Gawande is a physician and uses stories from medicine to illustrate the effectiveness of simple checklists (there are also some fascinating examples from building construction and finance). One of the areas where checklists have made the most difference are in operation rooms. It turns out that for even the most developed countries--those with great hospitals, state-of-the-art medical technologies, and highly-trained physicians--surgical complications are a fairly significant problem. Gawande and his team have managed to develop simple checklists that, when used properly, have drastically reduced complication rates. It is important to note that these have not been modest findings, the results have been startling and and hard to argue with.
The interesting thing in all of this is that the vast majority of physicians and hospitals have refused to use the checklist. Instead most have opted to invest in $1.7 million remote controlled surgical robots that have driven up costs massively, without producing any significant improvements. Meanwhile, the low-tech, low-budget checklists are saving lives.
There seems to be a parallel here to education. More and more, institutions are adopting technology with the hope that it will revolutionize learning. In my graduate work I spend a fair amount of time with instructional technologists, some who tout technology as the saviour of schools. I should also confess that I am sometimes a sucker for cool ed tech gadgets because they seem to make learning fun and engaging. That's not to mention my reliance upon technology for some of the most basic functions of my job (just last night I made a presentation to a group of parents of incoming students and used the bells and whistles of a fully-mediated auditorium to "enhance" my remarks).
The nagging question I keep having, though, is whether the very expensive technology we use has really improved the learning experience for students. It likely cost thousands of dollars to outfit the auditorium I spoke in last evening. And, I would estimate that there are at least 100 other rooms of various sizes just like it across the rest of my campus. In many ways this is nice. It means that instructors can use PowerPoint slides, show media clips, play music, etc. These things are entertaining for students and can deepen engagement. But, how much more did the parents in my session learn because I used technology? What if the computer had crashed mid-presentation? Would I have been prepared enough to make the remaining 15 minutes useful? Would a low-tech "technology" like a "minute paper" have been just as beneficial as a data slide?
I'm not arguing for the elimination of technology in higher education (or any setting for that matter). But, I wonder how often we falsely assume that twitter, tech classrooms, and iClickers will simplify the educational process and prevent educational failures. Could it be that simple pedagogical tools, processes, or philosophies could be just as impactful and at a much lower cost? And, what sorts of new failures does technology introduce? Gawande frames this question well:
"We have most readily turned to the computer as our aid. Computers hold out the prospectof automation as our bulward against failure. Indeed, they can take huge numbers of tasks off our hands, and thankfully already have--tasks of calculation, processing, storage, transmission. Without question, technology can increase our capabilities. But there is much that technology cannot do: deal with the unpredictable, manage uncertainty, construct a soaring building, perform a lifesaving operation. In many ways, technology has compicated these matters. It has added yet another element of complexity to the systems we depend on and given us entirely new kinds of failure to content with."
What are our "educational checklists?" (i.e. those simple and frugal things that can make signficant differences in learning). And, what are the "surgical robots" in education that look cool, but deplete budgets without making any meaningful improvement to the educational landscape? And, maybe most importantly, how do we know when we're dealing with an expensive failure or something that, while expensive, truly will revolutionize learning?