I have added some more SoundCloud answers and added and sorted the links in Part C Chapters 5,6,7. Getting there.

First, it maintains a disciplinary focus to education at a time when our disciplinary boundaries are becoming prisons that prevent us from fully understanding the rapidly changing world around us…

Second, it suggests kids should go into disciplines that are particularly vulnerable to automation…

Third, it seems to be driven by the sense that we’ll all need to become “techies” in order to survive in a world increasingly shaped by technology…

Great post from John Hagel. Worth reading in full. I had heard of STEMM but not STEAM —proves the acronyms are more about vested interests than education.

The University believes the Secretary of State should not have the ability to determine, or even to have significant influence over, which subjects universities can and cannot teach.

Written evidence submitted by the University of Cambridge (HERB 17). Higher Education and Research Bill Committee.

Years ago, we would have said that the state trying to control education would have been a characteristic of societies — Russia, China, spring to mind — that paid little attention to individual liberty or which failed to understand that most expertise — and power — should reside outwith government. No longer. Sadly, medical education is already increasingly subjugated to the state.

Knowledge is not a looseleaf notebook of facts. Above all, it is a responsibility for the integrity of what we are, primarily of what we are as ethical creatures. You cannot possibly maintain that it informed integrity if you let other people run the world for you what you yourself continue to live out of a rag bag of morals that come from past beliefs. That is really crucial today. You can see it is pointless to advise people to learn differential equations, or to do a course in electronics or in computer programming. And yet, 50 years from now, if an understanding of man’s origins, his evolution, his history, his progress is not the commonplace of the schoolbooks, we shall not exist. The commonplace of the schoolbooks of tomorrow is the adventure of today, and that is what we are engaged in……

It sounds very pessimistic to talk about western civilisation with a sense of retreat. I’ve been so optimistic about the ascent of man; and I going to give up at this moment? Of course not. The ascent of man will go on. But do not assume that it will go on carried by Western civilisation as we know it. We are being weighed in the balance at this moment.

The Ascent of Man, Jacob Bronowksi 1973.

What defines a conservative? The answer must include reverence for institutions that have successfully stood the test of time and a deep belief in their autonomy. In the UK, no institutions have more successfully stood the test of time and none better illustrate the value of enduring autonomy than universities. So why does this government propose not only to turn them into the equivalent of purveyors of baked beans, but to seize the power to abolish their independence by administrative fiat? This disaster has to be stopped.

This is from Martin Wolf in the FT

And here is THE

Cambridge says: “The proposal for the OfS to make arrangements for the assessment of standards is an unprecedented extension of powers and contradicts a cornerstone of the UK higher education sector, namely that providers with degree awarding powers are responsible, as autonomous institutions, for the standard of their awards”.

The university also objects to powers for the OfS to revoke an institution’s degree-awarding powers or university title, even when granted by Royal Charter. “These sections effectively grant the OfS the competence to revoke parts of primary legislation and Royal Charters, without full parliamentary scrutiny,” says Cambridge.

Back to another FT article

Finally, this is no time to add to the challenges UK universities face. Legislation that will lower the barriers for new institutions offering degrees and introduce a controversial system to measure the quality of teaching requires caution. Further obligations — linking higher fees to the sponsorship of schools, for example — are an unhelpful distraction. Britain’s universities are a huge national strength — they need protection.

Finally from the recently published book by Anthony King and Ivor Crewe, ‘The Blunders of our Governments’.

In previous generations, foreign observers British politics viewed the British political system with something like awe. Governments in Britain was not only highly democratic: it was also astonishingly competent. It combined effectiveness with efficiency. British governments, unlike the governments of so many other countries, knew what they wanted to do and almost invariably succeeded in doing it. Textbooks in other countries were full of praise, and foreign political leaders often expressed regret that their own system of government could not be modelled on Britain’s. Sadly, the British system is no longer held up as a model, and we suspect one reason is that today’s British governments screw up so often. They screw up more often more most people seem to realise. Our strong impression is that, while a majority of Britons know about this, that or the other cock-up, they are by no means aware of the full range of them.

The worst aspect of all these acts of vandalism, it that they get in the way of the genuine change we need in higher education. Britain used to make great British cars, and if you ever visited Cardiff docks, like I did as a child with my father, you would see thousands of them, row upon row as far as you could see, ready for export.

There are hidden rules not just in grammar, but at every level of language production. Take pronunciation. The –s that marks a plural in English is pronounced differently depending on the previous consonants: if the consonant is “voiced” (ie, the vocal cords vibrate, as in “v”, “g” and “d”), then the –s is pronounced like a “z”. If the consonant is “unvoiced” (like “f”, “k” and “t”), then the –s is simply pronounced as an “s”. Every native English-speaker uses this rule every day. Children master it by three or four. But nobody is ever taught it, and almost nobody knows they know it.

From the Economist: Hidden in plain sight.

I am fascinated by linguistics. It never existed in my mind as a subject before I read some Chomsky, and yet I find it fascinating. See the papers in last week’s Nature about human genetic diversity and our history, and linguistic diversity in Australia (there is an article about this in Science).

But one reason why the above amuses and intrigues me, is that it is clear in so many clinical situations that we know more than we can say. We really are very poor at explaining clinical competence, and until we think hard about this issue, our teaching remains worse than it might be.

I have posted some new audio SoundCloud answers to questions from the first three chapters of ed.derm.101 Part C.

I can seldom revisit anything Alan Kay has said or written and not find ideas worth exploring. Here is one such quote:

If you take all the anthropological universals and lay them out, those are the things that you can expect children to learn from their environment—and they do. But the point of school is to teach all those things that are inventions and that are hard to learn because we’re not explicitly wired for them. Like reading and writing.

Virtually all learning difficulties that children face are caused by adults’ inability to set up reasonable environments for them. The biggest barrier to improving education for children, with or without computers, is the completely impoverished imaginations of most adults

If we think of medical education, and subjects like mine in particular, it is clear that some of the skills we wish to encourage are ‘natural’. I think children in the right environment could acquire them. Humans are hard wired to learn to be able to classify their environment and divide the world on the basis of form. We can do this even when we have little idea of causality or underlying structure, or of that branch of formal knowledge called science. Feedback is required but the basic tools are there. Think of the way children learn to distinguish between cats and dogs, and even though it is hard to formalize the basis for this expertise, it is easy to demonstrate. Jared Diamond in ‘Guns, Germs and Steel’, tells how he compared his ability to classify the natural world with that of Yali, a native of Papua New Guinea. Diamond is an an expert ornithologist, and natural historian and yet Yali had difficulty understanding how and why Diamond was so poor (relatively) at some classification tasks. Classifying fauna and flora — or at least the machinery that allows expertise in this area— is hard wired. And of course it is not unique to humans or even mammals, but humans have the ability to meld these faculties with cultural transmission and make them very powerful. Of course, varying degrees of formal and informal learning is part of this process.

Not all skills we want students to know are like this. Statistics and insight into probability — key clinical skills — are wonderfully counterintuitive. Worse still, we know that on many occasions our strongly held convictions are mistaken, and hard for us to self-diagnose. But to return to the ‘natural’ skills and related to the points Kay is making, one question is whether beyond childhood, we create the right environment that allows natural learning to take place. Many of us suspect that when we explain why lesion X is diagnosis X because of appearance Y and Z, or worse still some formal rule, we are not seeing the world as it really is. Rather, we should realise that whilst feedback of one form or another is critical, students have to discover and grow their own abilities, even though they too may not know how they do it. So I might change some words:

The biggest barrier to improving medical education is the completely impoverished imaginations of medical schools.

“The NHS has developed a widespread culture more of fear and compliance, than of learning, innovation and enthusiastic participation in improvement.” It also said “Virtually everyone in the system is looking up (to satisfy an inspector or manager) rather than looking out (to satisfy patients and families)” and “managers ‘look up, not out.’”
—
The Institute for Healthcare Improvement (IHI), a US organisation, report on the NHS ( quoted by Brian Jarman in the BMJ. BMJ 2012;345:e8239 doi: 10.1136/bmj.e8239 (Published 19 December 2012)).

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The NHS could then become a threadbare charity, available to avoid the embarrassment of visible untreated illness. Julian Tudor Hart  BMJ 2016:354;i4934