Getting Better at Being Better.
I enjoyed reading, recently, a comment in The New Yorker, by James Surowiecki, about the rather remarkable ongoing increase in human performance in a wide range of sports. Surowiecki notes how athletes have become better in both individual sports, like sprinting, and team sports, like baseball and basketball. Perhaps most remarkable is that the improvement over the past 30 to 50 years has come both in sports that rely on physical achievement, and in activities like chess that rest on intellectual achievement. Surowiecki attributes this improvement to a variety of factors, principal among them a greater understanding of the factors that contribute to success in a particular activity, and then the engagement in training, focused to achieve success in that particular activity. So, baseball players engage in exercises to improve rotational activity, basketball players in two-hand dribbling, and chess players in studying moves with the greatest potential for success.
It struck me on reading that the central observation motivating the article—that of ever-improving human performance in a range of activities—concords well with the observation one hears frequently voiced by senior faculty in academic institutions: trainees today are really much better than we were when we were at their stage and level. I am consistently impressed by both prospective and incoming public health students who are well-prepared, engaged, and focused on learning; who ask focused, informed questions; and who are clearly thinking several steps ahead to how they can best tailor their education to their ultimate goals, and how to make sure that they indeed use their education as an opportunity to get better, and in many cases do so quickly.
This then strikes me as prima facie motivation for all of us in the academy: to make sure that we are meeting these ever-rising standards and expectations with our own ever-increasing excellence, both in our scholarship and in our education. While it seems, from the outside, that there is much that is interesting and fun about a career in athletics, it also seems self-evident that one of the downsides of that particular life path is that excellence in athletic endeavors peaks very early, and that most athletes are well past their prime by their mid-30s. We are fortunate to be in a business where we have opportunities for ever-increasing excellence throughout our careers. The senior faculty member brings to the table a combination of scientific contribution and experience in getting there that stands to have her at the peak of her game, and getting ever better even as she becomes more senior in her field. This is but one of the many reasons why academic positions are truly a unique privilege—presenting an opportunity for ongoing vivid engagement in interesting topics, and to keep doing so, at ever-higher levels, throughout one’s career.
This opportunity also suggests, as opportunities often do, that we have a tremendous responsibility—a responsibility to make sure that we continue to get better at what we do, and to ensure that we pass to the up-and-coming generation how they too can get better, and have even steeper trajectories than we have had. It is a responsibility that suggests the ongoing need for, yes, self-improvement by all of us, but also the need for ongoing self-reflection about how we can do better in our educational mission. I comment briefly here only on the latter, leaving the former for another day.
When I had the privilege of presenting to the school during the dean search process, I commented that the world is changing, the world’s health needs are changing, and, commensurately, our educational imperatives are changing. I have written about this in previous publications, informed by my engagement in my previous position in helping the Mailman School shift our core MPH training. This effort aimed to reflect this changing world and to make sure that we were getting better at making sure that our trainees can be as good as they can be. It is tremendously exciting that SPH launched a similar process more than a year ago, under the leadership of Associate Dean for Education Dr. Lisa Sullivan. It reflects to my mind a clear-eyed perspective on a changing landscape, an envisioning of potential opportunities to optimize the “training environment” to make sure our students receive the best possible training, to be as good as they can be. This seems well in line with the notions articulated in Surowiecki’s popular media article. We can well contribute to the future generation being better at what they do—indeed, better than we have been at the same task—but to do so we need to think carefully about the context, about what our students will need to be doing, and about how we may better train them to achieve ever more ambitious goals.
I am not blind to the challenges that are associated with curricular change. I have co-authored a paper on some of these challenges as we experienced them at Columbia; I will share that paper when it is available. Paraphrasing Brecht, change is always difficult, and sometimes resisted. I both understand that and respect that. And I also realize that in academic institutions, one of our contributions to the world is indeed our constancy, our caution to make sure we do not change on a whim, but rather consider carefully our responsibilities to make sure that when we do change, we do it for the right reasons, and do it well.
In the context of our educational program I am convinced that there are abundantly good reasons to consider how we may improve our education to better reflect changing global needs. And such change needs to be reflected in our full suite of educational programs, including our MPH certainly, but also, in time, our research master’s and doctoral training—all with an eye to making sure our training is as good as it can be. I have been impressed by the work that both the MPH Implementation Task Force and the entire school have done so far, and I look forward to seeing us bringing this to fruition in the coming months. We shall together then consider how we can extend a vision of even better improved educational programs to our other professional training, the DrPH, and our research training, the MS and PhD.
Coming back to Surowiecki’s article, were there no change in chess players’ training, today’s players would still be operating at the level they were operating in the 1950s, and today’s golfers would be spending a lot more time finishing 18 holes. And, perhaps more importantly, were we not willing to change, we would not have introduced hand washing in health care contexts and accepting high rates of iatrogenic infections and attendant mortality and morbidity. I will comment in a future Dean’s Note on the nature of the changes I see us aspiring to achieve in our curricular review. In this note I simply wanted to reflect on change that aims to improve us all, and how such change reflects both broader trends towards improvement in a broad range of human endeavors, as well as perhaps an inevitable response to the desire of the next generation to get better at being better, and our responsibility to help them get there.
I hope everyone has a terrific week. Until next week.
Warm regards,
Sandro
Sandro Galea, MD, DrPH
Dean and Professor, Boston University School of Public Health
@sandrogalea