Thinking About Teaching and Teaching About Thinking
For the past five years I have been teaching in the Psychology Department at California State University, Long Beach (Go Beach! Of course, when you think about it, the beach can’t really go anywhere. And what school has a beach as a mascot? But I digress.). My students are very diverse and many are the first in their families to attend college. Communication skills and scientific knowledge are often lacking. But when I speak to my students during office hours I find that they are intelligent, enthusiastic and motivated to learn. They make me want to learn how to be a better teacher.
My previous experience in teaching at the University of Chicago and Northwestern University medical schools was quite different. Medical students and even residents, for the most part, were irritated by uncertainty. They wanted a list of symptoms or a treatment algorithm to memorize. When I was asked to teach statistics, I was faced with a similar attitude – many students wanted to memorize the formulae (yes, formulae) and leave it at that.
However, the more I teach the more I think that memorization is a function of our brains that we will outsource in the near future. Do you know your grandmother’s phone number? You don’t need to: your iPhone knows it. And would it kill you to give her a call now and then? Do statistics students need to know the formula for a within-samples t-test? No, they will most likely run the data through SPSS or some other computer program and get an answer in nanoseconds. And IBM’s Watson already does a much better job of sorting through symptoms and arriving at the most likely diagnosis than any medical student can.
During the last presidential campaign, Jeb Bush was famously quoted as saying that psychology majors should wise up and prepare for jobs at Chick-fil-A, rather than wasting their parent’s money on education that will buy them nothing. But during my last trip to San Francisco I saw a vending machine in the airport with an assortment of hot and healthy foods and I realized it won’t be long before fast food restaurants are replaced by automation. Those who dropped out of school and took those Chick-fil-A jobs will be out of work. They could become truck drivers for a few years until Elon Musk replaces them with self-driving electric trucks. Or they could go back to school.
As a teacher, what value can I provide to my students beyond showing them how to operate a tartar sauce dispenser? How can I prepare my CSULB students for the future? What should I recommend to the AAST Board of Directors as the direction for the education they provide?
I think the first step is to teach critical thinking. It involves taking a skeptical approach to what you see on the internet and what you read in scientific journals, as well as using methods for deconstructing claims and determining the level of evidence that supports them. Evidence starts with case studies and anecdotes, moves through correlation and experimental evidence and culminates in meta-analysis. Understanding levels of evidence and what they mean is important not just for researchers, but for consumers of scientific information (or what pretends to be scientific information). And at some point, we are all required to make decisions about our medical care, our lifestyles and our diets. How does scientific literature inform these decisions?
The second step is teaching decision making. Can we make a diagnosis, or do we need more information? What treatment would be best? How do I decide if the treatment is working? This requires an understanding of probability. Following probability leads you on a critical pathway – decisions that lead to the highest probability of success. But patients may fall off the critical pathway and need a nudge or even a push to get back on. How do we decide if someone is on the right path? What do we need to measure to keep track of our patient’s progress?
The third step is delivering information that changes students in a way that works. Both CSULB and the AAST are providing me with new technologies to help innovate learning. In the past we have used a one-hour video module, usually with my soporific voice droning on and on. My voice has been described as more powerful than a handful of Ambien. Even I have fallen asleep listening to myself. In the near future, expect educational modules move away from passive learning and become more interactive.
Journal Club will shift from a summary of the results of studies to a critical review of original research, meta-analyses and practice guidelines. We will review the experimental design, statistical evaluation and conclusions of the literature. We will search for flaws in studies and propose methods for resolving them. We will explore the conclusions of articles and decide whether practices should change as a result.
Case of the Month will evolve from arguments about when a spindle becomes a spindle to something more like a clinical simulation. Do you think the patient needs more oxygen? You just caused a respiratory arrest. Now what do you do? The patient has central apneas. Increase PAP pressure or shift to ASV? I just saw a 3/second spike and wave discharge. Call a code? Put a tongue depressor in the patient’s mouth? Do nothing? Expect more complex and challenging cases in the future.
The AAST will continue to offer modules captured from live courses and state society meetings, as well as basic training and help preparing for examinations. We will be providing self-assessment tools and as time goes on repackaging old materials in ways that help engage learners.
I always welcome suggestions for improving the educational offerings. You can email me at firstname.lastname@example.org. I know it’s a high bar, but I’m going to try to make AAST learning modules as much fun as watching cat videos. Because there is almost nothing as engaging as a cat in a Kleenex box.