Rethinking Medical Education

The ThinkerQuestions, observations, and recommendations toward reform of the process and content
Showing posts with label Learning. Show all posts

Might Apple Inc Revolutionize Education?  

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Apple’s Education Announcement: 
A potentially large step into the future for textbooks and learning
Today (19 Jan. 2012), Apple Inc introduced three initiatives intended to "reinvent the textbook” and enhance learning. Did they live up to my dream of yesterday? No. Instead, they surpassed it!
Instead of announcing the “rental” system for textbooks that I had imagined, they are doing something better. To make textbooks more widely affordable, they announced agreements with several dominant textbook publishers to make their new e-textbooks available online for $15.00 or less each! At least 15 of the new generation e-textbooks, within this price limit, are already available. (Conventional texts in the US are typically priced at $60-100 each.) And these are permanent purchases. No need for them to be returned! And they will be so much more than static, printed texts. Among their main characteristics, they will be:
  • Highly dynamic, including audio, graphics, animations,  and videos.
  • Interactive, with adaptive questions and answers, changeable graphs and diagrams, and more.
  • Easily up-dateable by authors.
  • Customizable by students, with easy highlighting and note-making.
  • Fully searchable, for words, phrases, highlights and notes.
  • Enriched, with glossaries, study guides, and more.
In addition to announcing agreements with major textbook publishers, Apple unveiled a new, free app that will make it relatively easy for teachers (and others, perhaps even students) to create dynamic, “modern” textbooks using iBooks Author, available now for free download at the Mac App Store.
For accessing and using these new kinds of books, Apple also announced an update of their iBooks iPad app to iBooks 2. This app is also free, and also available now. Once installed or updated on you iPad, launch that app, click on the Store link in the upper-left corner, and you will see the promotions for the newly available textbooks. I suggest you consider downloading the free sample of the first two chapters of the E.O. Wilson Foundation’s new e-book, Life on Earth. It will give you a glimpse of this new category of “textbook”.
To see Apple’s video on these and other initiatives, including public commitments to these new style textbooks by the CEOs of 2 textbook major publishers, click here .
iTunes U app: Apple also introduced their enhanced iTunes U, with a dedicated app for accessing and using the resources offered there. As you likely know, many universities have been making some or all of their courses available online via iTunes U. The new iTunes U app lets teachers create and manage their courses, including components such as lectures, assignments, books, quizzes and syllabi, and offer them to iOS users (iPad, iPhone, iPod Touch users) anywhere. Some highly regarded universities, including Cambridge, Duke, Harvard, MIT, Oxford and Stanford have offered courses via iTunes U. As of today, elementary and high schools can also offer full courses through the iTunes U app. 
Learners anywhere can now take an entire course, with complete access to all course materials. Students are able to access their e-textbooks from within the iTunes U app, and any notes and highlights they add in these iBooks can be consolidated for review in one place. In addition to reading books, viewing presentations, lectures and assignment lists, registered students can receive notifications of the latest class information, can make appointments with their teachers and advisors, check class and school events, and more. The iTunes U app is available today as a free download from the iTunes App Store.
Educators are said to be able to quickly and easily create, manage and share their courses, quizzes and handouts through a web-based tool and utilize content and links from the iTunes U app, the Internet, the iBookstore, or the App Store as part of their curriculum. They can also upload and distribute their own documents such as Keynote, Pages, Numbers or books made with iBooks Author.
How much of a breakthrough is all of this for future education? That remains to be seen. On first exposure, the tools made available today seem genuinely impressive, with considerable potential for helping move education into a more engaging, meaningful, participatory, and consequently more effective era for learners. But this potential won’t be realized without major transformations in the sensibilities, understandings, and skills of the teachers who need to adopt, learn, and implement these resources. The record of our species generally, and of teachers specifically, as constructive responders to new opportunities that require alterations of assumptions, mindsets, and attitudes is hardly encouraging. But, enough teachers may have already moved into the world of twenty-first century technology to have the comfort base that will help them welcome, rather than be intimidated by, these new tools and processes.
I’ll be watching closely and hopefully (while experimenting a bit with these new tools myself). 
    Hill
Hilliard Jason, MD, EdD
Jan. 19, 2012

My hope (dream) for future textbooks  

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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*: http://www.khanacademy.org. 
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

An inescapable hazard of meaningful learning  

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An inescapable hazard of meaningful learning

A man learns to skate by staggering about making a fool of himself.
Indeed, he progresses in all things by making a fool of himself.
George Bernard Shaw (1856-1950)
A lesson about learning (from an unlikely source) For several years, while we lived in Florida, we traveled to Colorado in the winter, where we spent time with close friends from California and went skiing together. Like me, our friend Bill had grown up in Montreal and we both had been skiing for many decades. But neither of us had taken any ski lessons. During one of our Colorado trips, Bill excused himself from our little group and headed off to take a ski lesson. When we met up again at the end of the day, Bill announced that he had been hugely impressed by his instructor, Gary. With his characteristically generous impulse, Bill had hired Gary to be available to all of us for ski lessons the following morning.
Well, I immediately had a visceral understanding of Winston Churchill's telling observation, "Personally, I am always ready to learn, although I do not always like being taught." My trepidation about the coming ski instruction was substantially reduced after watching Gary work with Marcy and Jane. With each of them he did something we have tried for years to get medical teachers to do, with only marginal success: he began by being diagnostic. He talked to each of them about their sense of their capacities as skiers and then watched them as they did some skiing. He nicely customized his subsequent coaching to what they seemed to need most.
Then came my turn. After learning that I hadn't missed a ski season in more than 40 years, and that I was reasonably content with my capacities for handling the sorts of mountains we choose, he watched me ski. Then the fun began. Gary's first comment was, "When were they teaching that stuff you do with your shoulders? Was that in the 1930s or the 40s? We'll have to get rid of that habit. And the way you move your knees toward the slope. Am I right that that was fashionable in the 50s? That's got to go also." After two more questions and comments of the same type I was beginning to doubt my capacity to stand up on skis, let alone negotiate challenging runs ever again. I turned to Gary and asked, with a smile, "Tell me, is all this meant to be helpful, as it surely isn't feeling that way?"
To his credit, Gary laughed and immediately apologized quite sincerely. He explained that he should have known better, that he and the other instructors at their ski school are warned about situations like this and that he had neglected to act on what he knew. He went on to explain that whenever they were teaching someone who wanted or needed to make reasonably substantial changes in their accustomed ways of doing things, the learners needed to be cautioned that they would be going through a phase of feeling "functionally grotesque"! Oh, my, how that resonated for me! That was exactly how I was feeling. That day, thanks to Bill's generosity, I learned a great deal about becoming a better skier, but I learned even more about learning.
A companion of meaningful learning As George Bernard Shaw recognized (above), meaningful learning demands that we start doing things, or start thinking, in ways we've not done before. And, inescapably, as we undergo the transition from where we now are to where we want or need to be next, we are often faced with some unwelcome feelings. The process of making worthy progress in learning often brings with it a sense of feeling awkward, unsure, perhaps like being a beginner again. Sadly, many of us, and many of our students, are no better prepared for the unpleasant sense of feeling functionally grotesque than I felt on that ski hill a few decades ago. Programs that seldom or never push learners beyond their current capabilities sufficiently to cause them to feel functionally grotesque aren't serving those learners well.  And most learners, not understanding the need for this process or its value, will typically do what they can to avoid straying too far from their current comfort zone.
The process of meaningful learning When education is effective, it takes learners through a continuously escalating spiral, involving the sequence: diagnosing their current competence ➔ identifying those activities and tasks these learners most need right now for moving to a meaningfully higher level of competence ➔ active engagement by the learners with those activities and tasks at the new, higher level ➔ sufficient practice, reflection and feedback at the new level for achieving stable effectiveness ➔ offering new challenges to help the learners move to the next higher level, and so on. If meaningful learning is to occur, there is no avoiding the hazard along the way of feeling the uneasiness we associate with being a stumbling beginner. We are continuously needing to climb beyond our stabilized comfort level to an unfamiliar higher level. If learners are being appropriately stretched by their program, the feeling of being newly functionally grotesque is unavoidable. In well-functioning educational programs, that feeling is transformed from being an unwelcome set of sensations that are to be avoided, into being a welcome sign that some appropriate stretching is happening, from which meaningful — and desired — learning can grow. 
Making the uncomfortable acceptable, even welcome Several conditions are needed in an educational environment if learners are to be helped to feel that being stretched is constructive and desirable, rather than abhorred or ineffective. Most prominent among these conditions are:
  • a sense of trust between learners and teacher
  • an atmosphere of good humor  throughout the process
  • a continuous process of ensuring that the levels of challenge each learner confronts is appropriate to his/her level of need and readiness.
Insufficient challenge, which enables learners to remain within their existing comfort zone, isn't helpful. Excessive challenges can cause learners to retreat, to become self-protective. Ultimately, excessive challenges are more hurtful than helpful to learning. 
In future postings I will discuss the process of determining and titrating the levels of challenge we offer, and the processes of earning and sustaining authentic trust.
Some questions for your reflection and possible comments:
  • Do you have a reasonably clear sense of your learners' entry levels and their readiness for challenges that will stretch them sufficiently, without being excessive?
  • What steps do you and your colleagues take to prepare learners for feeling functionally grotesque at times and for supporting them through this phase of meaningful learning? (As GBS might ask, do you help them deal with the experience of feeling they are making fools of themselves?)
  • Have you and your colleagues developed any approaches to diagnosing and challenging your learners that you are willing to share with us? Your contributions here will be most welcome.
Thanks,
  Hill Jason 
Hilliard Jason, MD, EdD
First posted 10/27/08
Updated 11/27/08

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