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.