We Don't Need Anesthesia, It's Painful This Way and That's How We Like It!

If you needed surgery to save your life and you had a choice to have the surgery with an anesthetic or without, which would you choose? Which option do you think your doctor would recommend?

Today a surgeon wouldn’t think of performing painful surgery without anesthesia, but there was a time when surgeons couldn’t imagine surgery without pain...

Robert Krulwich interviewed Richard Holmes on National Public Radio's Morning Edition yesterday about his book Age of Wonder. Holmes recounted that in 1799, Sir Humphrey Davy, then a 21 year old scientist and apprentice to a surgeon discovered that nitrous-oxide (laughing gas) could stop pain.
In his book, Holmes describes Humphrey Davy’s discovery and his suggestion in an article to the medical community that nitrous-oxide could helpful for patients undergoing surgery. Unfortunately, it took 40 or more years for surgeons to see past preconceived notions about pain and accept that pain was not necessarily a good thing. They just couldn't imagine surgery without pain.

Here is an excerpt from the NPR interview:

"The idea that you could have pain-free surgery was completely radical, novel," says Richard Holmes. Doctors at the time had a different view: that pain was a good thing! The doctors thought pain helped them polish their surgical skills (screaming being a prompt to cut fast and accurately), and it was believed that pain would help the patient rebound. "It was proof that the body was fighting back and healing itself," Holmes says.

The education profession can be like the medical profession of the early 19th century. We know that the way things have always been done in schools is not working for many students, but we "can't image" it working any other way. We have new discoveries from brain science research, new methodologies and innovations that could stop the "suffering" and meet individual student needs. We have a better way, but lack the collective vision and will to put such a radical change into practice. It is a crisis of belief, what I like to call "cultural inertia", that prevents individuals and groups from seeing the answer that is right before them.

Maggie Dugan and Tim Dunne at InstantBrainStorm said it well in this video clip about the "aha moment". (They graciously produced this clip for me to use in a presentation to the National School Boards Association annual conference back in 2009.):


I hope it doesn't take 40+ years for the education profession to have an aha moment, to see that learning can be less "painful", to imagine a system where all failure to learn is not the norm.

How can students reading significantly below grade level catch up?

Students reading below grade level are not only behind in reading, it is also harder for them to keep up in other classes when text books and other content are written at grade level. Part of the solution is providing reading materials across the curriculum tailored for the student’s reading level. Richard Allington, one of the country's most recognized experts on early literacy, addresses this in a recent EdWeek article (http://www.edweek.org/tsb/articles/2010/04/12/02allington.h03.html?cmp=clp-edweek):

“…reading instruction has to take place all day long. In other words, if he’s reading at a 2nd grade level in 4th grade, this child would need texts in social studies, science, and math that are written at the 2nd grade level but cover the 4th grade curriculum, so he has a book in his hands all day long that he can actually read.”

Of course the reading instruction itself must also be adaptive and effective. Students reading below grade level must have more time reading with the right materials, and the reading instruction must be high quality and adaptive to individual needs and learning style. Allington asserts that the teachers working with these students must be trained to use proven instructional practices, that far too many teacher don’t know how to teach kids to read. This includes teachers providing pull-out instruction in small groups or one-on-one and teachers in the typical classroom setting.

Allington is critical of packaged reading programs. “Well, the problem is that the concept of a packaged reading program doesn’t have any scientific validity to start with, because we know that if you take 100 kids or even 10 kids, there are no prescribed programs that will work with all of them,” he said. I think that might be true for one-size-fits-all classroom-centric packaged programs. However, I would argue that computer-adaptive "packaged reading programs" can work with most students if they are created by experts in reading instruction and apply the same diagnostic and prescriptive logic that would be applied by a reading specialist when working on-on-one with a student.

I don't claim to have expertise in early reading instruction, but I would argue that the factors that make good computer-based reading instruction effective when compared to static reading programs, are some of the same factors that set apart good reading teachers from those who don't know how to teach reading. The teacher (or program-logic) must continually assess how well and how the student is reading (using a variety of indicators). More importantly the teacher (or program logic) must recognize WHY the student is struggling with a particular aspect of reading, and know the appropriate response(s) to overcome the block. The response must fit the need, be it strategies for coping with dyslexia, more time reading engaging content matched to the student's interest and ability, or activities to strengthen phonemic awareness.

It is the diagnostic and prescriptive ability of the teacher, or similar logic within the "packaged reading program" that makes it work for the individual learner. Research is now being done on biometric feedback that can give the interactive program some of the cues that a good teacher would use when observing a struggling reader (e.g. vocal inflection when reading out loud, eye position when reading on screen or device, posture). While traditional outcome-based assessments can diagnose competency, these in-process cues can help diagnose process problems, and point to appropriate remediation.

Personal one-on-one instruction for all struggling readers with highly proficient reading specialists would be the ideal, but would be cost prohibitive. An effective alternative for many students could be an interactive one-on-one program, designed with the knowledge of top experts on early literacy and with the diagnostic and prescriptive logic of proven-practice reading instruction. I predict that such programs will increasingly be accepted and proven scientifically valid as our education system shifts from a teacher-centric model to a student-centric model.

Presenting the Public Domain Education Data Warehouse at MIS Conference

Last week I presented with colleagues from New Hampshire Department of Education at the NCES Winter Forum and 23rd Annual Management Information Systems (MIS) Conference in Phoenix. The presentation introduced a "Public Domain Education Data Warehouse—Including Student-Teacher Connections That Inform Instructional Change".

At a time when national education data standards are a priority, NH has taken a leadership role in developing a public domain data warehouse model, that is a practical implementation for a data warehouse based on national standards. It has been a privilege to help shape that public domain architecture and work with selfless group of people working hard to make a difference for students in New Hampshire, and in other places that can benefit from the public domain model.

Out of School Time Matters

The time that students spend learning outside of the traditional classroom/school is increasingly important. Student's not meeting minimum learning objectives inside the box of the fixed-time/fixed-space classroom can be successful when in-school time is supported by the right learning experiences and support during out-of-school time. And for students succeeding inside the classroom, the out-of-school time help them reach their potential as contributing citizens.

A recent article, Not just and add on, in CatalystChicago makes the point that "Forty years of research has proven that after-school and summer programs for low-income students can help to close the achievement gap."

A good resource on out-of-school-time is the Harvard Family Research Project.

It Can't Be Done!

Yesterday, NASA Administrator Charles Bolden, testifying before a congressional committee, said that NASA's ultimate goal is "eventually Mars", but it could not be done in 10 years or more "because there are some things we just don't know."

We would have never landed a man on the moon if NASA leadership in the 1960s took that position. We didn't know in 1961 how to land a man on the moon and return him safley to the earth. And there are some things we don't know when it comes to the goal of quality education for all. (That is, an education system from which 100% of PK-12 students are equiped for college or the workforce, for life-long learning as a foundation for a productive/fulfilling life.)

When President Kennedy set the "man on the moon" goal everyone in the United States understood why we wanted to do that. The "how" was not 100% clear, but the "what" and "why" was concrete.

It occured to me that our education system operates like the NASA of today. We don't have a common understanding of "what" and "why". We need a concrete vision, understood by all, that fosters a willingness to do whatever it takes. An understanding that part of the pursuit is a pursuit of knowledge, to overcome the "things we just don't know".

Please let me know your thoughts on what should be our "man on the moon" goal for education by the end of this decade.

Student Learning "Outside the Box"

Please view this 6 1/2 minute video that I produced as food for thought concerning the current education hierarchy and what it will take to approach 100%, learning for all.

This generated some good discussion at a recent CELT planning meeting. Please let us know what you think...

A Tale of Two Learning Organizations # 2

My last post presented a vignette highlighting contrast between use of data by typical education organizations and by a high performing private sector retail organization. There is a stark contrast in the way in which high performing organizations use individualized 'customer' data to improve delivery of core services. This vignette looks at a similar case from the health care industry.

Don Goodwin just arrived at work. It has been a busy morning already. He had an earlier than usual start in order to bring his three children to get their annual flu shot and then to school. He breathed a sigh of relief after getting to his desk, the pre-vaccination drama was over for another year. He started up the computer on his desk and logged into email. Scanning his inbox Don noticed an email from the family’s health care provider, but that would have to wait.

…Don was in meetings until after lunch and it was almost 3 p.m. before he could take a break for lunch, which he took at his desk getting caught up on email while he ate. He opened the email from his health care provider and read “Your child’s medical record has been updated, click here to view.” Don clicked on the link, logged in and saw that the update was for the immunizations received earlier that morning. Based on the email sent time the online medical chart was updated at 7:39 a.m., within minutes of when the child received the shot.

Just then his cell phone rang. It was his wife. “Don… report cards were sent home today and Brian got a D in math.” Don was surprised, “Where did that come from? Brian usually gets 'A's and 'B's!” “I don’t know,” said his wife, “There is a parent night next Tuesday and I think we should go to find out what is going on.”

As he hung up the phone Don glanced back at the online medical chart. “If we had the kind of real time alerts from the school as we do from the clinic we may have been able to see this coming, and maybe even helped to prevent it,” he thought.

Health care providers recognize the value that good communication has in the delivery of service and that health outcomes improve through better collaboration between the service provider and the patient. The industry has applied information technology to its core business, caring for the health of patients. Few education organizations are applying similar technology to its core business, caring for the learning of students.