Larry Cuban examines the dream of replacing messy humans with neat, orderly machinery.
Treating patients and teaching students also have advocates touting medical high-tech procedures (e.g., MRIs, CT Scans, electronic health records) and student learning (e.g., hybrid schools, online learning– see K-12 online programs.) Yet, and this remains a big “yet,” there are voices, albeit in a distinct minority, who, recognizing clearly the advances high-tech devices have made in both health diagnostics and schooling, point out the critical importance of doctors and teachers using low-tech ways of caring for patients and students.
First, most doctors have come to increasingly rely on CT scans and MRIs while fewer physicians actually probe a patient’s body. Physical diagnosis, touching a patient’s body to ascertain normal and abnormal functions (think stethoscope), is becoming a lost art even when it is taught in the first two years of medical school because once students enter the clinical phase of their training they see that daily practice means “getting tests ordered and getting results, having procedures like colonoscopies done expeditiously, [and] calling in specialists.”
Abraham Verghese points out that beyond the importance of carefully touching the body of the patient to diagnose illnesses there is the ritual of a physical exam, one that often establishes trust between the patient and the doctor. After examining an elderly woman in his hospital ward, Verghese said, “[r]ituals are about the crossing of a threshold, and in the case of a bedside exam … is the cementing of the doctor-patient relationship, a way of saying: ‘I will see you through this illness. I will be with you through thick and thin.” Caring and trust, the precious ingredients of the doctor-patient relationship, are not one of the metrics used to measure medical effectiveness; it is also missing from the Medicare incentives that reward the high-tech tool-kit that doctors use rather than listening to the patient or spending time doing a physical exam.
It is that all-important human connection in medical practice that also exists between teachers and students in classrooms daily for deep and lasting learning to occur. Both researchers and experienced teachers have found that teachers with the requisite skills and knowledge of children and subject matter have built strong bonds of trust, respect, and caring with students–classroom relationships–from preschool through graduate seminars. Surely, high-tech aids in the hands of competent teachers can and do enhance learning. Nonetheless, those high-tech aids depend upon both teacher’s knowledge and skills and those hard-to-measure bonds of trust that unfold between teachers and students. Note the phrase “hard-to-measure” and that is the rub.
