I like Gerd Gigerenzer’s writings (see for instance The Empire of Chance and Simple Heuristics that make us smart) and I am sure it is not his fault that the same stories keep coming round again and again. This story on the BBC web site treads over old ground but of course the lessons remain the same (even if the book is different). Doctors don’t like working using Bayes’ theorem in clinic — at least not if we have to use algebra, rather than real numbers (as Gigerenzer makes clear). And I still think we do a poor job of teaching medical students statistics. But something niggles me about his line of argument, and in part it it is not a million miles away from some of Gigerenzer’s other work on heuristics and ‘quick and dirty’ computation.
One view of expertise is that doctors somehow work from ‘basic principles’ and then work out what to do. This used to be the dominant view of medical expertise: we had to understand the physiology, so that we had a live model in our brain of what was happening to the patient. This may well be true in some instances, but more often it seems to me that the burden of knowledge to do this is so great, that we just follow simple shortcuts or heuristics— or we read it off look-up charts. I actually think this is sensible. We don’t need to fret about the molecules, just as I don’t need to worry about machine code or C+ when I write this blog. What Gigerenzer is drawing attention to is the absence of the relevant cognitive prostheses that takes care of the number crunching for us. Of course if the prosthesis existed, we would play with it, and actually become more at ease with the algebra.

Universities have become Wal-Mart. “We put our courses on line”

 

Roger Schank.

He spied the current final exam on the professor’s desk and exclaimed: “But the questions are exactly the same as on our exam 20 years ago!” “Of course,” said the professor, “but the answers are different!”

From a letter in the FT, about economics degrees. And for medicine?

The worst-functioning part of the US educational market at the tertiary level is the private for-profit system,” he said. ”It is a disaster. It excels in one area, exploiting poor children.”

 

Joseph Stiglitz telling it to the Australians

Every day the scorecards went up, where they could be seen by all of the hospital’s emergency room doctors. Physicians hitting the target to admit at least half of the patients over 65 years old who entered the emergency department were color-coded green. The names of doctors who were close were yellow. Failing physicians were red.

The scorecards, according to one whistle-blower lawsuit, were just one of the many ways that Health Management Associates, a for-profit hospital chain based in Naples, Fla., kept tabs on an internal strategy that regulators and others say was intended to increase admissions, regardless of whether a patient needed hospital care, and pressure the doctors who worked at the hospital.

— Its business. In the UK the incentives would be the other way around.

What ties universities to the modern LMS’s is this link to the bureaucracy, first, and pedagogy last.

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There are some tremendous textbooks, Molecular Biology of the Cell, to quote an example, but many are dull. I understand a little about the business of textbook production, and change seems long overdue. My own efforts are of course very humble, but I am working on improving things. This graph does not attest to much innovation: more Eroom’s law than Moore’s law.

http://qz.com/225483/runaway-college-textbook-inflation-is-about-to-get-disrupted/

I don’t tire of the arguments around MOOCs. MOOCs are just the start of a process of examining how student teaching could be improved and made cheaper. There is a lot of room for both. The Economist this week has a leader entitled ‘Creative Destruction‘ (well, at least it wasn’t ‘disruption redux’) and a Briefing article: The future of universities: the digital degree. All well and good. What was missing however, was any consideration of how changes in teaching provision will feed through to research. Many —if not most— UK institutions use teaching moneys to cross subsidise research. Research buys kudos, but rarely do funders pay for the full cost of research (even with overheads added in). This is a particular problem for medicine, where much research is charity funded. Unit costs of research are going to rise.

According to the futuristic report, it was around 2010 when degrees began to lose their reliability for proving the bearer’s competence, knowledge or expertise. Until then, “doctors and engineers with degrees were considered safe” to practise and “even degrees in disciplines without any obviously useful knowledge at their core, such as English Literature, or Golf Studies, were treated as valid, and marketable, evidence of general competence”.

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Q:What made you decide to go from brewing as a hobby to brewmeister as a career?

A:Eventually, every postdoc has to decide, “What are you going to do?” Janelia Farm is a very prestigious institution, so people often get very good jobs afterward. But I wanted to do something else. I saw people around me who were all very stressed. It was just very hard for them to get these papers published, as it was for me. I had been scooped many times, competing with people outside and maybe even inside the institution. And I was like, “This is not something I would like to do forever.” I thought, “Maybe I can just take my success with yeast and get some experience at this brewery, and then take that experience and maybe move somewhere else in the future.”

Jasper Akerboom in  Science