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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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Holding Donors Accountable

The sad story that Washington Post journalist Valerie Strauss tells about the recent RAND report on improving teacher effectiveness, an effort partially funded by the Bill and Melinda Gates Foundation–$215 million of a half-billion dollar project–is neither the first (nor the last) failure in donor funding. After all, philanthropists take moderate to great risks in funding projects that promise high returns (as do  venture capitalists) and such ventures do fail. Here is the background story for the Intensive Partnerships for Effective Teaching.

Based upon the extensive research of Tom Kane, professor of Economics and Education at Harvard University, the premise of the project was that a multi-measure evaluation system of teachers anchored in student test scores (and peer evaluators) would sort out “effective” from ineffective teachers of low-income students in five districts and charter school networks. Districts and charter schools would then staff classrooms with “effective” teachers–the “good” teachers–and their students, following the premise of the initiative,  would outscore similar students in classrooms with regular teachers during the six year project (2009-2015). In addition, participating districts and charter networks gave cash bonuses to teachers designated as “effective” and substantially increased professional development.

Result? Outcomes for economically poor students in those schools staffed by these designated “effective” teachers, according to the RAND report, “were not dramatically better than outcomes in similar sites that did not participate in the … initiative.”

I could only guess that Professor Tom Kane was disappointed in the findings of the report. As were, again only a guess, program officers at the Gates Foundation. For donor Bill Gates, it must have been dismaying since this was another top-down, research-informed loss that the Foundation had launched to improve schools with results falling far short of what was promised (e.g., spreading technology into libraries and schools, the “Small Schools” initiative, backing Common Core standards). These top-down funding strategies have now given way to yet another Foundation effort: a $1.7 billion project aimed at K-12 school improvement announced a few months ago. More than 500 applications have poured in to get a chunk of that money that will go to local stakeholders.

Journalist Valerie Strauss classifies the RAND report documenting the Foundation’s effort between 2009-2015 to raise test scores of low-income students as an instance of “they-were-warned-but-didn’t-listen….” Donors, she says should have listened to individual researchers and organizations of researchers who repeatedly criticized efforts  to evaluate teachers by  relying on student test scores (see here, here, and here).

Perhaps. Let me imagine a conference room at the Gates Foundation in 2008 before the Intensive Partnerships for Effective Teaching was launched. In this conference room are  program officers and researchers who had provided the underpinning the experiment. Here are the exchanges that I imagine:

Senior program officer:

“The American Statistical Association and the Board on Testing and Assessment of the National Research Council have argued against our doing this project. Many researchers have written us and spoken out against using student test scores to determine how good the teachers are. How should we handle these criticisms?”

Senior researcher funded by Foundation to do studies upon which initiative is based:

“C’mon, guys, when was their ever unanimity or even a preponderance of evidence supplied by researchers on any innovative experiment? OK, that is a rhetorical question because we all know the answer: the quality of educational research ranges from poor to mediocre and even when a study is rigorous, researchers split over how the study was done and the statistical significance of the findings. So I say, plow ahead because the research we rely upon here is solid. The research we have done is rigorous and the findings we can depend upon.”

Junior program officer:

“May I say that I, too, am impressed with what studies I have examined. They do point in this direction for identifying effective teachers of low-income kids. What I worry about is what happens if the results of working with these districts and schools that have volunteered show that the students of these teachers we identified as effective did pretty much the same as poor kids in classes of regular teachers outside of our project?

We would have intervened in the district, claimed that we have identified “good” teachers, assigned them to classes of at-risk kids and nothing much happened when these kids took the state tests, compared to a group of teachers and students we did nothing with. Who is going to be held accountable for disappointing outcomes of this initiative?”

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Yes, this is an imaginary conversation that I constructed among Foundation staff and researchers in the year prior to implementation of the project.  And, yes, again, I end it with the question of who is held accountable when donors fund moderate-to-high-risk projects and the results range from disappointing to harmful.

Insiders to the donor strategy of taking funding risks have noted the issue of responsibility for outcomes.

If you agree that philanthropy should be taking big risks, you shouldn’t be too surprised by big failures. Nor should you be reflexively critical of the funders behind them, since they’re doing what we want them to do. At Inside Philanthropy, we make a point of not piling on when funders fail. If donors and foundations are kicked around too harshly for their mistakes, they’ll take fewer risks and we’ll all be worse off. 

All that said, risk taking in philanthropy needs to be approached with great care, especially in an area like public education. When risky initiatives go wrong, they can impose major costs on all involved. In the case of K-12, that means students, parents, teachers, administrators and the taxpayers who pick up the bill for failure. 

The Los Angeles Times editorial board went one step further in slamming an earlier Bill and Melinda Gates Foundation initiative in California:

Philanthropists are not generally education experts, and even if they hire scholars and experts, public officials shouldn’t be allowing them to set the policy agenda for the nation’s public schools. The Gates experience teaches once again that educational silver bullets are in short supply and that some educational trends live only a little longer than mayflies

I end this post on this issue of accountability and setting the educational agenda through funding projects that philanthropists believe will make a difference in schooling U.S. children.

Lack of donor accountability

When foundation grants fail to achieve the objectives officials sought, philanthropists turn their backs, shrug, and walk away. Or try again. They have no responsibility to districts, individual schools, teachers, students and parents for hopes raised and dashed. Donors are beyond the reach of being fired or voted out of office. Yet as anyone knows from personal experience, admitting error is crucial to insights into a problem and, ultimately invention of better ways to solve it.

For those who support philanthropic giving, this unaccountability is an exercise of personal liberty and risk-taking in acting for the public good and is in the best tradition of a democracy. Moreover, some have argued: “[S]uch virtual immunity represents foundations’ greatest strength: the freedom to take chances, to think big, to innovate, to be, in the words of the late Paul Ylvisaker of the Ford Foundation, ‘society’s passing gear.’”

Being society’s “passing gear,” however, assumes that funders and their retinue of experts know best how to identify educational problems, sort out symptoms from fundamental causes, and adopt solutions that solve the problem. When donors bet foolishly or are simply wrong and projects and programs fail who are these funders answerable to for their errors in judgment? No one, as far as I can see.

Nothing “nasty” will happen to the Gates Foundation for their slip-ups in top-down policy making to improve schooling. At least so far. I do have a proposal, however, were foundations to awake to their responsibility for errors in policy judgment rather than shrug and walk away.

Proposal

When foundations give money to districts and schools to alter school organization, curriculum, or instruction (or all three) stipulating what districts have to do to spend donor money and what results are expected, then districts and donors should have a separate written agreement for what happens if the project falls short of achieving desired goals.  If the district has met its part of the agreement–as confirmed by an independent outside source chosen by both donor and grantee–and still the project fails according to the agreed-upon metrics to be used, the foundation would provide additional funding–no strings attached–to districts equal to the original grant.

Would this reduce risk-taking on the part of foundations? Possibly. Would it be an incentive for districts and schools to insure full implementation of the strategy and program? Yes, it would.

Were such an agreement to be struck between donor and recipient it would be a small step in the direction of foundations being held accountable for their initiatives to improve schools in the U.S.

 

 

 

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Remembering Career Failures

Looking back from my ninth decade, my career as an educator has been marked by many successes. But I cannot forget the failures I encountered.

I began teaching high school in 1955, a goal I had pursued as an undergraduate at the University of Pittsburgh. I taught 14 years on and off in various school districts until the early-1970s. During those years I participated in an innovative, district-based teacher training program that prepared returned Peace Corps volunteers to teach in urban schools. I also created culturally diverse curriculum materials and co-authored a series of U.S. history textbooks both of which were published in those years.

Left teaching in 1972 to get a doctorate at Stanford in history of education and in 1974 achieved my dream of becoming a district superintendent. I served seven years. I returned to Stanford as a professor in 1981 and for 20 years taught, advised doctoral students, returned to high school teaching three times, and did research and writing until I retired in 2001. Since then, I began a blog in 2009, taught seminars until 2013, and have written extensively about the history of school reform while continuing to do research in public schools. I have published many articles and books about U.S. classrooms, schools, and districts always with a historical perspective whether it be teaching, using technology, or a current reform.

OK, this is beginning to sound like a draft for an obituary. It is not.

What I want to write about is not my successes but my failures. While on the surface my long career as an educator appears as an unvarnished success albeit a modest one, it was a zig-zag path with cul-de-sacs and, truth be told, a road pockmarked with failure.

Why note failures?

Because successes in life, however defined, are built on failures that often go unnoted. The common pattern in talking or writing about a career is to deny or cover up disappointments and failures. Carefully prepared resumes are silent on mishaps. The point is that everyone’s career is marked by failures but in our competitive, highly individualistic culture, talking about failure is like talking about body odor. Not done. Failure means you are a loser in a society that praises winners.

So here I want to recount my career failures to make clear that chasing success in one’s life is anchored in confronting repeated failures. I am not the first to reveal such a list. Others have as well (see here and here).

Failures as a teacher:

*In 1955, I graduated from the University of Pittsburgh as a history teacher. I applied for a post in the Pittsburgh school system where I had lived and gone to elementary and secondary schools. I was rejected because I had no experience and was told to teach in the suburbs for a few years and then re-apply. I did teach elsewhere but never re-applied to the Pittsburgh schools.

*Even though I was considered a high-performing teacher by my superiors at Glenville High School (Cleveland, OH), Cardozo High School and Roosevelt High School (Washington, D.C), between 1956-1972 I had a small number of students in various classes that I could not reach or teach well. It was obvious to me and to those students that I failed in connecting with them.

Failures as administrator:

*In 1968 while teaching at Roosevelt High School in Washington, D.C., I was offered a post in the U.S. Commission of Civil Rights to be in charge of a research group on race and education. It was a time in the city and nation when racial antagonisms ran high in the wake of the assassination of Martin Luther King, Jr. After six months, I realized that I could not reduce the racial friction evident in the department that I administered. I had failed to make a dent in lowering tensions and achieving the stated goals of the unit. I resigned.

*In 1972, I applied for an elementary school principalship in Washington, D.C. where I had taught and administered programs for nearly a decade. I was turned down for that post.

*After receiving my doctorate in history of education and getting certified as an administrator, I applied for 51 (not a typo) superintendencies across the country. My wife and I and our two daughters were willing to go anywhere a district offered me the school chief position. I was turned down by 50 districts—the one that hurt the most was a district to which I had not even applied—until Arlington (VA)—the 51st application– offered me the post in 1974.

*In 1985-1990, as a professor, I applied for six urban and state superintendencies and while making the final cut to a short-list of three candidates, each board of education chose someone else.

*in the mid-1990s, I was a finalist for deanship at Stanford’s School of Education. Didn’t get post.

Failures in getting published: 

While occasional articles I wrote and a book were published in the 1960s,  over subsequent decades, publishers and editors regularly turned down submissions I made. At one point for a manuscript I had written on Southern migrants moving northward before and after World War I, the rejections letters overwhelmed me and I shoved the manuscript into a bottom drawer. Eventually, I threw it out.

When I began writing op-ed pieces on school reform in the 1990s, the New York Times, Washington Post, and Los Angeles Times regularly turned down my work. The New York Times has never accepted an op-ed I wrote while the Washington Post and Los Angeles Times accepted one of every ten I submitted.

When I get requests for my resume or curriculum vitae, none of the above failures are listed.

Why is it important to talk about career failures?

 This is the point where such accounts as mine throw in a few inspirational quotes about the importance of failing. Such as:

I’ve missed more than 9000 shots in my career. I’ve lost almost 300 games. 26 times, I’ve been trusted to take the game winning shot and missed. I’ve failed over and over and over again in my life. And that is why I succeed. Basketball star Michael Jordan

 Success consists of going from failure to failure without losing your enthusiasm.
Winston Churchill

 You may encounter many defeats, but you must not be defeated. In fact, it may be necessary to encounter the defeats, so you can know who you are, what you can rise from, how you can still come out of it.” Maya Angelou

But there is far more that is important to confronting career failures than citing maxims. Defeats were doors that closed in my face. Yet other doors opened.

There are many ways to respond to failure. For me, however, closed doors did two things. In some instances, I doubled down and persisted—50 rejections in applying for superintendent posts—in other instances, it nudged me to open doors that I had not considered–going from the failed attempt to manage a governmental research group riven by racial animosities to administering the Office of Staff Development in the Washington, D.C. schools or getting rejected for a principalship and deciding to pursue a doctorate.

Persistence and ambition are, of course, married to one another. Yes, I have been a go-getter in the early decades of my work as an educator. The cliché of “a fire in the belly” captures in large part what drove me through open doors. But it was doggedness in the face of errors and defeats, harnessed to that ambition, that help explain, at least to myself, the corkscrew path I have taken these past nine decades.

Now, that fire has been banked yet embers still glow. Looking back at my career and the mix of success and failure make clear to me how complex the interaction between wins and losses is. In remembering how failures tinged with success and successes tinted with failures have resulted in unplanned twists and turns, I remember, and smile, at an old saying:

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Asking Different Questions about Personalized Learning (Leigh McGuigan)

Leigh McGuigan worked in district leadership roles in New York, Chicago, and Cleveland, He is now CEO and co-founder of Vertus High School. Addressed to Rick Hess, head of educational policy at the American Enterprise Institute, this letter appeared May, 30, 2018.

Dear Rick,

I appreciated the recent blog posts from Larry Berger, Joel Rose, and Jonathan Skolnick on getting real about personalized learning. I loved their straight talk about the challenges of “engineering,” the need to rethink classrooms, and how to get students to “eat their vegetables.” But I wanted to raise a different issue based on our experience at Vertus High School, a blended high school for at-risk boys in upstate New York. Our students arrive at our door very far behind. Most do not know basic math, cannot recognize an adverb, and have never met an engineer. But when they graduate, most will go to college, some to the military or technical training, and a few to living-wage jobs.

We have four years to prepare our students for the world they will encounter. For our boys—like for most people—success after high school will mostly require that they do things someone else’s way, on someone else’s schedule. Much of this will be boring, and very little will be “personalized.” In most colleges, they will be expected to learn what their professor teaches, in the way he or she teaches it. In their jobs, their boss will likely dictate what they should do, and how and by when they should do it. Maybe a lucky few will go to colleges that nurture their individual interests and cater to their learning preferences, and to first jobs with lots of agency to pursue interesting questions as they see fit. But not many. We have a moral obligation to prepare them to succeed in the world they’re going to actually encounter.

Of late, it seems that talk of personalization focuses on the question, “What kind of personalization will make school engaging for students?” My experience leads me to think that’s the wrong question. And I worry that much of the thinking that results when it comes to personalization approaches fantasy—or educational malpractice.

I think the more useful question about personalized learning is, “How do we personalize learning for students while preparing them for what life will actually be like after high school—which, in truth, will be largely impersonal?” Some might wave this off as a misguided concern, but I think that’s a profound mistake and a disservice to our charges. As Vertus has grown over our first few years, this tension has been central to our work.

An undue focus on “engagement” personalization risks students not building the broad body of secure, automatic knowledge and skills they’ll need to succeed in college, and that they may not develop the self-control and grit to independently weather challenges, setbacks, and annoyances. Our students need a great deal of practice in that stuff which we might call “the basics.” We’ve found that we can’t let them just rely on their strengths or follow their preferences if we’re going to help them master those.

At Vertus, we do personalize, of course. Our students spend about half their time in learning labs completing online courses. We meet each student at their starting point, and each moves through courses at his own pace. In a self-paced environment, we learned early on that we had to provide strong incentives for making progress, as students who have not had success in school don’t have a compelling vision of the future to motivate them. We have learned the importance of giving our students explicit instruction and patient practice in how to concentrate and motivate themselves.

We also make it a point to incorporate plenty of traditional instruction. Students spend the other half of their time in typical small classrooms. The so-called “tired old model” of teaching a group of students the same thing in the same way is easy to dismiss, but it is still mainly what students will encounter after high school. In classrooms, students can learn to be part of respectful discussions and how to wait patiently while someone else’s needs are attended to. Since many of our students come to us with bad classroom habits, we’ve doubled down on fostering strong classroom cultures and student engagement. Our students use their classroom time to deepen skills in reading, writing, and math and to learn and practice the specific knowledge and skills that the New York State Regents tests require. Learning to succeed in a classroom and learning material that may not feel relevant or seem interesting are core skills in college.

Personalization done right can help cultivate self-control and self-motivation, the characteristics that students will need in the real world. But personalization done wrong risks graduating students who are ill-equipped to succeed in the real world, lack important knowledge and skills—and of doing all this because it’s trying to answer the wrong question. I hope we’re not experimenting on our students to satisfy our theologies, as they won’t get many second chances.

 

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Cartoons on Educator, Student, and Corporate Decision-making

Unlike the Garfield cartoon, everyone makes decisions. Especially educators and CEOs.

 

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This month my gallery of cartoons look at different folks making decisions in and out of education, with or without data, and similar contradictions. Enjoy!

 

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Cartoons on Using Data to make Decisions

Go anywhere in education, medicine, justice system, and, of course, corporate America and evidence-based decision-making and Big Data are the rage. Cartoonists have joined the fray. Enjoy!

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Cartoons on Teaching English

For this month I have turned to cartoonists who draw on their experiences in English, reading, and language arts lessons. Enjoy!

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