Video is cool. Text isn’t.

Houston, we have a problem.

Exams begin next week. Type-A Anita is particularly nervous. Beginning last week she has refused to learn anything that is more in-depth than the NBME questions: “only high-yield.” She interrupts class once per day to complain when a professor gives more detail than the Step 1 exam books do. She also requests clarification about the number of questions per exam topic. She dropped her sweet Midwestern demeanor and submitted a formal complaint to the administration when an older physician said males have to work more to learn patient interviewing because women are more naturally caring.

via Philip Greenspun

Nice turn of phrase that seems apt way beyond its intended target, attributed to the physicist, John Stewart Bell (NYRB 10/11/2016).

” I hesitated to think it might be wrong, but I knew it was rotten”

I went to the OEB meeting for this first time this year. I was not certain how much I would like it, but found it really enjoyable. Not a meeting I would go to each year but, if you are interested in teaching and learning in the broadest sense, it is well worth a visit. I would go again.

One of the sessions I enjoyed most was a fairly small concurrent session with the title ‘The value and the price: discussing Open Online Courses’, chaired by Brian Mulligan (IoT, Sligo), and with panellists Stephen Downes(NRC, Canada), Nina Huntermann (edX), Diana Laurillard (UCL), and KonstantinScheller (European Commission). It was all wonderfully informal, with not too many people there and plenty of time for questions and discussion. I got involved too, rather than just listening. The discussion ranged widely over MOOCs (c or x), online learning, ‘conventional teaching and learning’ and other topics, but that is to be expected. You cannot discuss online learning without thinking about offline learning; you cannot discuss new tech, without discussing old tech; you cannot discuss scale without discussing one-to-one; you cannot discuss value without talking about money and non-money.

I didn’t take notes but the thoughts going round in my head (prompted no doubt by the panel were):

• You cannot hide from the question of value. You can think about this is terms of money, time, inner wealth or job prospects, but the calculus has to exist somewhere. If the learning takes place in an institution that performs other tasks and has other goals (research, outreach, engagement, certification), this value has to be factored somewhere. Cross subsidies will be under challenge, whether they are they are sensible, or not. Sensible for whom?
• I am, to use somebody else’s phrase, a libertarian paternalist when it comes to higher education. I really do think I can guide people through difficult terrain. But putting glorious autodidacts to one side, to what extent do many students need coaches, and under what conditions. The answer, at least in some of the domains I know about, is far less than we like to think. And, those who require least guidance are, in many senses, those we want most.
• Content. What is the content, how is it presented, how does it hang together, how tested is it, how has it been curated, how personal is it? I will start ranting about this soon, so I will shut up now. Except to say, it is not a rant: this is so important.
• How important is place? Where is the community? How do you maximise the sense of place?
• How do you balance private study with communal learning. What is the right balance, and how does the answer influence costs?
• I can see differences between MOOCs and other forms of non-institutional learning, but only of degree. Penguin books, and BBC OU broadcasts were open to many of us, and used by many of us. But they only allowed local conversations, rather than networked learning. We can — or at least –could do a lot more now.

The annual cost of protecting our digital world from hackers will exceed the benefits of being connected by 2019, according to a study by the Zurich Insurance Group and the Atlantic Council, Here.

Well, I guess it is sensible for Insurance companies to be cautious. But I continue to be amazed by how much sensitive information around health care and university personal data is put online — just because we can. NHS systems have been hacked, and university sites are continually under assault. There is a lot of personal data stored, that could be used against people. This is the spreadsheet obsession of top down management, where data is equated with reality, and surveillance with caring. And that is before people try to sell it.

From a review in the FT of Steve Silberman, of what sounds like a book for our time, ‘How to survive a plague’, by David France.

“Jesse Helms, the five-term Republican senator from North Carolina, personally blocked spending on Aids prevention, treatment or research for years, pontificating from the Senate floor, “We’ve got to call a spade a spade, and a perverted human being a perverted human being.”

“Some of the most haunting passages in the book record twists of fate that delayed effective prevention and treatments for years. A young chemist at Merck who suspected early on that a class of drugs called protease inhibitors might yield promising avenues for research was killed on Pan Am Flight 103, downed by Libyan terrorists over Lockerbie, Scotland, in 1988. Years passed before other researchers went down that road again, discovering a drug that became a template for the “cocktails” that have turned HIV infection into a manageable chronic illness rather than a certain death sentence.”

Sunday evening a few students were invited to my favorite professor’s cabin. She is a never-married woman in her late 60s who has dedicated her life to the craft of trauma surgery. She entered medicine expecting to go into family practice. While a third year student, she requested to be sent for her family medicine rotation to a rural area. She drove into the mountains to a small mining town of 10,000 with two family physicians. Although regretting her decision at first, it was here that she learned to love emergency medicine. Sitting around the bonfire, she shared vivid memories of driving the ambulance up moonlit dirt roads to a mine and going down the shaft to retrieve injured miners.

What has changed in trauma surgery? “Well the cases have changed,” she answered. “I started out treating young males in high-velocity, multi-trauma injury cases: car accidents, gunshot wounds, stabbings. Now it is mostly low-velocity cases: an elderly patient who has fallen. The family feels terrible for not having been there when the trauma occurred. The family flies cross-country to say ‘Do everything you can to keep Grandpa alive,’ not understanding what this requires doctors to do.  Too often they ignore palliative care.” She’d learned about hospital funding priorities: “It is easy to find donors for a state-of-the-art pediatrics wing; there is no money to remodel a decrepit geriatrics ward.” Her bonfire advice to us: (1) find a field where you will get more interested in it as you go on; (2) you can be happy in more than one residency field (i.e., don’t cry if you don’t get your first choice).

Statistics for the week… Study: 8 hours. Sleep: 6 hours/night; Fun: 2 outings. Example fun: Camping with Jane and Sunday BBQ at trauma surgeon’s cabin.

Here.

The bonfire advice (1) is very true (‘find a field where you will get more interested in it as you go on’). Just tricky. Note the ‘editor’s comments: “From the editor: Health care is nearly 20 percent of our GDP. The surest way to be a full participant in this massive and growing sector of the economy is to get an MD.”)

I am just back from OEB16 in Berlin. A really terrific meeting, which I enjoyed more than I anticipated (my philosophy; check out that I wasn’t missing too much: I was wrong). I will write some more later. And although I have been to Berlin many times, on this occasion I had time to see much of the city. Also  to chat  with some bright and talented young people who have left the UK, fed up with Brexit and the State of the UK, aiming to make their life there.

Roger Schank at OEB16. But this is just the hook. What is going on is that school isn’t working, and people end up having to go to college, with a resulting increase in expense for both students and the state. It is wasteful — except for those selling degrees, and a proportion of students.

Reminds me of the Alan Kay quote, to the effect that the US has the best high school education in the world — it is just a shame you have to go to College to get it. Of course if you go to graduate school….

I am at the OEB16 meeting in Berlin. As ever, thoughts cross. If you go around the stands you have to ask about the relation between learning — a personal act — and all that you can sell to go with it. Software, hardware etc. And you have to wonder about the balance of goods and dreams.

Marcia Angell reviews Alice Gopnik’s ‘The Gardener and the Carpenter’ in the NYRB (November 2016)

‘Among the book’s strengths is that Gopnik leaves no doubt about where she stands on the peculiarly American way of leaving families on their own in an increasingly unequal society. “Middle-class parents are consumed by the pressure to acquire parenting expertise,” she writes.

(Gopnik quoted text)

“They spend literally billions of dollars on parenting advice and equipment. But at the same time, the social institutions of the US, the genre at originator and epicenter of parenting, provide less support to children that those of any other developed country. The US, where all those parenting books are sold, also has the highest rates of infant mortality and child poverty in he developed world.”