Rethinking Medical Education

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

My hope (dream) for future textbooks
Tomorrow, 19 January 2012, Apple Inc will host a media event, at an exceptional venue for one of their closely-watched announcements. Almost all their announcements are held in generic auditoriums in the San Francisco region. Tomorrow's will be held at the Guggenheim Museum, in New York City. Mystery always surrounds these events. The invitation for this one says only: "Join us for an education announcement in the Big Apple." 
The company's cryptic advance communications about their events generate rumors, speculations and predictions. This time, several commentators have wondered if Apple will be bringing electronic textbooks (e-textbooks) to their mobile devices, especially the iPad. 
For the first time, I’ve joined the guessing game. Yesterday (18/01/12) I contributed to an online discussion of Apple's coming announcement. The following is what I said, (slightly edited for this different context):
Traditional vs. Digital textbooks
Some college students have been quoted as saying they prefer paper-based textbooks to the digital versions. They aren't clinging to their conventional textbooks out of love for their size, weight or tradition. They choose paper-based texts because they can be resold at the end of their course. Currently, e-textbooks can't be resold. I suspect that textbook publishers manipulate the economics of textbook sales as part of their devotion to preserving their established business model.
My guess (dream) is that Apple will disrupt a whole industry again. This time it will be the textbook publishing industry (much as they've done to the computer industry, the music distribution industry, and others). They will announce a revolutionary model: they will start "renting" textbooks, not selling them. The student's cost for rental for the duration of their course will be a fraction of their cost for purchase. The students will be relieved of the hassle of reselling, and of carrying several heavy books around all day. They will no longer have to try keeping their textbooks clean to sustain their resell value. And the publishers and authors will get enough of a cut of every rental to keep them happy, because there will be many more of these books rented than were typically sold. Students on tight budgets will no longer have to struggle with depending on their library's small number of loaners, or on the awkward arrangement of sharing one book among several friends.
Like most people, I have no inside knowledge. But, I'll be sorely disappointed if my predictions aren't at least partially correct, largely because electronically published textbooks can bring huge advantages over their dead-tree-based counterparts. They are FAR less expensive to produce, warehouse, and distribute; they can be revised on the fly, rather than every 10 years; and the current influence of extremist groups on textbook content, especially for the early years of education, will be nearly eliminated (except for their local school districts). And, of greatest importance, the students will have use of far more valuable texts. In addition to being more up-to-date, their e-texts will be highly searchable for words and phrases, and for each student’s own bookmarks and notes. These twenty-first century “textbooks” will become far more powerful educational resources than conventional textbooks ever were or ever could be.
E-textbooks will eventually offer multi-media, interactive presentations. They will signal the arrival of a whole new era for the educational process itself. Teachers will eventually stop seeing themselves as conveyors of information. They will accept the research that has been confirming that the large-group lecture is an inadequate approach to teaching and learning. Instead, they will assign sections of these new "textbooks” as preparation for the highly participatory events that will replace traditional lectures. A functioning version of that future model can already be seen at the Khan Academy*:
In the new model, I'm persuaded, these learning resources will be far more like an elaborate, highly focused web site than like our current image of a textbook. The notion of a publication date will become obsolete. There will only be version dates for sections within the "book". At some point, hopefully soon, these educational resources will be unrecognizable as "textbooks”.
In my view, this is the way textbooks must evolve. A key question remains: how long will this transformation take? I don’t know, but here’s hoping this transformation begins in earnest very soon! Say, tomorrow. I can dream, can't I?
    -  Hill
Hilliard Jason, MD, EdD
The Khan Academy is an important glimpse of aspects of the future. But, the fact that it is offering its resources free isn't a forecast that appropriately presented, interactive, e-textbooks can't be sources of revenue for authors, publishers, and others. This site and its resources are free because they've received substantial funding from the Bill & Melinda Gates Foundation. As you likely know, many breakthrough innovations first happen because of support from philanthropy or the government.
Jan. 18, 2012


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