Personalized Learning and Personalized Medicine (Part 2)

No more bumbling Inspector Clouseau who I introduced in the previous post (for snippets from his films, see here, here, and here). For this post, I turn to another film character for inspiration: scientist Mr. Spock on the starship Enterprise. Logical and imperturbable–see here and here— I (but without the pointed ears) copy him by comparing and contrasting Personalized Learning (PL) and Personalized (or Precision) medicine (PM).

Similarities:

*History of individualizing treatment.

In medicine, currently, the mantra repeated in medical journals, conferences, and in hospital corridors is “patient-centered” care. Within the past half-century, the explosion of technology-driven diagnosis and treatment, rising costs, and growing dismay with patients being sent from one specialist to another has led to calls for clinicians to individualize their diagnosis and therapy to the varied needs of their patients.

…. In the quest to conquer disease, the fact that the patient is a person can often get overlooked. In the predominant U.S. healthcare model, people are often treated as a collection of diseases that episodically rear their ugly head and require drastic, increasingly expensive medical interventions. Practitioners of patient-centered medicine hope to change this, focusing on the overall well-being of the patient from day one with a combination of prevention, early detection and treatment that respects the patient’s goals, values and unique characteristics.

Counter to “doctor-centered,” the individualizing of diagnosis and treatment can be traced back to Hippocrates.  But it is only in the past half-century that calls for “patient-centered” practice have become front-and-center in the debate over how to deal with chronic diseases which afflict nearly half of all adult Americans.

As for schools, historical efforts to “personalize” teaching and learning have periodically occurred ranging from getting rid of the age-graded school to varied groupings of children during a lesson to teaching machines used in the 1920s and 1950s to the technology-driven “personalized learning” in the early 21st century (see here, here, and here)

*Reliance on technology to diagnose and treat differences among patients and students.

Hospital nurses have COWs–Computers on Wheels–that they bring to a patient’s room; doctors have scribes who take down what they say to patients. And teachers carry tablets with them as they traverse a classroom while students click away on their devices.

Technologies for diagnosing and treating patients’ new and chronic ailments and technologies that assess students’ learning strengths and limitations have become ubiquitous in doctors’ suites and classrooms.

*Over-promising and hype.

From miracle drugs to miracle software, both medical and school practitioners have experienced the surge of hope surrounding, say, a new treatment for Alzheimer’s disease or a quicker way to learn math.

Doctors will diagnose and treat diseases through mapping a person’s genome or by analyzing one drop of blood from a prick of the finger; childhood cancers will disappear (see here and here).

Claims that children using computers will have higher test scores and get high-paying jobs came with the earliest desktops in the 1980s. Promises that teachers will teach faster and better (see here and here) accompanied those devices then and since.

In a society where both business and government compete to provide private and public goods, where Americans are both consumers and citizens, the tension between making money and providing the best medicare care and education inexorably lead to over-promising and hyperbole.

Differences:

*In PM, analysis of patient’s DNA to find genetic disease markers (found in human genome) and then matching a specific, already tested drug matched to specific gene in patient’s genome that is connected to patient’s disease is common practice now.

In PL, no such intense and specified diagnosis of each student’s strengths and limitations currently exists. Nor are treatments for students–new curricula, new devices– tested clinically prior to use on individuals. Finally, the essential, overall knowledge and skills of a subject such as math, biology, U.S. history, or reading–analogous to the human genome–that can be targeted to the strengths and weaknesses of an individual child or youth is, in a word, absent (see here)

*In PM, individual patients do decide whether a new treatment for diabetes or atrial fibrillation should be administered.

In PL, however, adults decide on overall goals for students to reach. Both content and skills necessary to master come from state and district standards upon which students are tested to see if they have acquired both. In some settings such as problem-based instruction, students may decide what goals they want to achieve on a particular day in a particular lesson but not what they should learn overall–that is what district and state curriculum standards and tests determine.

*While in PM there is some research and clinical trials on specific therapies for particular diseases (e.g., breast and ovarian cancers), very little research (or clinical trials) for brand-name software content and skills exists currently. If anything, use of new math, reading, science, and social studies software in classrooms becomes a de facto clinical trial but without control groups.

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These are similarities and differences between PL and PM that I see. I am certain there are more than what I have listed. Readers can suggest others.

Like Inspector Clouseau I stumbled over the connection between PL and PM and, unlike the French detective, I now, inspired by Mr. Spock, have analyzed both similarities and differences in being applied to both students and patients. Thank you Peter Sellers and Leonard Nimoy!

 

 

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