Rethinking Medical Education

The ThinkerQuestions, observations, and recommendations toward reform of the process and content

Why have you chosen to write a blog, not a book?
To my surprise, this has been a frequent question asked by friends and close colleagues.
I'm not a stranger to book writing. Together with Jane Westberg, we've written seven academic books  (and I've been involved with several other books). Truth be told, however, without Jane's persistence, discipline, and skills, I doubt if any of our joint books would have been done. 
I don't enjoy the process of working on books, but I'm exulting in the process of working on this blog! If you are interested in this topic, here's why I feel that way.
Books impose closure on writers Books bring a sense of finality. That end-point characteristic of writing that is to be published in books or professional journals is vital for those of us who would never stop writing or re-editing without an external deadline. But, for me, it is also a turn-off. For me, writing about teaching and learning involves dealing with thoughts and ideas, not immutable facts. Paper-based publishing can serve an important purpose, providing recorded snapshots of stages in the evolution of understanding, but I've found the process constraining and uncomfortable. Thoughts and ideas, by their nature, continually evolve, or should, not just year to year, or research study to research study, but moment to moment.
The arrival of blogging and "Web 2.0" The relatively recent availability of the Internet and the newer collaborative approaches it now supports have been a dream come true for me. I'm now dealing with a medium in which there is no closure on my writing, unless I choose to impose it (or I'm forced to by health problems or other personal issues). I spend almost as much time massaging what I've already posted on this blog as writing new material, and I expect that ongoing tweaking of my own ideas and writing to continue, especially if they generate comments from you and others. 
Brevity is important Inevitably, academia is afflicted with the same high-pressure, brief-attention-span mindset that has been gripping much of the comtemporary world. Blogging, for me, seems to fit well with that sensibility. I've decided to limit each of my essays to roughly 1500 words, with most of them being under 1000 words. Brevity doesn't need to imply superficiality. In a blog, I can add links among my essays as they evolve, even returning to previously published postings to add and update links. Overall, this process really fits for me, while no prior writing process has come close. I'm now able to fulfill my decades-old fantasy of how idea-writing might one day be done.  
One additional time-related factor There's another big issue for me associated with book writing and time, which may also be relevant for you: book-writing demands that you have a gargantuan capacity for delayed gratification. From the day you conceive a book idea until you complete all the processes involved in conducting research, writing, re-writing and editing, finding a publisher, and stepping through all the stages of publication, several years have usually passed. This time-scale fits well for some people, but not for me.
Blogging is certainly not for everyone Devoting oneself to creating and sustaining an academic blog, especially one that is as consuming as this one, requires some rather specialized circumstances and personal characteristics. Most prominent, at least for now, is the requirement that one has arrived at a place or stage in life where you feel free to devote yourself to an endeavor that holds little or no promise of contributing to your career, and no hope of financial income (at least as I'm choosing to do it and as most academic blogs turn out). In addition, it is best if you don't have, or are past the stage of having had, serious responsibilities to regular work or for raising young children, or for maintaining a household.
It works for me I'm delighting in having found an outlet for my accumulated and evolving notes, ideas and positions without the constraints of a schedule, someone else's idea of acceptability, or any arbitrary rules (a/k/a the circumstances of conventional journal and book publishing). I'm at an age where I'm assuming that this will be my culminating writing project and contribution. Although I'm hoping that a fair number of people will find helpful ideas and information in my ongoing musings, and in the comments from others that might be generated, I'm delighted to be liberated from feeling dependent on the judgment of others. I'm undertaking this project more for me than for anyone else, except maybe a hope that it will someday have meaning for one or more of my five grandchildren, or perhaps even my new great-grandson. 
My apologies if all this seems excessively narcissistic, which it probably is. I don't mean it to be. While some self-interest is part of this equation, I'm sustained by the hope that all of this work may actually make a small contribution to the future of health professions education and health care (and may even provide some personal guidance to a few young people who are embarking — or considering embarking — on careers in health professions education). Whether or not that happens is the one area in which I'm fully dependent on — and welcome — the judgment of others. If you have a point of view on the potential or actual value (or lack of value) of this blog to you and others, I'm eager to hear from you. Everything about this blog is open to reactions. Please leave a public comment right here (how do I do that?) or click here to send me a private note.
Thanks,
  Hill Jason 
Hilliard Jason, MD, EdD









First posted: 11/17/08

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Rethinking Medical Education by Hilliard Jason, MD, EdD is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
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