On August 31, 2020, I had surgery to replace my left shoulder. Now, six weeks later, I am at a point of being able to type again and excited to re-enter the conversation of change and transformation. This was my first major operation, and as such, I have tried to observe and process all I experienced. From the flow of work of the medical professionals, to the scaffolded structures of support, to the use of technology in my surgery and rehabilitation, this has been a great learning experience. As I have thought of what education, teaching, and learning, could be, I can’t help but think, our educational system could benefit from and apply many of the strategies, practices, and protocols from the medical profession. Just as Dr. Richard Elmore's work suggested, school administrators institute "instructional rounds" based in practice on doctors "medical rounds", there could be deeper connections and applications of medical practices and protocols to teaching and learning.
From the time of my injury, the goal was to regain use of my shoulder and arm. The initial diagnosis by my nurse practitioner to begin the process was easy, my shoulder hurt a lot and did not work. She ordered an x-ray at the local hospital which showed that indeed my shoulder was messed up. My nurse practitioner then referred me to a bone and joint specialist.
The surgeon at the Bone and Joint Institute prescribed an MRI to give greater detail on the damage to my shoulder and arm. With this information, surgery was scheduled, performed, and I got a new shoulder. The surgeon was highly skilled and qualified. It should be noted that he was supported by a physician’s assistant, specifically trained, but not a doctor. Leveraging the physician’s assistant, less qualified than the surgeon, increased the ability for the surgeon to apply their advanced skills to more patents.
Upon completion of the surgery, rehab was prescribed to be performed by yet another specifically trained group. Again, it was interesting to note that the rehabilitation was provided by a licensed therapist, who was assisted by a “therapy tech”. Like the surgeon, the tech enabled the licensed therapist to see more patients.
I think it is interesting to note that the process began with my nurse practitioner, who is not a doctor, establishing the diagnoses. As the diagnosis progressed, special trained individuals were added and courses of actions were designed.
It seems a child’s learning challenge has to be acute, or highly discrepant from their peers in order to be “eligible for services” beyond the basic education. It is assumed that if a teacher has a “teaching license” they are highly qualified to serve your child. But the fact of the matter is, just like my nurse practitioner, a school or teacher may not have the expertise or technology to truly diagnose and address a problem or concern. This creates frustration for the student, the teacher, and the parents.
Scaffolded structures of support
In education today the concept of scaffolding is emerging as a strategy to support students not only in their academics, but also in their behaviors. This is great in concept, but in practice it is calling on teachers to become the nurse practitioner, surgeon, and rehabilitation specialist all in one, with anywhere from 18 to 30 students in their class. In this time of COVID-19, social distancing, remote learning, and school closures, this is adding to a teacher’s stress.
Technology
My nurse practitioner, surgeon, and physical therapist were heavily dependent on technology, specifically internet access, wireless computers, email, x-ray machines, MRI equipment, and other technologies. The communication between all my health care providers was via email. My surgery observations were this was a clear example of the Internet of Things (IoT) and the seamless embedding of technology.
My paperless medical records were shared in almost real time between all concerned (even me!). Big ticket technologies like the x-ray machine, MRI, and surgery monitoring devices, were shared and leveraged, family clinic to surgeon, surgeon to hospital, surgeon to rehab. It seemed many with expertise and skills were able to timely collaborate and provide me with the best patient care. This would be hard to imagine without robust, reliable, affordable, high-speed internet access.
Bottom Line
Due to COVID-19, the transformation of education, teaching, and learning, has accelerated. The need to approach and rethink systems of learning is before us. In that the managed-health care model may not be a clean fit, there may be some concepts and strategies that are applicable to teaching.
Each child is unique, important, and special. The ability for teachers to access and collaborate with expertise beyond their classroom to address student concerns is powerful. The fact of the matter is a classroom teacher does not have the time or the resources to be the nurse practitioner, surgeon, and rehabilitation therapist for 20+ students. Perhaps restructuring class size and teachers’ workloads should be investigated? Maybe a new continuum of services needs to be designed?
I have said many times that each child is different, and as such should have a specific learning plan based on their learning styles and interest, much like I had a personal medical plan to address my shoulder. Maybe the Special Education practice of Individual Education Plans (IEP) should be applied to all students? It is exciting to think what this could look like!
COVID-19 has raised awareness of the gross digital divide between students within schools. The ‘have nots’ definitely are at a disadvantage to those who have high speed internet, access to computers, and other technologies. I can’t imagine what my shoulder surgery experience would have been like without technology. It seems the first step must be universal, equal access to the internet.
From these key ideas there needs to be further deep thinking, reflection, and actions steps designed. Additionally, how is all of this to be funded? Is there sufficient funding available now if it were to be reallocated or re-tasked?
New GROWTH RINGS
The question is: "can we continue as we have historically done?" I am not conviced we can. The times have changed and we have to think differently. We have before us an opportuity to create new!
