Wednesday, August 13, 2008

See one, do one...

We would never ask a doctor to learn surgery on the operating table.
Margaret Spellings, U.S. Secretary of Education

I ran into this quote while reading Laura Bush's comments at the Fifth Annual Reading First National Conference given a couple of weeks ago, which she attributed to Margaret Spellings.

I am naturally ritalin-deficient and spent previous life as a physician, so my distracted self wandered over to learn more about Ms. Spellings lack of understanding about how medical education works.

"See one, do one, teach one" was our mantra during the clinical years in medical school. (Given our track record, we often phrased it as "see one, do one, screw one....")

There are all kinds of ethical issues involved, of course, and it's a badly kept secret that physicians learn a good chunk of their skills on people who fall in the lower socioeconomic strata here in the States.

The first two years of medical school were (mostly) read/lecture/test. The third year we hit the hospital floors.

Assessments in the first two years were straightforward--just crunch the numbers. During the third and fourth years of medical school, grading was often haphazard, colored by personalities, and might best be described as grading by gestalt.

Still, the grading by gestalt method worked, at least in the general sense that those who practiced medicine well did (generally) better than those who did not, and I'd much rather know my docs 3rd and 4th year evaluations if I want a sense of what kind of physician she is likely to become.

All the pedagogy courses in the world could not prepare me for
teaching as much as my student teaching rotation did--I was blessed with a phenomenal cooperating teacher who let me make mistakes. Learning is messy, and there were days I felt like I was hacking up my science classes with a dull scalpel.

Ms. Spellings has not spent a whole lot of time as a doc in training, and about as much time as a student teacher; medicine and teaching both blend art and science in ways that still defy analysis.

Good docs and good teachers can be difficult to define quantitatively, and defining good practices in either field can be challenging, but in the famous words of Supreme Court Justice Potter Stewart, "I know it when I see it...."

Our children deserve to be held to high standards, and I applaud any efforts that get us there. Platitudes like the one above that opened this thread, however, cause me to yank out the ever fewer hairs I have left on my crown.

Just think we might want to keep our feet on the ground in discussions that matter.

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