what I call funny.

Worth a glance #21

by reestheskin on 31/08/2015

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Innovation as Discipline, Not Fad.

Former head of china’s genome powerhouse starts new chapter. I just find this sort of thing silly. Just me?

Obstacles to developing cost-lowering health tech. The Innovators dilemma. The problem that is not going away. See Jack Scannell and eroom’s law. Cost matters, and we fund research as though it does’t. The result is yet more subsidies to corporations that increasingly resemble banks; and a failure to promote real innovation.

The benefits of a liberal education do not go out of date. I always wonder what to make of the fact that most UK medics do not do other degrees first. I tend to think medicine is, in large part, a liberal art.

The end of the internet dream. Jennifer Granick talk at Blackhat. The battle is not lost. Yet.

US education is a $1.5 trillion industry and growing at 5 percent annually. On the face of it, those figures warrant attention from investors.’ As Dylan Wiliam tweeted:’ McKinsey’s latest report—Capitalists preparing to plunder education or a much-needed source of investment? You decide.’

Worth a glance #20

by reestheskin on 25/08/2015

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Surgical trainees seem unhappy (with good reason). Financial burden of surgical training  and  Why a career in surgery is no longer the golden ticket and Training to be a surgeon takes too long in the UK

In Students’ Minds, Textbooks Are Increasingly Optional Purchases. See this quote : Publishers are pushing a new model, called an “integrated learning system,” in which students buy access to an online system that mixes reading materials, multimedia, and quiz and homework tools. I think some universities  are asleep.

IBM Adds Medical Images to Watson, Buying Merge Healthcare for $1 Billion. I don’t know what to make of this, even though I have spent quite a few years trying to develop automated and semiautomated diagnostic systems. The old diagnostic melanoma systems looked promising, but they went no where — they were too brittle and lacking in robustness. And the size of training sets was far too small (by several orders of magnitude). On the other hand, if the total workflow is digital datasets can grow cheaply. A not in my lifetime moment? And Geoff Norman had some very cogent criticisms of the Watson approach to diagnosis, I remember.

[Stop] US Universities From Hoarding Money ‘While nobody has suggested that quid pro quos were involved in these cases, these gifts highlight the symbiotic relationship between university endowments and the world of hedge funds and private equity funds.’

Bullshit. FT article. Alive and well in my professional life


Worth a glance #19

by reestheskin on 14/08/2015

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Clinical research: Should patients pay to play?

Social care chief savages failing system for elderly. And Care homes are getting worse, not better.

The commencement speech: A look back at Jon Stewart’s 2004 commencement speech: ‘College is not necessarily predictive of your future success’

White House: Innovation in Higher Education.‘ No one knows what HE is becoming. Forget the think tanks and the consultants and the keynote speakers. No one knows how these trends will track or what the university will look like in the future.’

Certification gone mad: ‘Sometimes this is justified:airline pilots need licences. But often, as in the three years of training needed to become a security guard in Michigan or the thousands of hours required for hairdressers in Utah, the rationale is less clear.’

Worth a glance #18

by reestheskin on 29/07/2015

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I have been away, in Croatia. My former colleague (and troublemaker) Bruce Charlton remarked many years ago that many academics seemed to be embarrassed if they were found to be ‘just reading’ in their office. Reading and thinking, is not what most academics are about anymore. But holiday allows you to be a proper academic, so below are just a section of  the news items that bugged me.

Can higher education’s golden age of plenty continue? No, is the correct answer. I linked to this article with a quote earlier. Wolf writes: These figures show that we have been uniquely favoured. Where can we go but down? They also and more importantly underline how totally universities still depend on the state. Overseas student fees are sometimes discussed as meaning that we could cut free. But it is the generous funding for science and the growing levels of support for home students that underpin English higher education’s global success. Students everywhere go for the best they can afford, not the cheapest on offer, and rationally so. Students come to the UK, and pay high fees, in large part because of our reputation. High fees themselves signal quality – we’re expensive, therefore we’re good – but the signal needs to be plausible. You can’t carry on indefinitely if you are sinking in the global research tables or if your buildings are falling apart. If the state is good to us, why worry? Because this system is being seriously destabilised* And then:We can predict with confidence what will happen. Further education will seem even less attractive: why go somewhere funded at £2,000 a student when somewhere funded at £9,000 is wooing you? Universities will expand their intakes rapidly. The academic record of new entrants will be lower. As participation rates rise higher, the average salaries of graduates will fall and so will loan repayments. What she gets right is the way that the FE sector has been canabalised by universities. The only wealth member of my family, a graduate (as in apprentice) of the idyllic Univeristy of Port Talbot (as in the then British Steel) had to close his light engineering business when he retired because, as he said, in the UK you no longer could access  the sort of bright interested apprentices that you once could —they just go to university instead. Compare Germany, and then understand Mittelstand.

Writing an online, open textbook: is it worth it? This is from Tony Bates. I have a sort of online textbook, and students seem to like it and use it, but it could be a lot better.

MIT and German research on the [appalling] use of video in xMOOCs. This is Tony Bates again via Stephen Downes. Lots to agree with. I am interested because I am a fan of the use of videos, and I do not think we have explored their benefits for undergraduate medicine in terms of procedures or personalising what we do for the benefit of students. And I have read Richard Mayer.

In defence of the Research Excellence Framework. I am not alone, just in a minority in arguing that the RAE/REF has been a disaster for UK Higher Ed. Students and those interested in the greatest tech transfer universities can produce (i.e.students) are the losers. The recent announcement of the TEF will no doubt be another bureaucratic fit of nonsense. I am glad I am not at the beginning of my career. I hope Scotland ignores it, and concentrates on teaching instead.

Students under surveillance. This is from the FT, although there is lots everywhere about it. I am sceptical of much of the supposed benefits (tech solutions, for not knowing who your students are or what they know). But be careful not to throw baby out with the…..And sinister too. But then Amazon tracks my reading, and I love the fact that google analytics tells me things about interactions with my online book

This is the promise of learning – and the future of Pearson. I take the FT and the Economist although I tire of most of their supposed solutions to our many problems. But hey, the obits in the Economist are worth the subscriptions, and the book reviews influence what I read. But few have much good to say about Pearson. The line from Pearson, now divested of the FT and soon to be divested of the Economics is: We plan to reinvest the proceeds from today’s sale to accelerate our push into digital learning, educational services and emerging markets. We will focus our investment on products and businesses with a bigger, bolder impact on learning outcomes, underpinned by a stronger brand and high-performing culture. This will help us progress toward a future where learning is more effective, affordable, personal and accessible for people who need it most. By doing so, we can help more people discover a love of learning and make progress in their lives. This is the promise of learning– and the future of Pearson. I really hope not.

Lots of money in ed-tech. And Pearson.

‘The poorest students will leave university with the biggest debts’. This is about the abolition of maintenance grants (as in, what I received). Paul Mason may be on to something. This is all going to fracture. I was only an amateur activist when young, but I am much angrier now. Perhaps even a little less cynical.

You go to Stanford to get your ticket punched, and then you go off and you start your companyThe NSF budget and the NIH budget are relatively frozen; they’re not growing. Venture capitalists are increasingly making short-term bets rather than long-term bets. Google was supposed to be the latest corporate entity that was going to try to fix that. They created Google X that was supposed to do these moon shots. Maybe there’s a little bit of it, but you don’t see it very much of the notion of basic research, of doing science. You see applied research everywhere. Even the national labs, you see projects that are intended to find ways to commercialize technology. The notion of science for science’s sake is under assault. Paul Mason, comes to mind again.

I want to make the shocking prediction that the Internet of 2060 is going to look recognizably the same as the Internet today. ‘This exponential hangover leads to a feeling of exponential despair.’

Giving Doctors Grades:Ask any medic and they will have seen this. Once you dismantle professionalism (as the GMC and the government are doing in the UK) you end up here.

More Insights From Dylan Wiliam. Goes with being Welsh, bach!

Worth a glance #17

by reestheskin on 28/06/2015

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What you need to know before you blow the whistle. You just need to read Private Eye to understand how the NHS bullies those who criticise. I will use that awful cliché: bullying and stifling of dissent is part of the NHS’ DNA. Note the following: If a successful whistleblower loses their career, they may be awarded hundreds of thousands of pounds in compensation. However, there is no protection against blacklisting by future employers, so a whistleblower’s financial losses may be even greater. The author suggests doctors might contact the GMC, but again, Private Eye reporting (remember Bristol?) would suggest this may not be very helpful.

Peer review: not as old as you might think. Aileen Fyfe in the Time Higher. Even in my professional lifetime I have seen the meaning of the term peer review change, with journals attempting to claim ownership for their own purposes. Of course, editors used to make decisions without external experts, and how silly to imagine that a couple of reviewers could act as a marker of truth. The web should sweep all this aside, with the possibility of returning to the idea of communities of scholars. But the resistance will come from the journals, who are largely about making money; and the universities and grant awarding bodies, who are unable to actually read what people publish, and prefer to view the world through an Excel spreadsheet. This unholy alliance is of course now the substrate that allows performance management and the other  nefarious rituals of verification.

The invention of tradition: how ‘researchers’ replaced teachers. Again, I am feeling that one of the problems of being around awhile, is that you can see history being re-written to justify a particular point of view. There is much you can say and argue with about research in UK higher ed, but nothing compares with the neglect of teaching in many universities, or the lack of value in what students are paying for. As this article quotes, not long ago British academics were overwhelmingly orientated towards teaching rather than research. The marginalisation of scholarship and teaching, is particularly acute in medicine, where the need to have a third string to the bow — clinical practice — makes the problems worse. I used to use a quote from a web page of the late Roger Needham, who was Professor of Computing at Cambridge, but his web pages are no longer there. He said something along the lines of: the main form of tech transfer is something called ‘students’. Our biggest impact as academics is in the form of the graduates we produce.

Ask Doctor Clarke Should I feel guilty about this? Many of our students pay for this sort of extracurricular tuition.How good it is, I do not know. But it makes me feel sad. Reminds me of parents paying for full time private education, then paying for coaching in the evenings. You go to med school, paying fees of 9K with another 10K throw in by the government, or if you are from outside the EU, maybe 30K+ a year, and then you feel the need to pay not just for books, but for tuition.

Seven Questions for Personalized Medicine. This is from JAMA. I don’t think there is anything groundbreaking here, but it is nice to see some degree of scepticism, especially in a US journal. Again, the hype cycle is being remodelled. Its all business as usual.

Capita wins £1bn NHS contract to oversee administration. Private Eye of course refers to them as Crapita. An interesting example of how biased and superficial much of the FT is (just follow the comments, for an account of what Capita are like). This is all about what JK Galbraith called welfare for the rich. Or in the UK, subsidies for the corporate donors to the main political parties. Healthcare along the lines of the ATOS model.

Worth a glance #16

by reestheskin on 01/06/2015

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Neel Sharma: Reforms in medical education—are we missing something? But I think he is wrong on some points. The last thing much of med ed needs, is to ape the ‘Poverty of Trialism’. The search space for med ed is too big, and we are getting confused between science and design. And I really don’t think we have seen much change. Perhaps easier for me to state: I disagree with most of what he says.

What Happened to Educational Television: The Story of ‘The Learning Channel’. This is a great series of articles by Audrey Watters. But amidst the tropes (not that she sees them) about the last great educational tech being either the blackboard or the school bus, tech is going to be the direction of travel, and not just in the private sector [I hope].

Some experiences of life at Imperial College London. There are some updates here for those who have been following the story. It is hard to gauge the minds of some wannabe clinical academics. Many, I suspect are planning careers in which they know they will jump ship to the NHS —whatever they say at interviews for fellowships— but events at Imperial, Warwick, Cardiff and Dundee, suggest to me that the brightest need to go elsewhere.

The trouble with science. Via John Naughton. Yes. And, yes, again.

We need more nurses.. This is about the US, but brings back more unhappy memories of the care my late father received at a leading (sic) UK teaching hospital. We need more nurses, but more importantly, we need to put some trust back in the professional judgment of those on the wards. That of course is why many hospitals are called Trusts: there isn’t any. And, we need much more investigative journalism — it is more likely to change things than academic research.

The doctor shortage. US style. From the AAMC: you are warned.

Worth a glance #15. CAVE dwellers (colleagues against virtually everything)

by reestheskin on 18/05/2015

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The $2.6 Billion Pill — Methodologic and Policy Considerations. Jerry Avorn in the NEJM. Understated article pointing out the figures often used to justify drug prices are hidden, and tricky to accept at face value. And that help of the cost relates to capital costs, figured at over 10% per year, whereas bonds issued by drug companies only pay 1–5%. As has been said before, Pharma is doing its very best to enjoy the same reputation as Banks now have. It was not always this way, and they were profitable too, then.

I do hate agreeing with Richard Smith, but I think he is right when he says “I spoke at the centenary meeting of the MJA last year, and my core argument was that the time of journals as conduits for publishing science is coming to an end”. The context is that the Australian Medical Association keeps sacking its editors, and the reasoning appears to be about money (or at least morality versus money). Journals are major sources on income for many clinical societies, together with annual meetings. They need to plan for when both sources of income dry up. I argued this over 15 years ago and — you will point out — it hasn’t happened yet. But it will ( if only in large part). Of course, what will not want to accept the end of journals, will be the vast audit culture of UK Higher Ed.

Is the ‘closed’ mindset of the Open Educational Resources community its own worst enemy? Donald Clark makes lots of great points. A few quotes: “ I still encounter fierce resistance and an almost visceral dislike of Wikipedia by professional educators, yet universal acclaim by learners and users; Rather than celebrate the existence MOOCs, many educatiors immediately engaged in a guerrilla war against either the quality of the content or the ‘privatisation’ of education; More focus on saving costs would not be ‘managerialism’ but an honest attempt to lower the cost of education, which we know is spiralling out of control. Education (not information) wants to be free. “ Finally, a new one on me: CAVE dwellers (colleagues against virtually everything)

Message to My Freshman Students. Keith M Parsons. “However, things are very different for a university professor. It is no part of my job to make you learn. At university, learning is your job — and yours alone. My job is to lead you to the fountain of knowledge. Whether you drink deeply or only gargle is entirely up to you.”

Adjunct teaching: For love of the lecture. Nature. “Before and after her classes, Finley advises and tutors students, a commitment for which she receives no compensation. “I’m one of the first professors these students have, and I love it,” she says. “But I’m not paid for those hours, even though those are the hours I remember the most. Financially, it’s not easy.” Welcome to Baumol’s law, and the business model that now underpins most service industries.

U.S. Will Pay Med Schools To Reduce Glut of Doctors. Well this is from 1997, but made me smile. No doctors, no patients. Think of the savings.

Worth a glance #14

by reestheskin on 05/05/2015

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Wake-up call for UK as giants stir in the global student market. Around 20% of students at UK universities are from overseas, providing 12% of income. In the name of courting popularity, the current UK government is doing its best to encourage them to go elsewhere . Without these students, parts of UK higher education would suffer a major shock. Other countries, especially the US, are now stepping up recruitment. We used to make the best cars in the world as well, and as a kid I would visit Cardiff docks, and see rows and rows of cars all ready for export.

The First 70 Minutes of The Hour. This deserves a longer post but the parallels between ‘the pitch’ [I have only done one, and it was unsuccessful] and the death by Powerpoint lecture are obvious. “When, in 2002, I was invited to join the ranks of venture investors by Barry Weinman, my Gentleman Capitalist mentor, I voiced a concern: I didn’t want to go blind looking at PowerPoint presentations for the rest of my life.”

Preparing for the digital university. One of the authors (Dragan Gašević) is from my institution. Stephen Downes is not too warm about it. I think it is essential reading, but as Downes says, so is Tony Bates’ book.

The industrial education system myth by Martin Weller ( as a riff on Audrey Watters on the same topic).

Worth a glance #13

by reestheskin on 03/04/2015

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Change the cancer conversation. I was surprised to see this in Nature, but the article makes many arguments for why the terminology —War on Cancer — is inappropriate. It is also unusual for Nature to highlight how dysfunctional some medical research is.

Lectures revisited. My friend and former colleague, Bruce Charlton outlines what good lectures are all about. The problem is that few meet aspire to or meet his standards. Although, for the record, and since we qualified at the same medical school, I found most of our lectures fairly poor.

Oliver Sacks in Nature quoting Vernon Mountcastle on his retirement : Mountcastle wrote: “I miss laboratory work in a way that is difficult to describe. It has always been my heart’s joy, and my own experience has always been that even the most trivial original discovery of one’s own evokes a special kind of ecstasy — it is almost like falling in love for the first time, all over again!” If more scientists worked directly at the bench themselves, we would have better science.

How Medical Tech Gave a Patient a Massive Overdose. I find none of this too surprising. We know quite a bit about IT and design, but hospitals in my experience ignore it. They are increasingly run by people who lack any sympathy for either those providing clinical care, or real patients. Excel spreadsheet merchants, all over the place. And if it is the UK, politics.

Worth a glance #12

by reestheskin on 29/03/2015

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The University of Everywhere. Audrey Watters takes a scalpel blade to The End of College. I am not entirely convinced by the ‘more research’ mantra. Much professional education research is RCT: randomised, confounded and trivial. Improving education is about design, with large search spaces, where judgement, integrity and a genuine attempt to makes things better counts for nearly all.

The Economist has a feature on Universities (as in, outsource, disrupt, maximise shareholder value, and create more state welfare for corporations to enclose the commons….). Must have been bad news week, as they have little new to say. It is not penned by Pearson (their owner), but parts of it read as though it were. Nor do they a good job of scraping below the surface as to why university fees have gone up so much, nor why teaching is undervalued. As usual, part of the subtext is that taxpayers need to subsidise the corporate sector ever more, because firms cannot be bothered to pay the cost of finding nor training their employees. I am not being too generous: there are many truths here. And plenty of blame to go around.

The tragedy of the Germanwings flight. People often compare doctors and airline pilots, and safety in medicine with safety in the aviation industry (usually unfavourably with regard to medicine). There are some interesting posts herehere and here. No simple message, except that the systems you place professionals in may have big effects. And these systems themselves are increasingly designed by people with little first-hand knowledge of the tasks involved. It is why some NHS hospital chief executives (and medical directors, too) often avoid walking around hospitals.

I am not being very generous today, it seems.


Worth a glance #11

by reestheskin on 22/03/2015

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Children are not to talk about the exam. Pearson again, and the business of testing for profit. I think there is moral hazard in spades here. As one commenter says: Whatever happened to Freedom of Speech? Oh, wait, it was sold to Pearson. I seem to remember being told that some publishers paid MRCP candidates if they could remember exam questions, so that they could be included in books they published. If you use MCQs, they will always leak. You need tens of thousands, and then you can flood the world with them. If you know the answer to say 10,000 dermatology undergraduate MCQs, you know dermatology. (Apart from that which you can’t test in an MCQ format.)

A sensible letter on MCQs in medicine (and other subjects). It is not what we do. Am I missing something?

Goodbye, SAT: How online courses will change college admissions. Not certain, but ideas welcome.

I suffer from the disease of being addicted to discussions about statistical inference. Probably because it is a part of the problem of why so much medical science is unreliable, and does not provide a good guide to action. But, it consumes so much CPU time that I need to get therapy. Great example here. After the first life time it may become second nature. Otherwise, by advice to the young is: start young, and clear your desk. Reading Stephen Senn is not compatible with a family life. I wish I had stopped with Gigerenzer and Royall. Having said that, as far as the clinic goes, I am all for the Adaptive Toolbox, which is how we practice, rather than profess, I think. Remember each day: I must wean myself off…..

Worth a glance #10

by reestheskin on 14/03/2015

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New private university for Hereford. Good.

The business of paying for undergraduate education. And politics.

Welfare for the corporations. Just remember this when the government tell you how much they spend on science and research.

Nice talk by John Naughton at UCC. Most of what I know about this little device called the Internet, I learned from his blog and his books (here and here). Took me awhile to realise it was the same guy I used to read in the Listener as a TV critic. As Conor Cruse O’Brien said: an academic and a journalist, ‘one foot in either grave’.

MOOCs are closed platforms…and probably doomed, by Daniel Lemire. So, sort of, were our biological ancestors.

Reinventing MIT education.

Incidentolomas, put to music.

Worth a glance #9

by reestheskin on 07/03/2015

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US schooling. Includes a view nice lines: The claim speaks volumes about the low status of education, which (along with politics) is the only profession where lack of experience can be a credential instead of a flaw; and, the one-room schoolhouse of the nineteenth century was “the best school we ever had.

Textbook pricing and the naivety of academic economists here. Via Stephen Downes

Here’s What Will Truly Change Higher Education: Online Degrees That Are Seen as Official. I agree, at least re certification— that is where one battle must be fought (just look at the farce of medical degrees across the world, or even within the EU). I haven’t read the book.

In 1958, Walter Reuther, a powerful US union leader was taken on a tour of a newly automated Ford Motor plant. “Aren’t you worried about how you’re going to collect union dues from all these machines?” Response: “The thought that occurred to me,” Mr Reuther replied, “was how are you going to sell cars to these machines?” Steve Johnson.

OA and academic publishing. I still think the real issue is that publication is increasingly no longer about sharing discovery, but an accounting mechanism — and a way to make money or at least employ people.

Medicine’s dysfunctional research system here and here‘What do readers think? Do these constant reversals on everyday questions make consumers wary of science in general? ’Yes, is the only sane answer.

Worth a glance #7

by reestheskin on 18/02/2015

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Put that laptop away. Clay Shirky. This will run and run.

No profit left behind. I am afraid I have a visceral dislike of companies such as Pearson (despite reading the Economist and the FT). Ever since I learned that the UK Royal College’s now use Pearson testing centres for their professional exams, I have despaired at the way non-profits and the public sector lack any faith in their own ability to build things, or to realise that openness benefits all who embrace it. Copyrighting curriculums etc. It is obscene— and unnecessary. And, yes, I think the profit motive is not applicable to all human endeavour.

Stealth research, by John P. A. Ioannidis. I like the term, but is it really apposite? Anyway, much innovation has always taken place outside the formal literature. Arguably the biggest change in my clinical discipline in my career has been based on a certain degree of trial and error, and people copying others (in a good way). As Sam Shuster said, serious science takes over from relevance (sometimes, anyway).

Another couple of (here and here) papers on what is facing those who plan a career in biomedical science. I am not convinced by any of the solutions offered. But I do like the LENS format of PNAS papers— a real pleasure to read online.

Worth a glance #6. Holiday picks.

by reestheskin on 08/02/2015

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For the next time you use JSTOR and think about the openness of science, John Naughton’s review of the ‘Internet’s own boy’ (on BBCiPlayerfor the next few weeks, and soon in iTunes). For an earlier piece by the scholar Tim Wu see here.

MOOCs and the distance-learning mirage, by the ever insightful thinker Nicholas Carr.

The legend and legacy of Bob Marley. Students: remember not all melanomas are UVR related.

From Davos Man to Davos Bot. Automate the CEO or Vice Chancellor. In many walks of life the higher you climb, the less need there is for deep thinking, and hence the easier it should be to replace humans with robots.

And since the picture tells what I have been doing. A song from somebody whose album I first bought ‘blind’ on walking into a record shop on a skiing trip to Banff many years ago, and being unable to leave without parting with my money. Yes, there are thousands of singer songwriters, but this one has something special. There was a really cheap EP with an even better version of this tune on iTunes.

Worth a glance #5

by reestheskin on 02/02/2015

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Who Should Have Access to Your DNA? Eric Topol .

Prince Charles ‘silenced’ professor over row on complementary medicineEdzard Ernst No surprises here.

Draw-me! Audrey Watters on the parallels between MOOCS and correspondence courses on ‘How to draw’ and how to code (only this time, from the 1970s, for the latter)

Speaking out against the GMC. A turning point for medical regulation Authors: Hilarie Williams, Christoph Lees . I am not so optimistic. There are far too few predators for regulators.

Culture lost. More on the mess of postgraduate medical training in the UK.

Arizona State University is indistinguishable from Amazon. Sort of Club 18–30, seems to me.

Worth a glance #4

by reestheskin on 26/01/2015

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The continuing mess of funding for students to receive higher education. The only certainty is that nobody will sort this out for the long term and that all suggestions will be for short term political gain.

More on the battle between about and capital (from Yochai Bencher). Just watch if you think the NHS and Higher Ed is immune.

Philip Greenspun and academic deceit: “Economists, who get paid to teach at colleges, experiment with ways to get more young people from poorer-than-average families to become customers of colleges.”

More on MOOCs and unbundling. We are still at the beginning.

Worth a glance #3, or the heart of darkness

by reestheskin on 19/01/2015

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The Soul of the Research University, by Nicholas Lemann. This is one of the best (brief) histories of the modern research university and the conflicts that arise between teaching and research, and between the Ivory Tower, and training for that little bit of the world that is outside Higher Education. Nice summaries of Newman, Flexner, Clark Kerr etc. The author is a professor of journalism, and a former Dean at Columbia. It shows.

Pharma:We need to talk about Kevin…. oops I mean Pharma [link]. Depressing and dismal, if not shameful.

More dismal reading: The major scientific discoveries of the 20th Century would not have happened under today’s rules, they would not get funding now. [link]

Why good people leave science [link]

Rescuing US biomedical research from its systemic flaws. Bruce Alberts et al.here and a comment from an economic perspective (Malthus all over again). As the author says ‘Get it? It’s as if the Pope and three leading cardinals held a press conference predicting the collapse of the Catholic church. These people know what they are talking about and we need to listen.’

The Heart of research is Sick, by Peter Lawrence, and The mismeasurement of science, by Peter Lawrence in which he recalls the classic Leo Szilard parable about how to kill genuine discovery. Can you imagine Szilard in the academy?

It’s that time of year isn’t it?

Worth a glance #2

by reestheskin on 12/01/2015

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‘A Better Way Out’, Marcia Angell’s spirited review of Atul Gawande’s ‘Being Mortal’. Essential reading for all med students and doctors, and an indictment of much modern medicine and medical education. It will happen to you, and me— possibly sooner for the latter.

The MOOC Misstep and the Open Education Infrastructure, David Wiley (via Stephen Downes).

Occupy Your Brain: On Power, Knowledge, and the Re-Occupation
of Common Sense. Carol Black. A terrific read, aimed largely at school rather than universities.

Why lectures are dead (or soon will be) By Tony Bates. In talking about attempts to improve lectures he uses the phrase : ‘Nevertheless, all this is just lipstick on a pig.’ A new one on me, but I like it.

Worth a glance

by reestheskin on 03/01/2015

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The REFormation and all that, Derek Sayer.

Thomas Piketty and Rejecting Honours.

Learning is effortful, and other sound advice by Daniel Lemire.

MOOCs redux. Audrey Watters dissects.