Yesterday, I attended a presentation on the use of tablets in health screenings. It is a project CHC has been involved with together with UConn and another health care organization and it is funded in part by the Connecticut Health Foundation.
One of the comments that particularly jumped out at me was about research that questions the effectiveness of many earlier screening programs. The problem is that these screenings often took upward of an hour and were not necessarily all that accurate.
By using tablets with targeted screenings that the patient could do, typically in four to seven minutes on a tablet while waiting for an appointment, the researchers found much greater accuracy and patient satisfaction with the screenings.
Earlier in the day, I had read an article in the New Yorker, THE DEFIANT PARENTS: TESTING’S DISCONTENTS. It was a fascinating article.
The article is full of great quotes, “One teacher remarked that, if a tester needs three days to tell if a child can read ‘you are either incompetent or cruel…’” Applying it to health care, any practice that took frustrating grueling days to administer basic tests would quickly find themselves out of business.
Part of the Affordable Care Act was the creation of the Patient-Centered Outcomes Research Institute. Perhaps, as part of education reform, we need to look at student centered outcomes research. How effective are the existing batteries of standardized tests? Are there better testing methodologies? Are the components of the core curriculum really the components that will result in the best life outcomes for the students? How does the core curriculum relate to twenty first century skills? Is the focus on the core curriculum diminishing the focus on other key 21st century skills, like creativity and collaboration?
This ties back to one of the lines in the New Yorker article,
Allanbrook says that her decision to speak out was motivated in part by thinking about the fifth-grade social-justice curriculum at the school, in which children who are about to graduate are asked to consider the question “What are we willing to stand up for?”
That especially jumped out at me. Does the school your children go to have a social justice curriculum? It seems like such a curriculum may a great example of what needs to be taught to reach twenty first century skills, and getting skipped because of excessive focus on the core curriculum.
To return to the topic of testing, the article talks about a testing process which takes “seventy minutes a day for six days” and contrasting it with “alternative tests produced by the Department of Education, one in English language arts and one in math, each lasting just forty-five minutes”.
There is another of aspect of health care that jumps out at me which I’ll introduce by way of the infamous quote from the Harvard Educated son of a University of Chicago Secretary of Education, Arne Duncan, who
described critics of the Common Core as “white suburban moms who—all of a sudden—[find] their child isn’t as brilliant as they thought they were, and their school isn’t quite as good as they thought they were.”
Yes, I am white and suburban, though I’m a father, not a mother, and I have not found any of my three daughters any less brilliant than I thought they were. The older two both skipped high school to start college at fourteen. The eldest is teaching English in Japan and the middle daughter completed her Masters in Education at age 19 and has already published three books, her most recent pointing out issues with an education system that does not sufficiently promote creativity. The youngest who is attending a great public elementary school consistently is a top scorer on standardized tests.
Besides relying on false stereotypes, the biggest problem I have with Sec. Duncan’s quote is that it reflects a different issue with the core curriculum.
In health care, we have the National Culturally and Linguistically Appropriate Services.
Provide effective, equitable, understandable and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs.
One of the criticisms of standardized testing is that many such tests have been culturally biased. Is enough being done to address cultural biases with the core curriculum? Do these cultural biases also end up in the classroom as teachers “teach to the test”? Concerns about the cultural aspects of education are just one part of the larger concern about the ‘one size fits all’ aspect of the core curriculum. Should the requirements vary depending on a students learning style? Does it really matter at what age geometry is learned and at what age algebra is learned, or does what really matter is that adequate progress is made towards learning all the aspects of the core curriculum by high school graduation?
Perhaps Ken Robinson’s comment about ‘date of manufacture’ addresses this issue best
We still educate children by batches. You know, we put them through the system by age group. Why do we do that? You know, why is there this assumption that the most important thing kids have in common is how old they are. You know, it's like the most important thing about them is their date of manufacture.
Well I know kids who are much better than other kids at the same age in different disciplines. You know, or at different times of the day, or better in smaller groups than in large groups or sometimes they want to be on their own.
If you are interested in the model of learning you don't start from this production line mentality. This is essentially about conformity. Increasingly it's about that as you look at the growth of standardised testing and standardised curricula. and it's about standardisation. I believe we've got go in the exact opposite direction. That's what I mean about changing the paradigm.
As a final note, plenty of people have criticized the Affordable Care Act. It doesn’t do enough to reform health care and perhaps some of the reforms are headed in the wrong direction. We do need to improve the Affordable Care Act while recognizing benefits that it brings.
It seems as if the same applies to education reform. We do need a core curriculum, one that really addresses the twenty first century skills our students will need. We need proper testing and scientific research into how well these skills are being taught, the impact they are having, and even on the impact of testing, and we need to introduce ideas like the CLAS standards to education and move away from a one size fits all approach to testing and education.
Back to the starting point of this blog post, research at CHC has found that by coming up with new approaches to health screening, effectiveness and satisfaction can be improved. We need to look at similar ways to do this for education, perhaps individualizing and gamifying the whole process.
So, I asked my twelve year old daughter, “What if we replaced standardized tests with computer games?”
Her response was, “That would be awesome!” and then we went on to discuss how people could use it, track student and school performance and play the games from home.
A week and a half ago, Emma Keller wrote a column for the Guardian entitled, “Forget funeral selfies. What are the ethics of tweeting a terminal illness?” I have not read it. The Guardian took it down before I found out about it. It asks a very important question, which many others are writing about, much better than I can, but I hope to shed a little more light on the subject.
I first came across the column on Howard Rheingold’s Facebook wall where he talked about his experiences blogging about cancer four years ago, and pointing to an article in Gawker, Dear Bill Keller: I Have Cancer. Is That OK?
The author, Robert Kessler is undergoing treatment for non-Hodgkin's lymphoma and writing about it at Cancer? I Hardly Know Her!. He takes on Emma Keller, and her husband Bill who seem to take offense to people writing about cancer.
Another article posts part of Emma’s column, which is full of important questions. As the only part I have access to, I’ll stay away from attacking Emma, and instead, take these questions at face value.
Should there be boundaries in this kind of experience?
Yes! The patient should chose the boundaries that they are most comfortable with. Several friends have written beautiful cancer blogs and I have grown greatly from reading them. Others have chosen to remain silent about their cancer.
Is there such a thing as TMI?
Yes! This is a judgment call by the reader. What is too much information for one reader is fine for another. If you find you are reading something that goes into too much detail, whether it be a cancer blog or a steamy romance, the wisest thing may simply be to put it down and read something else. As I get older, I find I’m much more choosy about what media I consume. I wish more people were. For me, scripted reality shows are too much false information. Cancer blogs are much more real and valuable.
Are her tweets a grim equivalent of deathbed selfies, one step further than funeral selfies?
I’m not sure I would call them the ‘grim equivalent’, but they are related. My first thought is that in cancer blogging, there remains hope. Perhaps the treatment will be successful. Perhaps the patient will go into remission. Yet as I think more about it, even here there is equivalency. Even the deathbed selfie can contain hope, hope for something greater where there is no more crying or pain and God will wipe away every tear.
Dylan Thomas called us to ‘Go not gentle into that good night’ Cancer blogging and cancer tweeting, to me, are part of a grand tradition from deathbed and funeral selfies to Dylan Thomas’ poetry to so much great writing about all the struggles of life.
Why am I so obsessed?
I can’t say. I love reading great literature. It isn’t an obsession for me. I have the same reaction to people writing about all their life struggles. If Emma’s obsession is causing her problems, I would encourage her to speak with a therapist.
For the rest of us, let’s work together to have a healthier relationship to people’s health. Let’s find constructive ways to address health stigmas, whether it be cancer, mental health, HIV, or many others.
After printing a couple samples off the SD card in the new Makerbot Replicator 2 at work, my next step was to download some things off the internet and print them.
Actually, the next thing I had tried was using the Makerbot Digitizer. I downloaded MakerWare for the Digitizer and scanned my Google Glass. The scan didn’t come out all that well, and I started to look around for ways to edit the scan.
This led me to GETTING STARTED WITH 3D DESIGN. The first thing that they suggested was choosing one out of around a dozen different tools. A couple of them I had worked with in the past, including SketchUp and Blender. I downloaded both, as well as a few other tools and looked for a quick start guide. I like SketchUp because it is easy to use. I like Blender because it is powerful. Yet I couldn’t find a good quick start, so I set them aside and started exploring Thingiverse.
Being an Ingress player, I found a nice Ingress Enlightened Faction badge. It seemed like downloading something from Thingiverse and printing it was the next best step to get better acquainted with 3D printing on the Makerbot.
The file I downloaded was in .stl format which stands for stereolithography or Standard Tessellation Language, depending on who you speak with. You can open an .STL file in MakerWare and, if your printer is connected to your computer via a USB cable, print the object on the printer.
When I opened the faction badge, I received a message saying the object was off the platform and asking if I wanted to reposition it. I moved it on to the platform and printed it. Unfortunately, partway through the printing, it hung. It may be that my PC had gone to sleep during the printing, or there may have been some other problem. It also printed an edge around the object that I didn’t want.
When you print, you have a lot of options to choose. Getting going, I took the defaults. One of which was Raft, which creates this edge. It is useful if you have an object that doesn’t quite fit together, but most of the time of no value or downright annoying. Unfortunately, it took me a little while to figure this out.
To get around the issue of my PC going to sleep while printing, I took to saving the image as a X3G file. This is, essentially, the compiled format of the object, ready to be printed. I could then copy it to the SD card for the printer and print from that. This worked much better for me.
Along the way, I also found a few other file formats there are important to the initial understanding of 3D printing on the Makerbot. The STL file is the first, and most important format. You need to get things into STL format, so you can load them into Makerware to either print or save to the SD care. STL format can be Ascii or Binary. So far, I’ve only used the Binary format.
STL files can be combined into a zip file, along with a manifest file. These thing files can be loaded into MakerWare to load several STL files at the same time. The only thing file I’ve worked with so far is the example nut and bolt file.
When you export a file from MakerWare, you can export it in X3G, S3G or gcode. So far, I’ve only used X3G format and will experiment with the others later.
Blender can read and write STL format files. SketchUp needs an addon to do this. In my next blog post, I’ll write about taking existing images and objects in other formats, like JPG, SVG and OBJ and converting them to STL files that can then be loaded in MakerWare and printed.
As always, any thoughts, questions or suggestions are encouraged.
Recently, we got a Makerbot Replicator 2 at work, and I’ve been spending a bit of my free time learning my way around 3D printing.
The initial setup was pretty straight forward. Take it out of the box. Put it on the counter top you are going to use, plug in the power, put the snap the build plate in, connect the tube to the extruder on one end and to the back of the printer on the other end, feed the filament through the tube, and run the startup routine.
The startup routine displays on the little display screen on the printer the steps to start printing your first object, which you select from a few objects stored on an SD card that comes with the printer. Before you start printing, you need to level the build plate. You twist a few adjustment screws on the support below the build plate. It was fairly easy to adjust, much easier than tuning a guitar. We selected a comb to build.
We watched the extruder move back and forth across the build plate, squirting out a thin line of melted plastic. These lines combined, and we ended up with a comb.
This is where we ran into the first problem. The comb stuck to the build plate. After a little experimentation, we discovered that the easiest thing to do is to remove the build plate, by unsnapping it at the back of the printer and lifting it forward. Then, using a sharp knife and a bit of finesse, we finally got the comb off, without much damage to the comb.
The build plate is smooth on one side and frosted on the other. We had the frosted side up. We flipped the build plate over and tried another comb. It also stuck. Apparently the side of the build plate that is up doesn’t seem to matter.
Reading online, I found a lot of people have reported this problem and suggests are all over the place. Some say lowering the build plate a little. Some talk about heating or cooling the build plate, or using a different temperature for doing the build. Others spoke about using painters tape and putting down a piece of paper on the build plate.
I’ve taken to using left over printer paper and taping it on with scotch tape. This works pretty well. For bigger objects, or if I don’t tape well, the paper sometimes lifts up a little adding a little bit of a curve to the object base, but this has been minor.
One of my coworkers later asked how difficult it was to set up. It is probably a little less difficult than setting up a DVD player for your home entertainment system. If you’re comfortable with technology, you should be able to do it easily. If not, you should be able to get a friend to set it up for you.
Of course, setting up a printer, and designing interesting objects are two very different things, and I’ll get into some of that in later blog posts.
Do you have a 3D printer? How’s it been going for you? Have you been thinking about getting one? Do you have any questions about 3D printing?
Recently, at work, we got a 3D printer. I work at a health care center, serving mostly poor; people on Medicaid, or without insurance. People have asked, what does 3D printing have to do with that? Are you going to print syringes?
As I've been thinking a lot about it, 3D printers, at least in my work space, are about fostering creativity. How do we get people to think more creativity, not only about what they put down on paper or canvas, but how they live their lives and promote health around them? Does learning how to design and print 3D objects help empower people to be more creative? Does it even, simply, get people who should be getting primary health care, in the door?
How do we use having a 3D printer in our innovation center, to encourage people to come forward with creative ideas? Does fostering creativity in one realm, like 3D design, encourage creative thinking in another realm, like public health? These are issues for me to explore.
So far, I've been testing the 3D printer, getting to know what it does and doesn't do, getting to know how to operate it must effectively. So far, I've printed a couple comes and an Ingress Enlightened game insignia. I've started looking at 3D design and exploring different design packages. There are several free ones, like Sketchup and Blender. I've used both in the past, and I'm starting to relearn them to see if I can make some neat objects.
I started thinking about 3D design back when I was active in Second Life, a 3D virtual world. I’ve encouraged people to use 3D virtual games to create animated videos. These days, my youngest daughter plays a lot in Minecraft and related games. I like Minecraft much better than a lot of the other games she plays because it is a game that encourages rudimentary 3D design. Can I use it as a gateway to Sketchup, Blender, and Opensim for her?
I’ll continue to work on my 3D design skills. I’ll try to find others interested in these skills near where I work. It may not lead to a cure for cancer, but if it can provide even a small spark that improves the health of our communities, it will be worth it.
Do you do any 3D design or printing? Are their systems, tutorials, or projects you recommend? Let me know.