Personalized Learning and Personalized Medicine (Part 1)

Inspector Clouseau was the bumbling French detective (played with spirited, egotistic aplomb) by Peter Sellers in the series of Pink Panther films beginning in the 1960s and running through the early 1990s.  His incompetent investigations into crime that tumbled into chaos yet ended with miraculously identifying and arresting the culprit kept me in stitches. I experienced an Inspector Clouseau moment recently.

I had been reading about medical advances in technology since I see many parallels between doctors’ use of new technologies and teachers’. I came across a growing number of articles about “precise” or “personalized medicine.” The increasingly popular phrase  touted as the future of medicine is used by clinicians, pharmaceutical companies, and health insurers. As one would expect, definitions vary. One that captures much of what is meant by the phrase is: “customizing care to patients based on their predicted responses to treatments given their individual genetic profiles or other analyses.”

And this is where the Inspector Clouseau moment occurred. Had I stumbled over an obvious comparison between medical and educational practice that I had not considered? The answer is the Clouseauian response: “oui.”

In this series of posts, I will draw comparisons and contrasts between the practice of “personalized learning” in classrooms with the practice of “personalized medicine” as both unfold in doctors’ suites and public schools.

I begin with examples of personalized (or precise) medicine (PM hereafter) and then move to examples of “personalized learning” (PL hereafter),.

Personalized/Precision Medicine

 

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An example of PM in action

For Janice King Poulsen, 71, of Sandy, Utah, the crucial treatment match involved the “ALK” genetic mutation. Poulsen, a lifelong nonsmoker, was diagnosed with Stage IIIA lung cancer in May 2007. That lung cancer spread to her brain. Home radon exposure, it later turned out, was the likely culprit.

Poulsen had to retire from work as a travel agent and from managing a synchronized skating program. Cancer became the priority. She went through a grueling array of standard treatments: radiation, chemotherapy, brain surgery and gamma knife therapy, or stereotactic radiation, as new brain tumors developed.

Eventually, Poulsen connected with the Huntsman Cancer Institute at the University of Utah. She learned she might benefit from a targeted drug called Zykadia, or ceritinib, for treating non-small cell lung cancer. Genetic testing of her tumor revealed the ALK mutation, she says – the right type for the drug.

It’s been three years since Poulsen started her precision therapy. She takes three capsules daily, with minimal side effects of nausea and diarrhea. She says she feels great. Her cancer appears to be under control.

Insurance helps pay for the expensive medication, which costs about $13,000 a month, and Poulsen’s family pays roughly $460 a month out of pocket. “Cancer isn’t cheap,” she says. In comparison, Poulsen, who now advocates for stronger home radon-testing policies, notes: “If you put in a radon mitigation system, it’s about $1,500.”

Another example:

Tania Swain got bad news: her ovarian cancer had come back. This was in November 2013; almost three years before, Swain, who is herself a physician, had been surprised by the initial diagnosis. And despite the surgery that removed 30 pounds of liquid and tissue from her ovaries, spleen, and appendix, and the chemo drugs that were swished around the space they left, the cancer was back. She feared that this time the diagnosis was truly the “kiss of death.”

But this time, Swain learned about the Clearity Foundation, a nonprofit organization that compiles its own database of mutations that cause ovarian cancer and help patients find the best individualized treatment. After another surgery in December 2013, her doctors sent a tissue sample to Clearity. “They look at the proteins and receptors, and the different ways that the tumor tissue itself has mutated to find how they can best attack it,” Swain says. Her tumor had an unusually high concentration of a protein called Ki-67, which was good news—her cancer would be more responsive to typical chemotherapy agents.

The treatment worked well—Swain felt less ill after the chemo than she had the last time. Though her cancer has since returned, she’s hopeful because she’s so impressed by the progress of cancer treatment, and advances in precision medicine in particular. “I finished my training [to become a doctor] in 1982, when CAT scans were just coming online. I think cancer treatments now are as different as night and day compared to then,” Swain says….

For Swain, the choice to get a genetic test was an obvious one. She knew it would help her find the best possible treatment, but even as a doctor she struggled to understand just what was going on in her body. “It was still a little overwhelming. All that information just comes at you,” she says. Without that treatment, however, she may not have survived; when she was first diagnosed with Stage 3 ovarian cancer, in 2011, she had a 39 percent chance of living at least five more years. Now, almost five years later, Swain is hoping that this third round of treatment has finally rid her body of ovarian cancer. The genes driving her cancer have changed—“which speaks to the polymorphism of this cancer,” she says—and the drugs she’s using to kill it have changed accordingly. But she’s optimistic: “I am very happy with the status of my markers and I’m feeling good.”

 

Examples of PL in action

 

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Sitting in front of a laptop, Chris Pozo, a sixth-grade student at Truesdell Education Campus in Washington D.C., opens his Summit calendar to show his daily goals. “My goal is to do my task and get 50 percent or more,” it reads.

Like every other student using the Summit Learning platform, Pozo must start each class by setting his goals before doing activities. The goals are either typed or picked by the student from a drop-down list of options created by the teacher.

“Every morning I change it, and we type our goals right here,” explains Pozo, pointing to his screen. He then opens up an assignment on a Google Doc and a grading rubric, reviewing the comments and feedback his teacher has left on his work.

Sixth-grader, Chris Pozo, using the Summit Platform in is science class. Photo Credit: Jenny Abamu

When EdSurge visited Chris Pozo’s sixth-grade science class at Truesdell, the student was reviewing comments left by his teacher, Courtney Grant, on his writing assignment. He glanced back and forth between his Google Doc and the grading rubric on the right side of his screen. This is how he decides what to do to get a 4 (equivalent to an A) on this assignment.

“I have to add more transition words and make it organized,Pozo explains as I visit his class. “This is what they are going to be grading us about,” he continues, pointing to the rubric on the screen.

Another example:

Over the past two years, educators at Windy Hill Middle School in Clermont, Florida have been transforming their teaching, tailoring instruction to students’ individual needs and interests. Students have been using new tools to learn content at their own pace and taking ownership of their learning in the process. The whole school community has been building a culture of personalized learning.

As principal William Roberts describes it: “Personalized learning is considering the interests of your students, giving them choice in their learning, and meeting them where they’re at—academically and personally.” The approach appealed to the team at Windy Hill as a way they could reach all students and make their learning even more powerful. So, in the fall of 2015, a small group of teachers who wanted to try out personalized learning began piloting the approach in their classrooms.

Teachers in the pilot created units aligned with Florida’s Sunshine State Standards and with multiple pathways for students at different levels, organized around the prerequisite knowledge students may or may not have. Students worked through the unit content at their own pace on their own laptops, conferencing with their teachers and working on projects with their fellow students along the way. Teachers still provided direct instruction, but they also spent more time circulating classrooms and supporting small groups of students, or working with students one-on-one. And they reviewed their students’ data to better understand where individual students needed more support—or where they were excelling and needed more of a challenge.

The results have been encouraging. All 101 seventh-graders that participated in a personalized learning math class at Windy Hill last year scored satisfactory or above on the math portion of the 2016 Florida Standards Assessments. By comparison, only 55 percent of Windy Hill seventh-graders not in a personalized learning math class scored satisfactory or higher.

Mary Ellen Barger, a personalized learning facilitator at Windy Hill, also has seen how personalized learning can be especially powerful for struggling students. “In the traditional classroom, little Johnny is bored and doing things to distract the class because he is so afraid of being seen as behind. In personalized learning, Johnny has a goal, knows what he is supposed to learn and that he can do it, and knows how to get extra help,” Barger explains. “He knows that we are going to keep working with him until he understands.”

This year, personalized learning at Windy Hill has expanded even more. The number of teachers using personalized learning in their classrooms has grown from 14 to 47—about half of all instructional staff. And as the team continues to make the culture shift to personalized learning, they also are focusing on personalizing the curriculum in all core subjects as well as electives. Making these changes isn’t easy, but the community is dedicated to personalized learning and excited about the positive impacts. As one eighth-grader put it: “It’s beneficial to everyone.”

For other examples of how PL is used in schools, see (here, here, and here).

Like Inspector Clouseau, it took me awhile to figure out the similarities and differences    between PM and PL. Part 2 elaborates on each.

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7 Comments

Filed under compare education and medicine

7 responses to “Personalized Learning and Personalized Medicine (Part 1)

  1. Laura H. Chapman

    I think that the phrase “personalized learning” is fine for marketing and nearly meaningless in practice insofar. There is nothing personalized in offering students a choice in “tasks” framed by others. There is not much personalized in permitting a student to meet criteria for an A or some other “target” for mastery. Unless we are talking about student-initiated projects (vintage 1920s) it would be better to think of the actual changes being marketed as computer-mediated instructional delivery and management systems with pre-loaded conventional content and paths to mastery. Exemplary programs rarely focus on science labs, social studies, any of the arts (unless relegated to some sort of enrichment or bonus). Teach to One Math is really off the charts bizarre–completely programmed multi-grade curriculum with daily computer-mediated tests (exit slips). These tests determine the tasks/assignments for the next day. The levels of precision in some branches of medicene come from greater precision in diagnostics and analytics, usually with large data sets. I think that the quest for comparable precision in education is moving forward, but not without constant surveillance of students and more recently real-time monitoring of individuals for feeling states (affective computing) and focus.

    • larrycuban

      Part 2 will pick up some of the points you raise in your comment, Laura. The two links you sent to me are very helpful in writing Part 2. Thank you.

  2. Rachel

    I find it darkly reassuring to know that even a doctor can be overwhelmed by the amount of information that people get flooded by when they get sick. When I see some of the rubrics and scoring systems that teachers share online, I wonder how often students are overwhelmed by similar information overload. I wonder if the sentiment, “I’m not sure what this means, but I’ll just have to trust the experts” is as common in education as it is in medicine?

    • larrycuban

      Not sure about how common it is that educators say “trust the experts,” Rachel, but the surfeit of info is surely there for teachers. Thanks for comment.

      • Rachel

        I was thinking more of students who are given a complicated rubric and then still say to the teacher, “ok, but what do I need to do?”

      • larrycuban

        OK,Rachel, thanks for clarification. Anecdotal evidence (including what I have observed) supports your observation. I do not know of studies that have looked at students to answer the question.

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