Why should I be in the same room with these people?

That’s one of the many smart questions participants posed at a Stanford Medical School meeting I attended last weekend.  If I had been daydreaming (I’d never do that), I might have thought the question was for me. You see, the participants were a handpicked set of national medical education experts, folks nominally from the status quo medical-education-industrial complex—the very thing we’re trying to change.

You might think that they embodied that dreaded status quo.  I’m happy to report they did not—not even close.  I’m also relieved to tell you that the question (in spite of my paranoia) wasn’t for me. Instead, it was one of many challenges these thoughtful, passionate teachers tossed at each other.

“Why are we in the room?” was a challenge to each other. Why and when should teachers be in the same room with the learners?

When you think about it, that’s actually a central question if you’re attempting to use online education to flip the medical education experience.  It’s also a brave one if you’re a teacher: justify the time you spend with your students.


The immediate reason these leaders are challenging themselves?  The Robert Wood Johnson Foundation is looking for partners to help create a durable culture of health for all. In that effort the Foundation is trying to provide opportunities for people to create that culture. Technology isn’t the only tool that people will use—but it is an important one.

Online education technology can help improve and spread knowledge about health.

And we’re looking broadly for help.  The Foundation is at TED this year in Vancouver asking leaders at the epicenter of technology, entertainment and design for their thoughts and ideas. It’s not the first time we’ve turned to TED-sters, of course.

Sal Khan spoke here this week.

The last time we were at TED back in 2011, Khan’s vision and talk about reimagining education connected directly with our own hopes to reimagine health. Right after that meeting we began a successful Khan Academy collaboration with $1.6 million in funding to help build online health education content.

That brings us to the recent Stanford meeting.  Our Khan success pointed us to a new powerful collaboration. In 2013 we extended a $312,000 grant to Stanford Medical School that will support work by five medical schools, Stanford, Duke, University of Washington, UCSF and University of Michigan, as they create a consensus knowledge map of the critical things medical students should learn.

Why a knowledge map?  The simple answer: because there isn’t one, and we need one if we’re going to build massive core online medical education content.

Why change now?  There’s building pressure on fortress academia: pressure to push health care toward high value, pressure for health care to center itself on the patient rather than the professional, and pressure from technology, specifically the ability to move previously closely held knowledge of the expert more efficiently to the learner.

Here’s where this mapping effort also starts to get interesting. It wouldn’t be that surprising if these education leaders ticked through all the reasons why change is too hard—why it can’t or won’t happen. Instead something marvelous is happening: they’re challenging each other to examine the time they spend with their students—asking if they ignite the kind of passion in their learners that others ignited in them.

An even more hopeful sign—these leaders want to connect the teaching of new healers—from the beginning—with the key partner: the patient. Their early reimagining is fixed on patient and story.

The prototype case: an elderly South African grandmother, Nombulelo—an avatar who would teach students about her reactivated pulmonary tuberculosis. Nombulelo’s story is riveting, unforgettable and includes the unnecessary death of her grandson with gripping clinical details of the family’s TB infection.

To me teaching healers with patients’ stories rather than with lists of, say, organisms, is so obvious.

It’s also brilliant.

Hopeful times: leaders acting like leaders, showing the way to a reimagined future—a place where an ill grandmother avatar beckons us.

Stay tuned—great things just might be in store.

Michael W. Painter, JD, MD (@paintmd) is a senior program officer at the Robert Wood Johnson Foundation.

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2 Responses for “TED2014: Grandmother Avatar with TB Beckons Medical Education Her Way”

  1. Datum says:

    Great post, Michael. Thank you for sharing your insight with us. A follow up question for you, if you look in on this. You’re obviously getting a lot of experience and expertise with MOOCs through your involvement here, perhaps as much as anybody out there. (With the exception of Salman) There’s been a bit of backlash against MOOCs of late, with some critics noting high drop out rates and others questioning how much value courses actually deliver. Obviously, one drawback of MOOCs is that if you’re doing something online you’re as engaged as you want to be. Khan Academy has gotten pretty positive reviews. Can you share some of your thoughts on creating a successful online learning environment?

  2. Mike Painter says:

    Datum, Thanks for joining this discussion. We appreciate it. I completely agree that the MOOC version of online education seems to be struggling. See the Fast Company article from November 2013 on Udacity http://www.fastcompany.com/3021473/udacity-sebastian-thrun-uphill-climb or the late 2013 Penn research also showing the apparent low MOOC completion rates https://www.gse.upenn.edu/pressroom/press-releases/2013/12/penn-gse-study-shows-moocs-have-relatively-few-active-users-only-few-persisti But not all online education approaches and technology are the same. One could argue that MOOCs attempt to replace the classroom. The work in these RWJF projects, like the Khan Academy approach, instead attempts to improve not replace the classroom time–the time between teacher and learner–that’s the so-called flip. How could we improve the learning (and teaching?) experience in medical education if we were able to provide content online–and by the way make it thoughtfully standardized across schools? Certainly, there are many technical and adaptive challenges–but it seems worth it to explore.

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